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Identifying Target Groups, and Addressing Critical Health Needs

Introduction

In healthcare, needs assessment is important because it is a systematic method involved in reviewing the health issues faced by any population to determine the requirement of care among them. It is to lead effective resource allocation with priority to improve the health and reduce inequalities of care for the population. In this assignment, initially the population profile of people in Sandwell is to be explored and factors influencing their health are to be discussed. Thereafter, the target population in the area selected for the need assessment will be justified. The three health related needs of the target population in Sandwell will be discussed. Later, the most important need in the target population of Sandwell will be investigated and action executed locally to manage the need will be explained.

Step 1

A summary of the geographical profile of Sandwell is to be discussed because it is the 20th most deprived area in the UK which reports the presence of multiple health and social issues among the population that is compromising their health and well-being (Sandwell Trends, 2022). In this context, the population characteristics will be determined and factors responsible for influencing adverse health people will be discussed. Further, the current health status of the population will also be identified.

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Population Characteristics

Sandwell is one of the metropolitan boroughs of the West Midlands in England. According to mid-2020s population records presented by ONS, the population of Sandwell was 329,042 individuals which increased to 341,900 in 2021 which is 11% increase from 2011 (308,100 people) (Sandwell trends, 2022). This is an increased rate of population than in England where the population grew by 6.6% since the last decade (Sandwell trends, 2022). This informs that the population in Sandwell is rising at a faster rate compared to England making it one of the busiest localities in the country. The population in Sandwell who are 65 years and above increased by 6.1%, the population of 15-64 years of age increased by 11% and the population of children under 15 years increased by 14.5% in the last 10 years (Sandwell trends, 2022). This indicates that the number of children increased the most followed by adults and elderly adults in Sandwell’s population. In Sandwell, 168,200 individuals are males and 173,600 individuals are female with the population density referring to 3996 people living in per square kilometre which was 3600 people per square kilometre a decade ago (Sandwell trends, 2022). This indicates that females are more in number in Sandwell compared to males and the population per square kilometre has progressively increased in the area. The ethnicity figures of the population indicate that 69.9% are white individual and 19.2% are Asian, 5.9% are Black African, 3.3.% belongs from mixed race and 1.3% belong from other races (Sandwell trends, 2022). This informs the Asian and the Black population are the key minority individuals in Sandwell in comparison to White individuals.

Factors influencing health of people in Sandwell

The health profile of the people of Sandwell informs that deprivation is one of the key factors which influenced poor health and illness among people in the locality. This is because deprivation in people caused them unable to arrange adequate care resources to maintain good health and resolve health problems (Public Health England, 2022). The deprivation is present in Sandwell which is evident as it is indicated as the 12th most deprived locality in England (Public Health England, 2022). Brown and Long (2018) inform that deprivation causes poor health education and results in hindered reach of care services to the people. Thus, the deprivation in Sandwell is considered to be one of the major factors resulting in raised illness among the people. Bodin et al. (2020) argue that poor employment contributes to a hindered health conditions in people. This is because unemployment creates limited financial resource for the families and people in a society. It makes the individuals unable to avail healthy food and care due to poor monetary conditions leading them to suffer poor health consequences (Linden and Rotter, 2019). In Sandwell, the unemployment rate is 5.6% with the remaining 22.5% of people in the area remaining unemployed due to sickness (Sandwell Trends, 2022). This indicates that most of the people in the area are employed but the limited unemployment rate is also responsible in causing some form of health disruption in individuals.

The breastfeeding at birth is important factor in promoting the health and well-being of individuals. This is because enhnaced nutrients in breast milk help in developing the immunity and growth of the children in a steady manner to assist them having strong health and well-being (Tahsina et al., 2021). However, the breastfeeding rate at birth in Sandwell is only 39% indicates nearly more than half of babies are not properly involved in the process (NHS, 2022). This may have led increased prevalence of complicated health issues in the area among the individuals and children. Another factor which is adversely affecting the health of the people in Sandwell is low birth weight. It is mentioned that 3.77% of the babies in Sandwell are with low birth weight (NHS, 2022). The low birth weight indicates poor health of the babies at the initial stage which adversely affect their growth and development (Nakano, 2020). The criminal activities in Sandwell is seen to cause increased violence towards people. It has led to cause post-traumatic stress disorder in individuals (Varbes, 2022).

Health Status of the Population

Health status is referred to the relative level of wellness and illness in individuals by considering the presence of functional impairment, mental condition and biological or physiological symptoms (Talevi et al., 2020). The life expectancy of male in Sandwell at birth is 78.9 years and female are 82.7 whereas it is 79.6 and 83.2 respectively in England (Sandwell Trends, 2022). This indicates that the life expectancy of people at birth in Sandwell is below the national average informing increased health issues may be present in the area which is affecting the condition. The suicide rate in Sandwell is 9.67% which is similar to England the mortality rate from Cancer is 138.3 in Sandwell whereas it is 132.3 in England. Moreover, the mortality rate from cardiovascular disease in Sandwell is 78.7 whereas it is 71.4 in England (Sandwell Trends, 2022). This indicates that mortality for varied diseases are comparatively high in Sandwell compared to England making the locality to have poor health condition compared to the nation.

The lifestyle choices of people of Sandwell indicate that increased number of individuals are involved in substance abuse such as alcohol drinking, smoking, drug consumption and others. Moreover, they are inclined to get increasingly affected by diabetes, cancer, heart diseases and others (Sandwell Trends, 2022). In Sandwell, 70.8% of adults are mentioned to be obese or overweight (Sandwell Trends, 2022). This indicates that a major part of the population is involved in unhealthy activities which has led them to develop increased body weight. Moreover, 9.9% of patients aged 17 years and above are suffering from diabetes (Sandwell Trends, 2022). According to ONS Statistics, 2,3 deaths per 100,00 population are reported in Sandwell compared to 5.1 deaths per 100,000 population in England (Sandwell Trends, 2022). Moreover, 21.9% of people in Sandwell are suffering from mental illness among which most are 16 years and over (Sandwell Trends, 2022). This indicates that there is high prevalence of obesity, diabetes and mental illness in Sandwell.

Step 2

Target Population

The chosen target population is adults of 19-64 years of age living in Sandwell.

Justification of the Target Population

The adult population is focussed in the current study because of the driver for the improvement of the health and protection of the adults in society being set in the law of Care Act 2014 (legislation.gov.uk, 2014). The Care Act 2014 identifies the way adult social care working in England are to execute duties and provide services in meeting the care needs of the adults and avoid any serious care or delay in meeting their needs (legislation.gov.uk, 2014). The Care Act 2014 also mentions the way effective focus on safeguarding and protecting of adults from any nature of abuse is to be made to ensure their healthy living (legislation.gov.uk, 2014). Sulich and Rutkowska (2020) assert that staying healthy is important for adults to help them have effective potential in fighting against the risk of health complications from illness faced by them due to genetics and family history or interaction with the external environment as they age.

The adults between the age of 19-64 years are the key population in a society that works in maintaining economic growth and progression of the country to fight against various issues. They are responsible in creating social relationships and maintaining the cultural customs within the societies to pass them on to new generations (Stoica et al., 2020). Thus, it makes the discussion regarding the adult life stage an important stage for the promotion of health as they are the key support of economic and social improvement in the country (Stoica et al., 2020). The life course approach theory mentions valuing the health and well-being of current as well as future generation to maintain good functional society (Obi et al., 2018). As per the theory, without the adults, the advanced technological, education, political, peace and other motives of the country would not be advanced in progressing their place in the world. Therefore, adults are to be focussed in health promotion so that a good functional society can be established which support the present as well as the future progression of the country in the world (Obi et al., 2018).

According to Early intervention theory, effective early support for children and young adults who are at risk of poor outcomes is to be made to tackle the problems at the early stage without making to develop worsen conditions (Akhbari Ziegler et al., 2019). As per the theory, the discussion regarding health promotion is to be made for adults between 19-64 years of age as it is the age when most of the chronic and acute health issues develop and compromises the life expectancy of the individuals along with hinder their ability to develop healthy ageing (Atallah et al., 2018). Thus, the discussion of health promotion activities would lead people of the age understand the way to lead their lives and avoid taking up unhealthy behaviours at the early stages of disease to maintain good and lengthy life.

There are wide number of national policies and plans being made in supporting the discussion of health for the target adult population. Among them, one is NHS Long Term Plan 2019 which is established in boosting long-term care among adults (NHS, 2019). It focuses on the way out-of-hospital care is to be divided between the primary and community health services for adults so that the individuals get effective support to age well. It is also developed to identify actions to be made in preventing health issues and inequalities for adults to create stronger health support for the people responsible in building the economic and social condition of the country (NHS, 2019). Moreover, the PHE Strategy 2020-25 is developed by the UK government with the aim of extending collaborative approaches in ten years in delivering effective care services to create greater changes in the healthcare system which supports enhanced health and well-being of the public mainly the adults (gov.uk, 2020). The strategy plans to work on smoke-free society, clean air, healthier diet promotion, response to emergency situations, care surveillance and others in adults as well as others in public to create overall health improvement of the UK population (gov.uk, 2020).

In Sandwell, one of the local policies supporting the choice of the target population which is adults of 19-64 years of age is Health Sandwell which is Public Health Brand that shows intention to engage with the adult residents in the area for various services and healthcare activities in enhancing their health and well-being (healthysandwell.co.uk, 2020). The Healthwatch Sandwell is the local organisation who have developed Enter and View services to apply care for children as well as adults in improving their health and well-being.

Thus, the discussion mentioned that chosen population of adults in the Sandwell is important to be focused on for health promotion as they are the key individuals suffering from chronic diseases with age required to be safeguarded as they work for the present and future progress of the country.

Step 3

In Sandwell, varied health-related needs are present in the population among which health-related need regarding depression is one of the key issues required to be supported in people of 19-64 years in the locality. This is because depression is most prevalent health condition among mental health issues being faced by the adults of Sandwell which adversely affects their health (Sandwell Trends, 2017). It is supported by the statistical report present by NHS Digital where it mentions 7.8% of the adults above the age of 18 years in Sandwell are suffering from depression whereas it is only 9.9% in England (activeblackcountry, 2016). Thus, it indicates that adults in Sandwell are vulnerable and adversely affected by depression but to some extent lower compared to the people in England. The estimated cost in managing mental ill health of the adults in Sandwell is £958 million in 2014-15 which is mentioned to be increasing exponentially each year due to increased people being affected by mental illnesses like depression and others (Sandwell Trends, 2017). This indicates that depression in adults in Sandwell is causing the local NHS trust to bear increased costs and effective intervention in meeting the mental health needs of the individuals is to be promoted to avoid adversity of the condition and increased need of expenditure for its management in future.

The increased depression among the population of Sandwell is leading them to face poor income, lack of concentration in leading enhnaced life, expression of social isolation, antisocial behaviour and others (Lei et al., 2020). This is because of the inability of depressed adults to effectively manage their cognitive condition to behave appropriately in a society. Lee et al. (2019) argue that depression leads individuals unable to concentrate on education and effectively perform everyday chores. This is because they feel unhappy to lead life and execute own responsibilities. The increased depression among the adults in Sandwell has impacted them to develop self-harm and suicide. It is evident as 176 hospital admission from self-harm was reported in Sandwell for adults with depression (PHE, 2019). Mokona et al. (2020) argue that poor employment or unemployment leads adults to be depressed. This is because they are unable to have enhnaced financial stability in leading life which makes them worry regarding their family and future. In Sandwell, the employment rate is 65.8% whereas it is 75.3% in England (Fingertips PHE, 2022). This indicates that increased number of adults in Sandwell are unemployed and concerned number of adults both locally and nationally lack effective employment which may have driven them to be depressed and develop the need of access of effective mental healthcare services.

Apart from Depression, the other key need raised in adults of 19-64 years of age in Sandwell is smoking prevention because increased adult individuals in Sandwell is found to be highly involved in smoking (Fingertips PHE, 2022). It is evident from the NHS report which mentions that 12.9% of the people in Sandwell are involved in smoking which is near to the percentage of smokers in England (13% population involved in smoking) (Fingertips PHE, 2022). The inequalities in smoking prevalence in Sandwell exist based on the social class and employment. It is reported that 11.6% of people in managerial and professional position are involved in smoking in Sandwell. However, 29.2% of the adults involved in routine and manual work in Sandwell are involved in smoking whereas 17.7% of the adults who are unemployed in Sandwell are actively smokers (Sandwell Trends, 2017a). Moreover, it is mentioned that people involved in routine and manual work in England are 2.5 times more likely to smoke compared to people involved in managerial occupations (cancerresearchuk, 2022). This indicates that the lower class and involvement in routine work along with unemployment are local and national drivers for raising need of smoking in adults in Sandwell. Sonnex et al. (2020) assert that smoking causes pleasant feeling and distracts people from adverse experiences. The people involved in routine work experience increased stress and to overcome the adverse experience they are highly involved in smoking.

The national driver for increased smoking in individuals is reported to be poverty and unemployment. It is evident as 1 in 3 household in England who are living under poverty and facing unemployment are involved in smoking (JRF, 2022). The likelihood of smoking is also found to be 4 times higher in deprived localities in England such as the rate of smoking among adults in Hasting is 25.7% which is a greater deprived area compared to Sandwell (ONS, 2022). This indicates that social situation and deprivation nationally and locally influences people to involve in smoking. Stolz et al. (2022) inform that smoking by adults affects them to develop an increased risk of adverse respiratory conditions like COPD, lung cancer, breathing issues and others. This is because harmful chemicals present in the tobacco smokes irritates the alveoli and inner lining of the respiratory tract leading to cause hindrance in breathing. In Sandwell, the presence of bronchiectasis, asthma and COPD are mentioned to be common causes of admission and readmission in hospitals (RCP London, 2022). DiGiacomo et al. (2019) argue that smoking causes increased risk of cardiovascular disease. This is because chemicals present in cigarettes causes the thickening of the blood in the arteries and contributed to the development of arteriosclerosis which leads to hindered effective blood circulation to and from the heart. In Sandwell and England, physicians have actively involved smoking as one of the key factors for rise of cardiovascular diseases (Sandwell trends, 2022; PHE, 2022). Thus, smoking is found to be nationally and locally responsible in hindering the heart health of the adults.

In Sandwell, the other health-related need raised among the adults of 19-64 years is obesity. It is mentioned that 1 in 3 adults over 18 years of age in Sandwell are either overweight or obese which is nearly 70% of the entire adult population (Fingertips PHE, 2022). According to the Active Lives Survey, 60% of the adults in managerial position at work, 63% of adults at an intermediate position, 63% of adults in routine and manual work and 65% of adults who are no longer employed or unemployed are found to be obese or overweight in Sandwell (researchbriefings, 2022). This indicates that unemployment is one of the major local drivers of obesity or overweight in adults living at Sandwell followed by increased inactive position at work such as managers. Kristi et al. (2020) argue that poor physical activity by individuals leads them to be at increased risk of being overweight or obese. This is because the sedentary lifestyle leads individuals to require minimum energy that causes the increased fat from the food to be stored in the body and contribute to increased weight instead of being depleted in supporting formation energy.

According to current statistics in 2021, 65.7% of adults in Sandwell and 65.9% of adults in England are actively involved in performing physical activity (sandwelltrends.info, 2022). However, they are not regularly involved in performing physical exercise which has contributed to increased need of obesity management in Sandwell as well as in England (PHE, 2022). Thus, poor physical activity is seen to act as national and local driver towards development of obesity and overweight in adults. The presence of obesity in adults contributes to the development of varied health issues such as diabetes, breathing problem, heart diseases and others. This is because increased fat deposition in the body in obese patients rises issues of insulin resistance along with high blood pressure which aversely affect the health condition in patients (Stefan et al., 2021).

Step 4

The most important need to be managed in Sandwell for enhanced health and well-being of adults aged 19-64 years is depression. This is because it is contributing to the adverse physical and mental health of the patients compared to the other two healthcare needs such as smoking cessation and obesity management (Sandwell Trends, 2022). It is supported by Weston et al. (2019) who mentions that depression in adults at work leads them to smoke and develop poor physical activity. This adversely affects the health of the individual along with lowers productivity at work. In Sandwell, the Sandwell Healthy Minds is developed which provides brief psychological therapies for adults experiencing common mental issues such as depression, stress, anxiety and others. It provides opportunity of self-referral to adults above the age of 16 years and extend care to adults who are above 16 years of age or registered with a general practitioner in Sandwell (Sandwell, 2022a). McPherson et al. (2018) argue that lack of effective psychotherapy in resolving depression leads individuals to develop the adverse emotional and mental state. This is because the depressed adults are unable to control negative perceptions and develop adverse emotions. Thus, the availability of psychotherapy as health promotion opportunity in Sandwell for depressed patients is helpful in providing effective care and support to depressed adults to understand the way they are to control their negative emotions and live life with positive thinking.

The Sandwell Mental Health Liaison Services is another mental health support available under the supervision of Black County Healthcare for adults above 16 years of age who are experiencing emotional distress that is affecting them to unable to keep themselves safe (blackcountryhealthcare, 2022). The services allow a team to execute assessment of the needs of the patients and develop person-centred discussions to frame effective management plan in overcoming the mental difficulties faced by the individual (blackcountryhealthcare, 2022). The service is effective initiative in controlling major depression needs in people of Sandwell who are unable to control their emotion due to distress and intends to self-harm out of depression. In Sandwell, the Thrive at Work is one of the commitment programs present in helping workplaces in the locality to understand the way to nurture mental and physical well-being of employees (WMCA, 2022). Carrino et al. (2020) argue that poor workplace condition with lack of effective mental health support leads employees to develop hindered mental and emotional health. This is because the employees are unable to understand the way frustration and emotional turmoil develop due to the workplace environment are to be controlled and way to seek support in enhancing their mental health. Thus, Thrive at Work is an effective approach in creating a mentally friendly work environment in Sandwell for all so that all the individuals working in any organisation in the are have better mental health conditions. In Sandwell, the Mental Health and Well-being policy is present which focuses on assessing the mental health needs of adults suffering from any mental illness and develop as well as provide interventions to help the individuals overcome the mental health issues (Sandwell, 2022). This promotes the mental health of the people in the locality as it assists in resolving the causes leading to their depressed state with effective services based in personal need assessment.

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Conclusion

The above discussion informs that population in Sandwell is rising at an increased rate than England and common health issues faced by them are diabetes, substance abuse, mental illness and others. The target population selected for the study is adults of 19-64 years of age living in Sandwell because they are main age group with most risk of developing each of the health issues prevalent in the community. The three key needs identified in Sandwell are depression management, smoking cessation and obesity management in the target population. Among the needs, the depression management is the major need selected to be discussed because it is leading health issues which is contributing to adverse mental and physical illness in adults. few of the local services available in meeting the need are Sandwell Healthy Minds, Thrive at Work, Sandwell Mental Health Liaison Services and Sandwell Mental Health and Well-being policy.

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