Promoting good health health&social AS A01 Essay

Unit F912:
Promoting Good Health
Health & Social Care AS

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Promoting good health

This unit explores what is good health, the models, the range of lifestyle choices and societal factors which influence health and well-being - Promoting good health health&social AS A01 Essay introduction. Health and well-being are not only affected by an individual’s lifestyle choices (e.g. smoking, eating unhealthy ‘fatty food), but also by societal and environmental issues (e.g. living near a motorway – high pollution levels) Government policies and legislation have an imperative part to play in the promotion of good health, as the introduction on screening programmes (e.g. cervical smear test, antenatal screening etc.); which prevent ill health, has been an incredible and useful tool. Health promoters also have a significant role to play in helping individual’s using services to make the right decision about their health. As their choice of presentation approach can make or damage a health promotion campaign. Further, health promoters need to take into account the presentation methods, and to ensure that they have been chosen well to confirm that the message is successfully put over to the individual to whom it is directed. What is ‘health’?

The Worlds Health Organisation (WHO) defines health as a state of complete
physical, mental and social well-being and not merely the absence of disease or infirmity1. However, others may simply define health as the absence of illness, eating balanced diets, or exercising regularly. Consequently, because there are different views on ‘health’, its definition is referred to as ‘biomedical’, ‘positive’, and the social ‘holistic’ approaches. The ‘negative’ view of health

A very common way of defining health is the ‘negative’ concept of health, whereby ‘health’ is defined in terms of absence of illness. Thus, meaning that a person can be considered ‘healthy’ when they are not ‘ill’. This is a negative concept of health, both because it has a limited definition, as it focuses on the physical health status, and pays little attention to behavioral health and ignores social health all together2. More importantly, this concept of health is limited, as it doesn’t identify what health actually is. The Biomedical approach

One mutual way of defining health is the ‘negative’ approach, as ‘health’ is defined in the absence of illness. This approach suggests that an individual can be considered ‘healthy’ when they aren’t ‘ill’ or have any symptoms signifying they have a disease. Members of the medical profession tend to work on the basis that health constitutes the freedom from disease, pain, or defect, thus making the normal human condition “healthy”3. Hence, when a patient tells a biomedical practitioner (doctor) that they feel ‘unwell’, the doctor will carry out observations, examinations and tests to attempt to identify a biomedical abnormality that may be the cause of the patient’s ill health. A biomedical consultant who can’t identify any irregularities, are to believe that the individual being examined is ‘healthy’ as there are no physical signs of illness. Key features of the biomedical model of health are:

Disease is caused by bacteria, virus or genetic factor. Looks for biological process rather than social or emotional process Person is a type of machine. Other aspects of live doesn’t count e.g. living under strain of unemployment wouldn’t be a contributory factor to ill health under this model Deals with illness and ill health instead of promoting good health The ‘Positive’
definition of health

Health-promotion activity aims to promote health improvement by changing behaviour, whereby, health promotions generally adopt a positive approach to ‘health’. Campaigns that encourage people to stop smoking, eat fewer fatty foods and do more exercise are all part of the health improvement approach. These examples are based on the belief that ‘health’ is a positive state that can be acquired through individuals changing their behaviour and living in a ‘healthy’ way. Whereby all the individuals needs and health’s are taken into consideration. The ‘positive’ approach is in stark contrast to that of the biomedical approach, as it focuses on the presence of specific qualities or capabilities, such as: Being physically fit

Feeling happy and optimistic about life (mental stability)) Pulse rate and blood pressure in the ‘average’ range All these qualities incline to associate having ‘positive’ health. This approach clearly defines that being ‘healthy’ evidently involves more than just not being unwell, as it contains certain expectations, such as having a Body Mass Index (BMI) that is ‘healthy.’ A health specialist who uses this approach, may carry out procedures such as: Physical fitness tests

Discuss patients diet and exercise habits
Carry out a BMI test
All the above procedures are carried out to check whether an individual has the physical characteristics and lifestyle that is typically associated with being ‘healthy’. The WHO later offered a revised concept of health as

“The extent to which an individual or group is able, on the one hand, to realise aspirations and satisfy needs, and on the other hand, to change or cope with the environment.4” Health is now seen as a positive concept, as it focuses on personal and physical capacities together with social resources, adaptability and responsibility.

A ‘Holistic’(social) concept of health
WHO defined health as “The extent to which an individual or group is able, on the one hand, to realise aspirations and satisfy needs, and on the other hand, to change or cope with the environment.5”

The holistic approach is a distinction from the biomedical approach to health, as medical doctors tend to treat the body and ignore the mind. Whereas, the holistic health considers the ‘whole’ person (body, mind and spirit) and what affects one affects the other, as they are all intertwined. All these factors are a significant part when thinking about health. A holistic concept of health considers the whole person rather than just the separate aspects of health. The model recognises the important influence of factors such as: Emotional

Physical
Spiritual
Intellectual
social

The physical aspects of health (BMI, heart rate) can be measured objectively. However the wellbeing share of this approach recognises that ‘health’ also involves making subjective judgments about how the individual feels. Health consultants who use this approach, may carry out procedures such as: environmental health

acupressure
nutritional counseling
meditation
vitamin supplementation,
exercise
A holistic approach encourages the individual to engage in self-care and educate themselves about their health. It urges individuals to be an active participant in their treatment and health care, rather than giving all the power to a health care provider6. Consequently, the holistic approach to health contains more extensive set of characteristics to define an individual as ‘healthy’. The social model also recognises that there could be several factors which could contribute to a person’s state of health. Health and well – being are affected not only by an individual’s lifestyle choices, but also by environmental issues. Health and well – being can be affected by: Personal responsibility for health

Health as an absence of illness
Illness – wellness continuum
Concepts of ill health
Government policies on health In the 19th century, there were rapid growths of cities with individual that had poor physical conditions, and as a result major outbreaks of infectious diseases spread such as cholera, and typhus. Hence force, the government recognised that in order to improve public health, there would have to me major reforms. Some of these were the state provision of health and social welfare services, which were brought by the following acts of parliament, examples of these are: 1848 – Public Health Act

1906 – The Education Act (provision of meals)
1907 – The Old Age Pension Act
1911 – The National Insurance Act
1920 – The Unemployment Insurance Act
Comparisons between the holistic and biomedical models of health and well – being VS
Whereas

Whereas
Whereas
Whereas

Why do individuals often fail to conform to health education advice? Some individuals choose not to follow health education advice because of factors, such as: Addiction – it may be too difficult to give up

Fear – the individual may be afraid more of the change and what that may bring, rather than of the issue itself Peer pressure – fitting in with a ‘click’ and making friends is an influential reason to continue (e.g. smoking, drinking etc.) especially for young people Denial – individuals may choose to believe that ill health will never happen to them e.g. “My Granddad smoked 40 cigarettes a day, and he has no health problems, and lived until he was 90. Because my granddad smoked a lot and nothing happened to him, noting will happen to me.” I don’t know how I can relate these to the models to explain why individuals fail to conform to health education needs? Concepts of ill health

Terms signifying ill health are generally interchangeable, but in terms of health they have more specific meanings. An exemplar of this is that illness tends to be a word we use ourselves, to describe a situation that is occurring/had occurred if we feel less than well; either physically or mentally. The different views or concepts of ill health are:

Ill health as a subjective feeling of illness
Ill health as a disease (a set of symptoms)
Ill health as a disorder’ (a malfunction of a body tissue, organ or system.) There is a simple, but stark contrast difference between illness and disease. Illness is something what an individual feels e.g. a sense of ‘unwell-ness.’ Whereas, disease refers to any condition that impairs normal function, and is associated with dysfunction of normal homeostasis.7 Further, it can be diagnosed and named, it has certain signs and symptoms, and even a possibility of treatments and an outcome. Ill – health as a subjective feeling of illness

Illness is a subjective feeling (an individual’s personal opinion) that a person has when they feel unwell. Sometimes there are no symptoms of to see or describe, yet the person does not feel well. Case Study

This case study of Claire, shows an example of ill- health as a subjective feeling of illness, as Claire is claiming that although her GP says she is well, Claire still doesn’t feel in herself. This is an example also, of that her GP is using the biomedical approach (physical health), whereas Claire is basing health on the holistic approach. (Involving not just physical health, but intellectual, social, societal and emotional) Further, although Claire may be physically well, sometimes it could be that she might feel ill when no symptoms are present. Thus, showing that it is Claire’s own personal definition of her lack of health. Ill – health as a disease

Disease refers to a diagnosable problem, which might be physiological (a physical disorder) or psychiatric (a mental disorder). This view of ill health is objective (fact), i.e. ill health is something for which there is likely to be evidence — for example, two people with medical knowledge agreeing that a patient has a disease8. This involves a member of a medical team examing a patient after discussing their symptoms e.g. bleeding, pain, discomfort or breathing problems. After, the doctor will diagnose the medically named disease based on the observable sysmptoms. However, it is possible for an individual to have a disease and not to fell unwell, as some diseases are well advanced before the indidividual begins to fell ill. Case Study

Younis is an example of ill – health as a disease. As the medical professional (practice nurse) has examined him, and found a problem with his circulatory system. Younis is a further example that someone can still ‘feel’ well although they have something wrong with them. Ill- health as a disorder

The term ‘disorder’ refers to some malfunction of a body tissue, organ or system which does not function correctly. An example of this could be if the heart misses a beat, then there is a specific fault in the cardiovascular system. Personal responsibility for health

The primary responsibility for a person’s health rests with the individual, not the community9. This particular concept of well – being follows upon the extremely personal character of health in all its forms. However, someone’s personal responsibility for health is open to individual differences, and what each individual believes is responsible for their health is open to interpretation. This can be according to age, religion, race, background and past experiences, for example: An elderly woman will see her health as being relatively mobile – be able to get in and out of the house, meet up with friends and do her shopping. Further, she will ensure that she has independence and be able to perform basic day- to- day tasks. This will be her interpretation of personal health responsibilities. A person who is disabled will not see their disability as an illness, but view their personal health e.g. if they have colds, coughs or flu.

Their interpretation of responsibility for personal health will be being able to do ‘normal’ activities and have a happy life. A person who is eighteen will see their health as being relatively active e.g. going out with friends and going to the gym. The individual’s interpretation of personal health may be if they suffer mental or physical health problems. The New England journal of medicine propose that the concept of personal responsibility in health care is that individuals should follow healthy lifestyles, (exercise, maintaining a healthy weight) but also be responsible if we become ill10. For instance, the individual should go to their local GP when they feel unwell, go to the pharmacy for medication, and go to the nurse for regular check up’s and up to date vaccinations. Thus, this concept of health is based on how individuals look after their own health. Health as the absence of illness

The concept of health is so complex and rigorous, and it’s virtually impossible to think about health without thinking in terms of disease. In Lopsang Rapgay’s book, titled ‘The Tibetan book of healing’ he notes that “when we think about our health, we are accustomed to thinking in terms of disease… when we feel fine we rarely think about our health or what we have to do to maintain it11”. Rapgay refers to health as the absence of illness. Thus, meaning that individuals tend to notice their physical symptoms of what is wrong with them to indicate that they are ill/unwell. Therefore, when individuals become ‘well’ and/or physically ‘healthy’, they ignore the other aspects of ‘health’ called the six dimensions of wellness: Social

Environmental
Emotional
Spiritual
Intellectual
Illness – wellness continuum

This model signifies that wellness is a process, never a static state. The Majority of individuals consider wellness in terms of illness, as many assume that the absence of illness and nonexistence of signs or symptoms of disease indicates wellness12. In reality, there are many degrees of wellness, just as there are many degrees of illness. The illness – wellness continuum illustrates the relationship between the treatment paradigm and the wellness paradigm. The illness – wellness continuum was first proposed by John W. Travis, and once it was published in 1975 it became an immediate success, as this is an easy way to illustrate what the wellness concept was about. If an individual moves to the right of the neutral status, it indicates increasing wellness, which is achieved by awareness, education and growth13. Whereas, moving to the left indicates decreasing wellness due to various disabilities, signs, and symptoms of illness. Lifestyle choices that can affect health

The decisions that individuals make about how to live are called lifestyle choices. ‘Lifestyle’ tends to include issues such as diet, approach to exercise and recreation and whether you smoke, drink alcohol or take drugs. All these examples are decisions that individuals make, and have consequences to their health, wellbeing and personal development. The concept of ‘lifestyle choice’ assumes that individuals have the opportunity, understanding and ability to make choices that will affect how they live. However, this is an argumentative point, as it can be argued that some individuals have more choices and more opportunities than others, as certain social factors, like: Class

Gender
Ethnicity
For example, middle class (MC) or upper class (UC) will be more likely to exercise and have more choices and opportunities than working (WC) or under class (UC) as they don’t suffer from cultural or financial deprivation. (But WC do) The extent to which individuals are able to control their life course experiences varies for a number of reasons. For example, individuals ‘biological clock’ determines peoples ageing which we have little control over. Nevertheless, early lifestyle choices over which people do have some control can affect later health outcomes. For instance, many cancers are linked to many years of exposure to multiple risk factors, especially smoking. There are five majority lifestyle factors that have a huge impact on health and wellbeing: 1. Smoking

2. Poor diet
3. Inactivity
4. Alcohol misuse
5. Drug misuse
The lifestyle factor that I will be focusing on that has an impact on health and well – being to individuals is smoking. Smoking

The single largest cause of preventable disease and premature death in the UK is smoking, with an estimated 102,000 people dying in 2009 from smoking-related diseases including cancers14. In 2007 around a fifth (22%) of men (aged 16 and over) were reported as cigarette smokers15. Between 2007 and 2009, the rate remained stable, and fell to 21% in 201016. The percentage of women who smoke was around 20% during 200717. The choices that young adolescences make and select about tobacco (for or against) will have a profound effect on their chances of developing cancer in later life. Nicotine is a highly addictive drug, so the younger an individual initiates smoking, the more likely that person is to be an adult smoker. On the other hand, if young people can go through their adolescent years with developing a smoking habit, the chance are they will never start!18 Smoking has no health benefits at all, but it is more of a lifestyle choice associated with a wide variety of health risks. Smoking affects individuals health and well – being, as it causes cardiovascular disease (linked to intake of carbon monoxide and nicotine) and lung cancer (linked to tar) Further, there are some cancers that are more likely in smokers than non – smokers, and affects health and well – being, such as: Cancer of the oesophagus

Cervical cancer
Bladder cancer
Kidney cancer
Moreover, smoking likewise has detrimental effects on health and well – beings of babies while in their mother’s womb. As smoking while pregnant is linked to a range of unfavourable health outcomes: Low birth weight

Prematurity
Increased risk of infant mortality
Alarmingly, a survey in 2000 found that about one in five mothers smoked throughout pregnancy19 . (Wanless, 2003) Environmental issues that can affect health

An imperative part of the public health field is environmental health, which is very important in the public health field as it focuses closely on the circumstances and conditions in which people live and work20. Environmental health issues in the UK are monitored, managed and controlled through a comprehensive array of inspection services which are run by central and local government agencies. The central government develop and pass laws which establish environmental health standards and regulation systems, a key body involved in this is the Environment Agency. Further, the central government provides funding to local authorities to enable them to deliver local environmental health services. Local authorities (e.g. councils) have the responsibilities of enforcing laws through their environmental health departments21. Environmental health officers are the key staff in this area of public health, and their local focuses are: 1. Food Control

2. Health and safety at work
3. Housing
4. Pollution and environmental protection
The World Health Organization (WHO) defines environment, as it relates to health, as “all the physical, chemical, and biological factors external to a person, and all the related behaviours.22” Environmental health consists of preventing or controlling disease, injury, and disability related to the interactions between people and their environment23. Why is environmental health so important?

Maintaining a healthy environment is central to increasing quality of life and years of healthy life. Globally, nearly 25 percent of all deaths and the total disease burden can be attributed to environmental factors24. Environmental factors include: Exposure to hazardous substances in the air, water, soil, and food Natural and technological disasters

Physical hazards
Nutritional deficiencies
The built environment25
The greatest impact on people whose health status is already at risk, is the poor environmental quality. Hence, this means that environmental health must report the societal and environmental factors which increase the likelihood of exposure and disease. What is workplace health?

Occupational safety and health is an area that is concerned with protecting the safety, health and welfare of individuals that occupy in work or employment. The goals of occupational safety and health programmes include to foster a safe and healthy work environment26. Case study

The case study of Sam is an example of poor workplace health due to his environment. Sam’s workplace health has had a fundamental effect on his health and wellbeing, as he has been exposed to harmful fumes and poor air quality during his employment as a miner. Consequently, this has led him to affect his physical health and well- being as he is starting to have trouble breathing and regularly needs to have oxygen masks to aid him to breath. As a consequence to Sam being exposed to dust and harmful fumes, it has further affected his social and family life, health and well –being. As his bonding time with his children has changed dramatically, as he now finds it difficult to do day to day activities with his children e.g. take them to the park and play football with them. Additionally, he isn’t being invited as often to bicycle training and racing events with his friends. Which is consequently having a damaging effect on Sam’s emotional health and well-being, as he believes he is losing contact with his children and friends. He personally believes that his children aren’t having any fun when they are spending time with their father, as he isn’t the ‘cool’ dad he once was. Further, because he isn’t being invited out to bicycle training with his friends, he is barely leaving his house, and is effecting his self –
esteem, and is consequently suffering from depression. Thus, this fundamentally shows how environmental issues can effect individual’s health and well – being, not only physically, but socially and emotionally. The effects of ill – health on an individual’s quality of life An individual’s quality of life could be affected by ill health in either a positive or negative way. Negative

Ill – health can have a negative and detrimental effect on individual’s quality of life, as it can be debilitating. When or if an individual becomes ill, it will have a ‘knock on’ effect into all other areas of their life. One way in which ill health will affect a person’s quality of life, is that it may affect the individual’s ability to hold down a job, as they may be too ill to go into work, thus leading to a shortage of money. Therefore, Family life is then affected, as ill – health may lead to the person not be able to attend celebrations or events with the family, thus then the individual may feel isolated and withdrawn from the family. Evidently, this leads to the individual having a loss of self –esteem and self – worth. An example of this is that if an individual has been diagnosed with cancer, and they find out that the cancer is too far spread, and ultimately may be the cause of the death of the individual. Therefore, because of this, it can lead to the individual having a negative effect on their quality of life, because the person thinks that every day could be their last. Hence forth, this physical disease, will also affect their social and emotional health. One reason why it will affect their social health, is because the individual believes they are dying. They then may become socially detached with friends and family, as they may not see any point in staying in contact with them because the individual believes they will die soon. Thus results in the individual with cancer, barely leaving the house and becoming a recluse. This then has a ‘knock on’ effect onto the individuals emotional health, as the individual may believe that none of their family see any point in bothering with them, as the person with cancer may be dying soon, thus effecting their self-confidence and esteem and suffering from depression – hence making the individual with cancer have a poorer quality of life. Positive

However, ill health can have a positive effect on individual’s quality of life. An example of this is if an individual is diagnosed with cancer, and the person goes through the stages of chemotherapy and other treatments. The individual may come out of it cancer free, then the illness will have a positive effect on this persons quality of life. Thus, because they have beaten something and now can move on with their life and not have to worry about if the cancer is still there. Therefore, this will effect both their social and emotional health and wellbeing of the individual and improve their quality of life. For example, because the individual has beaten cancer their social health may have improved and increased, as they may adopt a ‘live for today’ mantra, where the individual has a better social life, and goes out regularly, and lives every day ‘likes it’s their last’ socialise and make new friends. Thus, this will have a ‘knock on’ effect onto the individual’s emotional health and well – being, as because the individual is making new friends, they might feel more emotional happy, confident and outgoing. Thus, because of this, it improves the individual’s quality of life.

Bibliography
1. http://www.holistichelp.net/holistic-health.html
2. http://knowledgex.camh.net/amhspecialists/promotion/Pages/holistic_approach_health.aspx 3. The New England journal of medicine – Imposing Personal Responsibility for Health, Robert Steinbrook, M.D. 4. Benedict M. Ashley, O.P., and Kevin D. O’Rourke, O.P – ‘Ethics of health care’ (3rd edition – 2002) page 55 5. Official Records of the World Health Organization, no. 2, p. 100, 1946 6. http://www.philipallan.co.uk/pdfs/txtheaaas.pdf

7. Annandale, The Sociology of Health and Medicine: A Critical Introduction, Polity Press, 1998 8. Moonie. M – AS Health and social care (2005) pg. 101
9. Health Care Policy: Issues and Trends, Volume 759 By Jennie J. Kronenfel pg. 21 10. ^ Kelley KW, Bluthe RM, Dantzer R, Zhou JH, Shen WH, Johnson RW, Broussard SR (2003). “Cytokine-induced sickness behavior” 11. “Regents Prep: Living Environment: Homeostasis”. Oswego City School District Regents Exam Prep Center. 12.

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