Health Promotion and Public Health Addressing Wellbeing and Inequalities in a Case Study Context

Introduction:

The World Health Organisation defines health as the condition in which a person has physical, psychological, emotional and spiritual wellbeing [WHO, 2010]. Evidence suggests that health is not just the condition in which illness or diseases are absent but the condition in which an individual attains his or her holistic wellbeing. Effective health promotion is associated with promoting emotional, psychosocial, behavioural and physical wellbeing thereby improving the quality of living of people [PHE, 2019]. This study will discuss principles of health promotion and public health and then demonstrate the importance of the effectiveness of health promotion in promoting good health and wellbeing in relation to the given case study. Then the study will demonstrate the social determinants of health in relation to discuss the health inequalities in the case study. The study will explain issues or barriers that impact on the health and wellbeing of people. Finally, the study will demonstrate the risks associated with health and wellbeing that are identified in the case study and healthcare advice as well as clinical support that can be provided by nurses to protect the service users in the case study from health inequalities.

Explaining the concept of health and wellbeing and principles of health promotion, public health, prevention and protection:

Health and wellbeing:

Health and wellbeing have been defined by many authors in different ways. As mentioned by Burden et al. (2017), health can be defined as the complete absence of any disease or illness. On the contrary, the concept had been rejected by many modern pieces of evidence, which suggest that good health is not the condition in which the person does not have any physical illness but the condition in which the person will have complete wellbeing of both the mind and body (Cantor and Thorpe, 2018). The WHO (2010) defined health as the condition in which people will not just have the absence of the physical illness poor infirmity, but have physical, emotional, psychosocial and spiritual wellbeing [WHO, 2010].

NICE (2019), mentioned that there are six major principles that every person needs to implement into regular practices for attaining good health and wellbeing [NICE, 2018]. These core principles are eaten healthy, be active, avoid unhealthy habits, toxin and poisons, sleep enough, manage stress and cultivate a supportive and loving relationship. In Ealing, due to lack of income and low socioeconomic standard, many poor families cannot afford healthy foods, three times meals, healthy habits, proper housing and sufficient sleep, which impact adversely on their health and wellbeing. Poor people struggle to manage proper sleep at night due to the severe noise outside. As mentioned by Chang (2019), enough sleep is important for having good physical and mental health. Due to lack of space in houses, poor people in Ealing are unable to maintain proper hygiene and a fresh environment within the room which impacts adversely on their physical and psychosocial health. NICE (2018), for attaining good health and wellbeing people needs to be active all time, which improves the oxygen level insides the body by increasing the blood circulation to the heart [NICE, 2018]. In many poor families in Ealing, children cannot access the playground or park facilities for performing physical activities due to the distance and poor financial condition of the family. The lack of physical activity of the children enhances their risks towards obesity, overweight, and other chronic illness such as diabetes and CVD [cardio vascular disease)

NICE (2018) mentioned goof health and wellbeing is strongly associated with healthy habits of people such as no skipping of meals, washing hand before eating foods, avoid smoking and drinking and eat 5 portions a day [NICE, 2018] majority of poor men are addicted to the unhealthy habits such as severe drinking and smoking to reduce their mental stress, which poses adverse impacts on their lung and heart thereby enhancing his chances of coronary illness, pulmonary illness and cardiovascular disease (de la Vega et al. 2019). On the other hand, lack of nutritional food intake children in poor families, contribute to the reduction of their immunity power. As mentioned, people with lower immunity are more susceptible to infection and diseases than people with higher immunity power. PHE (2018) recommend the loving and supportive relationship with neighbours, relatives and the society empower people in relation to develop their emotional, psychological and spiritual strength. As mentioned by Dinu et al. (2018), emotional, physical and spiritual strength are associated with developing a healthy mind and body. In Ealing, several families are of black ethnic and South Asian origin have no relatives in the new locality in the UK. On the other hand, due to transfer from one area to the other, they are unable to make any supported as well as loving relation with their neighbour and society members. This is why these families do not get any physical, mental and emotional support from the neighbours or relatives or society members that contribute to developing depression, loneliness and frustration.

Principles of public health and health promotion

The WHO (2018), mentioned that health promotion is the process through which a person is empowered by providing him or her with the proper psychological, physical, emotional, social and economic support thereby improving a person's quality of living [WHO, 2018]. NHS (2018) mentioned the effective health promotion is associated with addressing health issues in people. NICE (2019), mentioned that care professionals must follow the guidelines and principles of health promotion to promote the holistic wellbeing of people [NICE, 2018]. One of the core principles of effective health promotion is addressing the social, environmental and individual factors that interfere with people’s health and wellbeing. In Ealing there are several factors such as poor living environment, lack of proper accommodation, poor socio-economic condition, lack of social support and poor physical health of people that interfere with their ability to attain good physical, emotional and social wellbeing (Donkin et al. 2018). Another principle of health promotion is to implement the holistic approach for promoting a healthy mind and body of people. NICE (2018) mention that, health promotion must have long term perspectives that will create public awareness regarding different health determinants. Health promotion must be multisectoral that will not only promote the physical and mental health of people but also improve people’s living condition, improve their decision making, lifestyle and coping ability and develop strong self-management skill in them (Doobay-Persaud et al. 2019).

Identifying social determinants of health and inequalities:

NHS (2018) mentioned that there are six major determinants of health such as financial stability, employment, housing, food, transportation and legal aids.

Employment and economy:

Economy and employment opportunities in a country strongly influence the ability of people to attain good mental and physical health (Dzhambov et al. 2018). As compared to England, Ealing has a stronger economic structure that poses positive impacts on the livelihood of people. There are many start-up companies in Ealing, along with full of retail shops and large shopping centres such as Mark & Spencer, Sainsbury and Tesco. Large clothing centres such as primary Carillion and H & M. are also located in Ealing [ONS, 2018]. As compared to England and other parts of London Ealing has several facilities and construction management companies that create high job opportunities for citizens. In this context, people in Ealing have good employment opportunities which will assist them to earn sufficient money to feed healthy foods to his family. In many cases, it is identified that the financial condition of the family is highly unstable due to the lack of a permanent job of people. The lack of economic stability poses adverse impacts on the eating habits, accommodation and nutritional intake of the family members thereby contributing to poor health and wellbeing. As mentioned by Friedman and Banegas (2018), the poor socio-economic condition is strongly associated with developing unhealthy habits in people that interfere with their good health and wellbeing. In poor families, it has been seen that people are addicted to unhealthy habits such as smoking, and drinking for coping with their stress of being unable to afford a good life, education and food for their family. In this context, Ealing can be the better option for these poor people to get a permanent job in the shopping malls or retail sectors which will assist them to develop the living standard of their family.

Housing and shelter:

NHS (2018) mentioned that a good housing environment with enough space and more rooms is important for people to have good physical and mental health [NHS, 2018]. Although Ealing is economically developed in England and other parts of London, there is a severe shortage of affordable housing (Garg et al. 2019). In Ealing, people with low as well as moderate incomes are unable to afford good housing facilities. A recent report shows that people belonging to lower- and middle-class families live in two- or one-bedroom flat which makes the home environment clumsy and unhygienic that impact adversely on the physical and mental health of habitats [ONS, 2018]. Ealing has social housing, privately rented flats and owner-occupied housing, as compared to England as well as other places in London, in Ealing the housing prices are more which can only be afforded by the high society people with high income. In Ealing, the average price of housing is £ 743889 (Gostin et al. 2019). Many people belonging to low socioeconomic class cannot afford high housing prices which forces their family members to live in the one-bedroom flat. On the other hand, people residing in the poor societies experiences unhygienic and clumsy environment that is not suitable for having a peaceful accommodation which interfere with the physical health.

Transport and connectivity:

Good transport facilities are straggly associated with attaining good health and wellbeing, as it assists people to go to the necessary places easily such as healthcare centres, hospital, parks, schools, clubs and playground (Hatef et al. 2019). Ealing has a more well-structured transport system including, 5 Elizabeth line station, 14 tube station, 2 overground stations and 700 bus stops as compared to England and other parts of London [ONS, 2018]. Moreover, in Ealing, there is 24 hours bus services facilities and many cab riding facilities. In this context, Ealing can be a good living option for poot people which will provide them with 24 hours of transportation facilities. On the other hand, as compared to England, in Ealing people will get several alternatives transport option that will assist them to choose the budget-friendly transport and reach the target places. In Ealing poor people can get the bus and train facilities easily to bring her children to the nearby children’s parks, playgrounds and schools. As argued by Hunter et al. (2018), the health and wellbeing of people is not only dependent on the availability of transportation facility but also on the financial ability of low and middle incomes people to afford these transport facilities.

Foods:

As mentioned by Jani (2020), for having food physical and emotional wellbeing, people need to eat healthy food. Proper nutrition is important for improving the immunes system and maintain a healthy balance among all the internal variables insides the body. Low incomes of poor families in Ealing interfere with their ability to afford healthy meals and three times for. Due to deprivation, people are unable to afford healthy vegetables, fruits and grains to the children. On the other hand, children use to eat low quality junk foods that are enriched with sugar and trans as well as saturated fats that enhances their health such as obesity, cardiovascular disease and diabetes. On the other hand, skipping meals and lack of healthy eating also enhance the risk of diabetes mellitus.

Legal aid:

Under the health and social care act (2012), people in Ealing have the rights to access free health and social support from the NHS professionals (Hunter et al. 2018). Health services executives (HSE) need to provide effective health information to them to develop strong self-management skill in them and their children. The community nurses will also adhere to the health and social care policies to provide free health care support to family irrespective of their financial ability, ethnicity, race and religion

Issues impacting on the health and wellbeing of individuals:

several public health issues impact adversely on the health and wellbeing of people. These issues are as follows:

Physical issues:

Physical issues incudes the illness that is caused due to unhealthy habits, drugs and environmental exposure such as smoking-related illness, alcohol-related disease, drug-related illness, TB, antimicrobial disease, poor dental health and air pollution-related illness (Kolaitis et al. 2017). In the case study, Karim has a high risk of smoking and alcohol-related illness as he is highly addicted to smoking and drinking. On the other hand, Zainab and her children are highly vulnerable to the risk of nutrition-related disease as they do not intake enough nutrition that is required to the body to maintain a strong immunes system. The excessive intake of sugary and junk foods leads to a high risk of dental diseases in Abdul and Ayesha. They are already diagnosed with a dental problem, which can deteriorate further by developing chronic gingival recession and root carries if they would not stop eating junk foods.

Mental issues:

There are several mental or psychological issues such as depression, anxiety, feeling of self-harm, suicide, dementia, loneliness and frustration (Marmot, 2017). From the case study, it is clear that Karim and his wife deal with different mental or psychological issues such as low self-esteem, lack of confidence, high depression, frustration, helplessness and feeling of sadness. PHE (2018) mental health issues are associated with developing unhealthy habits in people that interfere with the ability to attain good health and wellbeing. In the case study, it is apparent that Karim has developed unhealthy habits such as smoking and alcoholism which interfere with the systematic function of his lung and heart. On the other hand, the low quality of living condition, poor accommodation with lack of spaces in the room noisy environment and lack of social support develop severe mental stress and depression in Zainab that impacts adversely on her emotional and physical wellbeing.

Social issues:

People belonging to the lower socio-economic class have to deal with several social issues such as margination, social isolation, domestic violence, violent crime, social discrimination and bias Kolaitis et al. (2017), these social issues pose adverse impacts on the mental and physical health of people. In the case study, it is clear that Zainab and Karim suffer from a lack of social support which develops emotional, spiritual and psychological distress in them. From analysing the case study, it can also be stated that Karim and his entire family suffer from social isolation due to their inability to make a good relationship as they have to move from one place to another. Karim does not have any relatives in the UK which makes him and Zainab face loneliness or social isolation as they cannot share their feeling and emotion with neighbours and other society members.

Explaining health risk for individuals and health advice as well as support that can be given to people for promoting their positive health and wellbeing:

Health risk:

In the case study, Karim and his family members are vulnerable to different health risks. Karim is overweight and a regular smoker as well as a drinker which enhances his risk towards different chronic illness such as diabetes, cardiovascular disease, coronary arterial disease, pulmonary illness, COPD and lung infection (Moffatt et al. 2017). In addition to this, Karim’s increasing mental issues such as his stress and depression regarding his inability to give a good life to his family enhance his vulnerability to the risk of comorbidity. On the other hand, Zainab is highly vulnerable to diabetes as she was previously prescribed as having gestational diabetes, on the other hand, she could not perform proper physical activities and struggle to have proper sleep at night which enhances her risk towards overweight, obesity, poor immunes system and metabolic disorders. As mentioned by O'Gurek and Henke (2018), for attaining a healthy body and mind people must have systematic lifestyles with good foods and sufficient sleep. Karim’s children (Abdul and Ayesha) are highly vulnerable to overweight, poor dental health and heart disease as they use to intake severe junk food that is enriched with sugar and fats.

Healthcare advise and clinical support:

Community nurses must provide the proper health information to Karim and Zainab regarding what health is, what ae healthy habits, what are the determinants of health and how positive health and wellbeing can be gained (Palmer et al. 2019). NMC (2018), Nurses must develop self-management skill in serves users to assist them to manage their health and wellbeing by themselves. in this context, the community nurses will provide stress management training to both Karim and Zainab which will help them to cope up with the everyday stress. Moreover, the nurse will perform a monthly health check-up for all the family members thereby assisting them to know about the current physical and mental health condition. nurses will provide emotional, psychological and spiritual support to Karim and his family members thereby empowering them to cope up with the issues.

Conclusion:

From the above-mentioned discussion, it can be concluded that health is the condition in which people can have complete wellbeing of their body and mind. Health and wellbeing are associated with the feeling of happiness and self-esteem. Effective health promotion is associated with implementing a holistic approach to promote the physical, psychological, emotional and social wellbeing of people. Here are several determinants of health such as food, financial stability, housing, legal aid, transportation and loving and friendly relationships. Several health issues impact people’s ability to stay healthy. These issues are social, mental and physical. By taking effective health promotion initiatives and adhering to the legal framework of healthcare it is possible to promote good health and wellbeing of people.

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