Unit abstract 1. Practitioners who work in health and social care require an understanding of the influences on the health of the individuals with whom they work. 2. This unit will provide learners with the knowledge and understanding of pertinent issues and also factors which prevent some individuals from accessing health support. 3. Learners will investigate a range of influences on health and also reasons for the varied success of health promotion campaigns and strategies. 4. Reference is made to the role of national and regional strategies and professionals. 5. Theories of health behaviour are examined and linked with government strategies to improve the health of individuals in society. 6. Potential conflicts between local industry and health promotion are considered, for example anti-smoking campaigns and parents employed within the tobacco industry. 7. Learners are invited to plan a health promotion campaign for a specific group in society, which could be conducted within their own workplace in order to provide a context for the unit. LO1 1.1 explain the effects of socio-economic influences on health 1.2 assess the relevance of government sources in reporting on inequalities in health 1.3 discuss reasons for barriers to accessing healthcare 1 Understand the socio-economic influences on health Influences: social eg disposable income, unemployment, lifestyle choices, environment (1.1) Access to healthcare facilities, access to information, citizenship status, discrimination (1.3) Sources of information: reports and enquiries eg Black Report DHSS 1980, Acheson Report ‘Independent Inquiry in ‘Inequalities in Health’ 1998, Health and Lifestyle Surveys (HALS), Health Survey for England (HSFE), census data (1.2) LO2 2.1 analyse the links between government strategies and models of health promotion 2.2 explain the role of professionals in meeting government targets for health promotion 2.3 discuss the role of routines in promoting healthy living 2 Understand models of health promotion Definitions: models eg medical, social; behavioural change, health educational, differences between health promotion and health education, health belief model, theory of reasoned action, trans-theoretical (stages of change) model, social learning theory), (2.1) Government strategies: campaigns eg anti-smoking campaigns, Healthy Eating, Dare campaign; vaccination programmes, safety in the home, sun protection, Sure Start, Every Child Matters, government health promotion targets (2.1) National and regional health promotion: structures eg National Institute for Clinical Excellence (NICE), role of Primary Care Trusts, partnerships between local authorities and strategic health authorities; role of voluntary groups eg Epilepsy Action and Asthma UK (2.2) “They can also be health promoter” Current targets such as for. obesity, smoking, alcohol consumption, sexual health, reduction in deaths from strokes, cancer (2.2) Role of professionals: health visitors and others eg school nurses; school dental checks liaison with parents and carers (2.2) Routines within the settings: personal hygiene; healthy eating; resting; exercise (2.3) 3 Understand factors which influence health promotion 3.1 explain how health beliefs relate to theories of health behaviour 3.2 discuss the possible effects of potential conflicts with local industry on health promotion 3.3 explain the importance of providing relevant health-related information to the public LO3 Factors: health beliefs, cultural and religious practices; previous experience of health promotion; education and understanding Health beliefs: scientific medicine, lay public (3.1) Importance e.g. relevance of information to target group reducing early deaths, reducing sickness and dependency, reducing cost of care, increasing personal responsibility, removing health inequalities, controlling communicable diseases, protecting vulnerable groups, reducing health risks. (3.3) potential conflicts with industry e.g. tobacco industry, leisure industry, alcohol producers and suppliers, hospitality industry, food manufacturers, cost of improving workplace, sponsorship of media (3.2) Theories of health behaviour: behaviours eg Health Belief Model (Becker 1974), Theory of Reasoned Action (Ajzen and Fishbein, 1980), Health Action Model (Tones, 1990), Stages of Change Model (Prochaska and DiClemente, 1984) (3.1) 4 Be able to plan a health promotion campaign 4.1 plan a health promotion campaign to meet specific objectives 4.2 explain how the health promotion campaign supports health promotion strategies. Purpose: aim eg improve the health of children, increase concentration, encourage healthy living in families, extend life expectancy (4.1) Strategies: assessing health needs, incorporation into routines, involving parents and carers; cultural eg awareness of religious and cultural practices, festivals and special days; timing, levels of understanding; involvement of other professionals eg community paediatric nurse, dietician, links with national campaigns (4.2) Legislation and guidelines: relevant sections from eg: Health and Safety at Work Act, Keeping Children and Families Safe Act 2003, Disability Discrimination Act 2005 (4.1) Evaluation: framework for evaluation (efficiency, effectiveness, economy); measured outcomes, Specific, Measurable, Accessible, Relevant, Timely (SMART) targets, goals and objectives (4.1) RESOURCES Books J.Naidoo & J Wills. Foundations for Health Promotion 3rd ed. Bailliere Tindall 2009 ISBN: 978 0702029653 J.Green & K.Tones. Health Promotion: Planning and Strategies. 2nd ed. Sage Publ. Co. 2010. ISBN: 978 1847874900 M.Gottwald & J.Goodman-Brown. A Guide to Practical Health Promotion. Open University Press. 2012. ISBN: 9780335244591 Old Before My Time: Obesity – Documentary(youtube) LO2 Health professionals have a prominent role to play in tobacco control. They have the trust of the population, the media and opinion leaders, and their voices are heard across a vast range of social, economic and political arenas. At the individual level, they can educate the population on the harms of tobacco use and exposure to second-hand smoke. They can also help tobacco users overcome their addiction. At the community level, health professionals can be initiators or supporters of some of the policy measures described above, by engaging, for example, in efforts to promote smoke-free workplaces and extending the availability of tobacco cessation resources. At the society level, health professionals can add their voice and their weight to national and global tobacco control efforts like tax increase campaigns and become involved at the national level in promoting the WHO Framework Convention on Tobacco Control (WHO FCTC). Health professional organizations can show leadership and become a role model for other professional organizations and society by embracing the tenants of the Health Professional Code of Practice on Tobacco Control. Health professionals include physicians, nurses, midwives, dentists, psychologists, psychiatrists, pharmacists, chiropractors and other health-related professionals. The role and image of the health professional are essential in promoting tobacco-free lifestyles and cultures. Through their professional activities health professionals can help people by giving advice, guidance and answers to questions related to tobacco use and its health effects. They can serve as a reference for the media, educating the public and policy-makers. They can also have an impact at national and international levels through their associations in influencing policy change for better tobacco control. How health professionals fit within comprehensive tobacco control programmes As mentioned above, all health professionals can help reduce tobacco consumption and its negative effects. Tobacco-related problems and tobacco control cut across a vast range of health disciplines. One of the roles of health professionals is to ensure that all of those affected by tobacco consumption or dedicated to the health sector are prepared to be supportive. Health professionals such as physicians, nurses, midwives, pharmacists, dentists, physiologists, chiropractors, and other health-related professionals have an enormous potential to play a key role in battling the tobacco epidemic. They have several roles in common and that work in unison, where one role does not substitute for another. These roles include: Role model. In community and clinical settings, health professionals are the most knowledgeable in health matters and they are expected to act on the basis of this knowledge. In their society and their communities they are expected to be role models for the rest of the population and that includes, in general, their behaviour in health-related matters such as diet and exercise, and particularly regarding tobacco. Health benefits after stopping smoking Some of the health benefits from stopping smoking can occur quite quickly as the table below shows. Other health improvements are seen over the course of a number of years, depending on how long a person has smoked. AFTER 20 Minutes • Blood pressure and pulse drop to a normal rate • Temperature of hands and feet increases to normal 8 Hours • Carbon monoxide level in blood drops to normal • Oxygen level in blood goes up to normal 24 Hours • Chance of heart attack starts going down 48 Hours • Nerve endings start growing again • Ability to smell and taste begins to improve 2 Weeks to 3 Months • Circulation improves • Walking gets easier • Lung function improves up to 30% “I can talk again when I walk up stairs!” “It’s great to not have to clear my throat all the time.” 1 Month to 9 Months • Coughing, sinus congestion, tiredness and shortness of breath decrease • Cilia (small hairs) grow back in lungs to better handle mucous, clean the lungs and reduce infection “I’ve missed so much less work because I get fewer colds and sore throats.” “It’s such a relief to not be bogged down with those headaches.” “I can concentrate so much better.” 1 Year • Risk of coronary artery disease is half that of a smoker “I’m not scared by heaviness in my chest in the morning anymore.” 5 Years • Lung cancer death rate goes down by one half • Risk of stroke becomes same as non-smoker • Risk of cancer of the mouth, throat, oesophagus, bladder, kidney and pancreas goes down In addition: If you have a chronic illness like diabetes, asthma or kidney failure, quitting can dramatically improve your health. Health benefits after stopping smoking Some of the health benefits from stopping smoking can occur quite quickly as the table below shows. Other health improvements are seen over the course of a number of years, depending on how long a person has smoked. Time since quitting Health benefits of quitting 20 minutes Pulse return to normal. 8 hours Nicotine is reduced by 90% and carbon monoxide levels in blood reduce by 75%. Circulation improves. 24 hours Carbon monoxide and nicotine almost eliminated from the body. Lungs start to clear out smoking debris. 48 hours All traces of nicotine are removed from the body. The ability to taste and smell improves. 72 hours Breathing is easier. Bronchial tubes begin to relax and energy levels increase. 2-12 weeks Circulation improves. 1 month Physical appearance improves – skin loses its grey pallor and becomes less wrinkled. 3-9 months Coughing and wheezing is reduced. 1 year Excess risk of a heart attack reduces by half. 10 years Risk of lung cancer falls to about half that of a continuing smoker. 15 years Risk of a heart attack falls to the same as someone who has never smoked. Health services Nurses School health nurses Health visitors Community public health nurses Midwives General practitioners Doctors Physiotherapists Occupational therapists Dietitians Exercise counsellors Pharmacists Opticians/optometrists Speech and language therapists Ambulance services Local authorities and non-statutory agencies Youth workers Teachers Play workers Community workers Social workers Environmental health officers Prison workers Private sector and voluntary agencies Occupational health doctors and nurses Trade union safety representatives Pressure groups, e.g. Action on Smoking and Health (ASH), the Royal Society for the Prevention of Accidents (RoSPA) Media Health correspondents PROMOTING HEALTHY LIVING Smoking Smoking greatly increases the risk of having a heart attack. If you smoke, your healthcare professional should advise you to stop and offer you the support you need to help you to stop. Diet You should follow a healthy diet and eat at least five portions of fruit and vegetables a day, in line with national guidance. avoid eating foods that contain a lot of fat (particularly saturated fats and cholesterol) Exercise 30 minutes a day, at least 5 days a week. Exercise should include things that can easily become part of your daily routine, such as walking, using stairs or cycling. Weight If you are overweight, then your healthcare professional should give you advice and support about reaching and maintaining your ideal weight. Alcohol If you drink alcohol, you should stay within safe limits and not binge drink. Men should drink no more than 3–4 units of alcohol a day, and women should drink no more than 2–3 units of alcohol a day.
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