Nottingham Health Dynamics

Introduction

Nottingham area in the UK exhibits interesting realities of life and health of the population living in the area. The demographic characteristics in the area present key health concerns that should be addressed and nursing intervention will be crucial.

Statistics show that in Nottingham, there is a general population growth and projects point to a further increased in the population. The population in the 2011 census recorded a 5% increase from the previous 2001 census (Nottinghamshire 2017). As of 2015, the population was estimated at 805,800 and projected to increase to 840,700 by 2021. Furthermore, compared to the national figure, the age structure in Nottingham is slightly older. In 2015, 20% of the population was composed of people aged 65 and above. This is higher than the UK national figure of 18% (Nottinghamshire 2017).

The older population is aided by carers especially among the wealthy communities living in the area. However, statistics indicate that by 2012, 41% of older people will be living alone. The statistics also point that the children and young people, who currently make up 20% of the population, will increase by 9% in 2021 (Nottinghamshire 2017). The dynamic nature of the population presents key health concerns. This essay examines the key health indicators and determinants of health as well as presents a case study of a health condition in the area by exploiting nursing interventions that can be relied upon to manage the condition.

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Indicators of health

Health and well-being are a subject of importance in the local area as well as nationally. The health profile of the people determines their productivity, wealth creation as well as national socio-economic and political growth. Nottingham area is affected by three main indicators of poor health and premature deaths and they are discussed in this section.

Socio-economic status

Studies have revealed the presence of inequalities in the economic levels of the people living in Nottingham areas with clearly visible areas of affluence and abject poverty. Socio-economic status classifies people according to wealth and the ability to meet the basic needs (Fitzpatrick et al. 2017).

People in the high socioeconomic status live in affluent areas that are characterized by developments in the roads, infrastructure as well as hospitals. Furthermore, they can afford medication expenses and are thus accorded quality medical treatment in case of illness. The wealthy people occasionally seek regular medical check-ups and observe the nutritional consumption of foods and are thus generally healthy. This is the exact opposite of the deprived areas (Chandler 2015). Throughout Nottingham, there are deprived areas that are characterized by unemployment, lower levels of qualifications or education, poor health choices and less healthy lifestyles. People in these areas live in poverty and thus cannot afford expensive medical services, as well as balanced diets and nutritious feeding since the income among the people, is so low.

Lifestyle factors

Lifestyle choices are made almost exclusively by individuals, though the environment equally plays a predisposing role. These choices affect the causes and consequences of major health complications (Fazel et al. 2008). The lifestyle choices vary between the affluent and the deprived areas in Nottingham as well as the severity of the consequent medical conditions.

In Nottingham, there are common lifestyle factors that impact the health profile of the area. Smoking contributes to inequalities in the death rates and life expectancy in Nottingham. Whereas the prevalence of smoking has reduced from 21.7% in 2011 to 15.7% in 2015, there are slight changes in the death rates occasioning from smoking-related complications (Nottinghamshire, 2017). The complications associated with smoking and affecting smoking people in Nottingham include cancer, respiratory diseases, and cardiovascular diseases.

Overweight or obesity is a lifestyle condition equally present among the population in Nottingham and is associated with cardiovascular complications. Statistics point out that 9% of children aged 4-5 years and 17% of those aged 10-11 years old are obesity. This translates to 80% of such children to become obese adults (Nottinghamshire 2017).

Life expectancy can be defined as the measure of the length of life estimated against the mortality rates. The estimates from Nottingham place life expectancy at birth at 79 years for males and 83 years for females. According to statistics, there has been a general increase in life expectancy both nationally and at Nottingham. However, there are inequalities between deprived and less deprived areas with poorer areas experiencing shorter life expectancy compared to the affluent areas (Kickbush et al. 2016).

Determinants of health

There are key determinants that influence the health experience of people in an area, Nottingham included. These determinants are generally occurrences or conditions that bring about the increased need for health services and shape the health of the population in an area.

Communicable diseases and infections

Occasionally, there are outbursts of infections and diseases that affect numerous people within the area. These are classified as communicable diseases and infections and vary in terms of the severity of the impact. These infections arise from particular human activities or natural occurrences that make people vulnerable to such infections and spreads easily from one person to the other unless mitigation measures are put in place (Fitzpatrick et al. 2017). Equally related are healthcare-associated infections that are caused by different infectious micro-organisms. These infections are associated with healthcare delivery be it in hospitals, long-term care facilities or households.

In Nottingham, statistics point that an estimated 9,000 people are living with hepatitis B and C which are largely communicable diseases. These infections, if not managed can lead to chronic illnesses like cirrhosis of the liver and liver cancer.

Air quality and impact on healthcare

Efforts have been made to improve the air quality in the UK and thus protect the citizenry against the harmful effects of air pollution. This includes the clean air Act of 1956. However, air pollution especially in urban centres in Nottingham is still manifest and can have multiple effects. The most deprived areas are the most affected following prolonged air pollution.

It is important to point out that the bulk of air pollution is caused by human activities. In urban areas of Nottingham, road traffic emissions are the leading causes of air pollution. Statistics point out that 5.7% of adult mortality results from long term exposure to air pollution (Nottinghamshire 2017). Long term air pollution results in respiratory and cardiovascular diseases and lung cancer.

Short term exposure to air pollution among people with existing medical conditions may trigger incidences like a heart attack. This is common to people with conditions like asthma, cardiovascular and respiratory diseases.

Homelessness and health

There is a relationship between housing, poor health, and wellbeing, and underscores the need for housing and bridging health inequality. In regards to health, it has been identified that safe and secure homes are essential to a good quality of life.

Poor health conditions can result from overcrowding and other conditions associated with poor housing conditions (Fazel et al. 2008). Furthermore, neighbourhoods with poor housing conditions are accustomed to other health hazards like poor sanitation, and indoor pollutants all of which may contribute to poor health in the area.

Homelessness is even worse since people who are homeless lack shelter, one of the key basic needs of human life. With homelessness, people in such conditions often find refuge in the open, tunnels, or temporary structures. This exposes them to extreme weather conditions and they can contract conditions like the cold. All these conditions can lead to physical illnesses such as eczema, hypothermia and heart disease.

Health and wellbeing also encompassed mental health, which shall be discussed later in this study. However, poor housing conditions and homelessness for that matter can lead to associated mental health complications such as stress and depression (Saxena &Hanna, 2015). This further impacts the health of the people.

Accidental injury

Accidents, especially those occasioning from road carnage bring associated health complications that affect the people in Nottingham. Road accidents result in deaths and injuries to motorists and pedestrians alike.

Besides the road accidents, other calamities and disasters can lead to accidents that can cause injuries and even deaths. The combination of these injuries occasioning from accidents also comes with other implications like loss of employment especially if the injuries cause disabilities or other injury-related terminal illnesses (Fitzpatrick et al. 2017).

Mental health and nursing interventions

Mental health an increasingly popular subject since health and wellbeing cannot be confined to physical aspects. There are increasing cases of illnesses that are not physical in nature and have serious implications. Nottingham area is no exception since mental health and wellbeing transcends national boundaries.

Mental health can be defined as a condition of individual wellbeing enabling them to realize their full potential, cope with normal stress and work productively. Therefore, mental health results in productivity while ill health is often linked to physical ill-health. People with serious mental ill-health have 3 times the risk of dying early.

In Nottingham, 1 in about 6 adults experience mental health problems. Mental illness can be classified into two categories based on the severity of the conditions. Thus, it can normal mental disorders such as anxiety and depression or serious mental illness such as schizophrenia, psychosis, and bipolar disorder.

There are different influences of mental illness presence and such conditions, present and manifest in Nottingham increase the chances of the occurrence of mental illnesses among people. Traumatic events such as calamities, disasters, and even accidents might result in post-traumatic stress disorder, one of the common mental illness conditions.

Personal problems and stressors like unemployment, housing problems, and debt are common especially in the deprived areas in Nottingham. People experience these socio-economic problems develop mental health disorders such as stress and anxiety (Lindseth et al. 2015). The escalation of the disorder may lead to more serious mental illnesses.

Risk factors for mental illness

There are serious risk factors that predispose individuals to mental illness. The presence of such factors presents a high likelihood of developing mental disorders or illness. There are risk factors common among children as well as adults.

Children whose parents have a mental health problem have a high probability of developing mental health (Saxena &Hanna, 2015). It is argued that parents with mental health conditions will often neglect their children and pressure them to equally develop mental health disorders. However, this doesn’t apply to all children living in such an environment; rather, it increases the likelihood of developing mental illness.

Children who have experienced personal abuse or domestic violence often develop mental health disorders and illnesses. Physical domestic abuse negatively impacts the psychological functioning and development of the children. The result of psychological impact is mental illness.

Teenage parenting is also another risk factor for development of mental disorders. Teenage parents often experience different mental problems and can result in mental disorders and illness occasioning from stress and depression (Barker & Buchanan-.Barker 2011)

Nottingham has a number of risk factors that can lead to mental illness among the population. The area has a higher rate of deprivation, ethnic diversity, unemployment, and youth offending compared to the national rate. Thus, mental illness is more prevalent in Nottingham compared to the national rate.

Statistics point out that based on the national prevalence over 5,000 boys and girls aged 5-16 years nationally experience mental illnesses. However, Nottingham statistics is nearly 3 times higher. Over 110,000 males and females aged 16 years and above experience a range of mental illnesses (Nottinghamshire 2017).

Nursing interventions

The role of the nurse is crucial in managing mental illnesses through the assessment, diagnosis, and evaluation stages. According to Saxena & Hanna (2015), the role of the nurse is supportive, restorative, educative and enhancing the wellbeing of the patients.

Mental illness management requires a comprehensive approach that aims at managing physical pain, as well as psychological and emotional issues that affect the patients (Chandler et al. 2015). It must be mentioned that some of the interventions may require the administration of Nottingham city to implement in order to guarantee complete recovery from mental health. Nonetheless, the role of the nurse is discussed herein.

Patient-centred healthcare has been fronted as an effective approach to managing lifelong and chronic conditions such as mental health disorders and illnesses. The nurse, being the professional, can foster a patient-centred intervention that tackles all the aspects of human life, be it physical, emotional and psychological (Lindseth et al. 2015). In this approach of intervention, the patient is treated as the master of their own recovery and the nurse acts as a catalyst to enhance the recovery of the patient. The nurse provides holistic care to the patients and addresses their needs depending on the patient’s manifestation and requirements. The nursing intervention in patient-centred healthcare is therefore classified into 3 main functions. The nurse assesses the needs of the patients, examine and understand the signs and symptoms of the illness or disorder, and anticipate changes to expect in the disease progression (Lindseth et al. 2015).

Interaction with mentally ill patients can occur both in the hospital setting and out of the hospital environment and using the patient-centred approach; the nurse can detect onset signs of mental illness and recommend the appropriate measures to manage the condition to the family members before the condition worsens (Saxena & Hanna, 2015).

The other intervention measure that can be crucial in managing mental illness is building the nurse-patient relationship (Cavanaugh, 2018). Since mental illness is largely psychological, the patients may have a difficult time discussing their private stressors unless they build friendship with the nurse and can comfortably confide in them. By building the nurse-patient relationships therefore, the nurse gains inroads into the psychological world of the patient and can easily understand the underlying factors for the mental illness. Furthermore, the friendly relationships will also make it easy for the patients to participate in the intervention (Chandler, 2015). For instance, with a warm relationship between the patient and the nurse, the nurse may understand the psychological condition of the patient and refer them for services like counselling.

Providing emotional support is another intervention measure by the nurse that can be utilized to aid in the recovery of the patients. Patients with mental illness often grapple with different emotional issues. Providing emotional support by the nurse, therefore, builds the patient’s confidence and self-esteem which can be helpful in recovering from mental health illness (Cavanaugh, 2018). The nurse also can help the patient feel loved and accepted in the community by providing emotional support. This can help patients whose cause of mental illness is largely feelings of rejection and loneliness.

Diagnosis and treatment of pain are often necessary for patients with mental illness. Occasionally, patients suffering from mental illness exhibit other physical pains and it may be necessary for the nurse to offer medication and treatment of such pains (Lindseth et al. 2015). For instance, headaches may be common to depressed patients and thus the nurse may be required, in the course of intervention to provide medication to the patient.

Conclusion

Nottingham city in the UK presents a dynamic area with a number of health inequality conditions and factors that raise the need for intervention. Social-economic factors, life expectancy, and lifestyle factors are key indicators of poor health in the area. Mental illness is one of the prevalent conditions in the area and thus, the nurse’s role for intervention of the condition is crucial in ensuring recovery and well-being.

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References:

  • Barker, P. J., & Buchanan-Barker, P. (2011). Mental health nursing and the politics of recovery: A global reflection. Archives of Psychiatric Nursing, 25 (5), 350–358.
  • Cavanaugh, S. (2018). Recovery-oriented practice. Journal of Mental Health and Addiction Nursing, 2 (1), 28‒30.
  • Chandler, G, E, Roberts, S, J & Chiodo, L (2015): resilience intervention for young adults with adverse childhood experiences. The journal of psychiatric nurses association 21 (6) 406-416
  • Fazel, S. et al (2008): The prevalence of mental disorders among the homeless in Western Countries: Systematic review and meta-regression analysis. PLoS medicine, 5 (12), pp. 1670-1681.
  • Fitzpatrick, S et al. (2017): The Homelessness Monitor: England 2017. London: Crisis. Available from: https://www.crisis.org.uk/media/236823/homelessness_monitor_england_2017.pdf
  • Kickbusch, Ilona & Allen, Luke & Franz, Christian. (2016): The commercial determinants of health. The Lancet Global Health. 4. e895-e896. 10.1016/S2214-109X(16)30217-0.
  • Lindseth G, Helland, B & Caspers, J (2015): the effects of dietary tryptophan on effective disorders. Archives of psychiatric nursing 29(3) 102-107
  • Nottinghamshire (2017): Nottinghamshire county joint strategic needs assessment summary. Nottinghamshire health and wellbeing board
  • Saxena, S., & Hanna, F. (2015). Dignity: A fundamental principle of mental health care. The Indian Journal of Medical Research, 142(4), 355.

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