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The aim of this essay is to critically discuss how social determinants of health impact on local health inequalities and predisposition to disease. This assignment seeks to discuss the public health issue of alcohol consumption and misuse and the multi factorialimpacts it has on men in the geographical area of the south west of England. The findings in this essay indicate the challenges in contemporary public health and explore the differences in global, national and local data. An important factor to discuss is how the role of the nurse can encourage and promote good healthy lifestyle choices and the different health models that could help tackle the public health issue of alcohol misuse. Alcohol misuse can create so many problems within public health, so it’s also important for nurses to work in partnership with other professionals to tackle public health challenges.
As indicated previously, the promotion and upkeep of public health are important to the health of the population and to society as a whole. It’s about helping members of the public stay healthy by protecting and educating them about the potential threats and risks that could affect their health and wellbeing. The government’s aim is to encourage the public to make healthier lifestyle choices regardless of their personal circumstances to reduce the risks of further complications of illness or disease.
There is considerable evidence that alcohol misuse is an important problem to address. According to the WorldHealth Organisation (WHO, 2017), it is well known that the use of alcohol is a fundamental factor in more than 200 diseases and injuries. However, apart from the physical effects, alcohol also brings significant social and economic loss. As a consequence, it’s important that the findings are studied in order to better understand the causes and reasons for alcohol misuse and to identify the best ways to address them. This is done through epidemiology, i.e. studying the incidence, prevalence, and rate. The British MedicalJournal (2017) explains that epidemiology is the study of how often diseases occur in different groups of people and why. This information is then used to plan and evaluate strategies to prevent illness, such as health needs assessments in local populations. The public sector bodies that have responsibility for health and care systems use the epidemiology to shape health needs assessments based on the place as outlined in the Public Health Report2016-17 (Devon County Council, 2017). Also, according to Evans et al (2014), the focus of epidemiology is the study of the severity, range, frequency, and duration of diseases. Therefore, incidence and prevalence play an important part in pinpointing new episodes of illness in a certain area over a specified period of time.
The epidemiology findings give public services data that is collected globally, nationally and locally. According to Public Health England (2017), there were 767 deaths in 2016-2017 related to alcohol misuse. The average age of these deaths was 50 with 63% being male. This data has been recovered from over 900 sites in England, varying from a community-based specialist, drug and alcohol services, GP surgeries, hospitals, rehabilitation centers and inpatient centers. According to the Office of NationalStatistics (2017), the most common underlying causes for these alcohol-related deaths were; mental and behavioral disorders due to the use of alcohol,fibrosis, and cirrhosis of the liver, accidental poisoning by exposure to alcohol, and the most common cause of death was an alcoholic liver disease.
The World Health Organisation (WHO,2014) launched a report on alcohol and health in 2014. This showed that 3.3million deaths worldwide in 2012 were all related to the harmful use of alcohol. It also showed that globally, Europe is the region with the highest consumption of alcohol. Data demonstrated that the greater the economic wealth of a country meant the more alcohol was consumed. It also showed that the highest prevalence of heavy episodic drinking among drinkers can be found in those countries with higher economic wealth. The United Kingdom is one of those countries highlighted to be at more risk of alcohol-related issues due to its economic wealth.
My chosen issue is a significant public health concern locally. According to the Devon County Council, there were around 17,500 admissions to hospital due to alcohol-related conditions inDevon in 2013-2014 which cost the NHS an estimated ?30 million. The North Devon and Torridge district areas have the highest alcohol-related admissions inDevon. These admissions varied from acute, mental and chronic conditions. Chronic conditions make up the largest group of alcohol-related admissions (74.6%), mental health is the next biggest group (18.6%) and acute conditions being the smallest group (6.8%) (Devonhealthandwellbeing.org.uk). By looking at local data it is proven that the overall highest alcohol-related admission in Devonare Barnstaple town center (North Devon) and Bideford East (Torridge) as shown in appendix 1.This essay is based on alcohol misuse in the south west of England as it appears from the data available to be a significant health issue in the local area.
Social determinants of health are factors which can change and influence health and the impacts it has on society, an individual and those providing healthcare services. Using the Barton and Grant health map (2006)it helps to show the relationship between health and the social, physical and economic environment and impacts (Naidoo and Wills, 2006). These social determinants help to demonstrate health inequalities, particularly those that contribute to the health of people who have a lower socioeconomic status and, as a result, experience worse health outcomes to those higher on the socioeconomic status spectrum. The Inverse Care Law (Hart, 1971) recognized that those who are most likely to benefit from health care are the least likely to be able to access it (Devon County Council, 2017).
The social determinants leading to inequalities are likely to be related to location (place) and the local economy(Devon County Council, 2017). It has been demonstrated that the impact of socioeconomic deprivation on health is significant particularly when the condition is associated with poverty and disadvantage such as alcohol-related disease.The south-west has a lot of very rural areas so getting access to health services can be challenging, especially for frail and vulnerable people with reduced mobility, i.e. the elderly. Rural areas have an aging population so getting access to health care can create a problem (Ageuk.org.uk, 2018). However, according to the Devon Public Health Report (2017), difficulties in accessing healthcare only account for around 10% of the reason for premature deaths, of which some will be alcohol-related.
In contrast to a more urban area like London, where access to health care, employment, housing, and public transport is easier, in the south-west, these are more challenging. However, no matter where you are in the nation certain risk conditions can affect health, whether its poverty, social marginalisation and discrimination, poor housing, educational achievement, polluted environment, low paid and stressful and dangerous work and all these do affect the numbers in premature deaths and shorter life expectancy (Naidoo and Wills,2006). Socio-economic status and social class are directly involved in health status.
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