Essay on Assess Health and Public Health Policy Formation and Implementation With Regards to Obesity
Number of words: 1915
Obesity in the UK is something of a prevalent health issue within contemporary society, with more and more people becoming what could be classified as ‘obese’. Certainly, the detrimental effects of the disease are not only constrained to individual and collective health outcomes, with further implications arising for contemporary health policy and nursing practice. For this reason, addressing obesity should be perceived as a whole system (or known in other circles as ‘holistic’) approach that incorporates issues of education, justice, fiscality (financial aspects of the situation), health and food labeling, as well as being familiar with the role of stakeholders in addressing it (i.e. the government, NHS and possibly schools and educational institutions if the interventions are aimed towards young people).
Theory and research around public health
In terms of empirical evidence there has been a vast amount of it which has been amassed, commencing with the Health of the Nation report in 1992 for which the aims and objectives were missed by 400 percent (an irrefutable indicator of perhaps the efficacy of initiatives to address obesity or possibly the pluralistic nature of the targets) and continuing with the aptly-named 2007 Foresight Report which made the startling (and worrying prediction) that approximately half of the people in UK will be obese in 2050, with to the financial outlay required to cover this a monumental £50 billion (i.e. interventions, surgical procedures and other such provisions) (National Obesity Forum, 2014).
The Health and Social Care Information Centre in England were forthcoming with the outcomes of their research, which discovered that the amount of the general population who exceed what is deemed to be the normal range of Body Mass Indices increased significantly during 1993-2011 (with the longitudinal nature of the study verifying its reliability to a certain extent). Specifically considering the effects on young people,31 per cent of boys and 28 per cent of girls aged between 2 and 15 have been classified as being overweight or obese (Department of Health, 2011). This could possibly been explained by the fact that young people, who have been prolifically highlighted in the media as being becoming overweight, are part of a generation of children who are more used to interacting with computers and digital appliances rather than exercising in the natural environment. Prensky (2001) terms this generation of young people as being ‘digital natives’, in that they are so acclimatised to a world of technology, that they cannot envisage existing without it. These findings are mirrored in various studies regarding adult obesity undertaken studiously by the University of Glasgow (2014), who unsurprisingly discovered that people tend to become heavier as they age, possibly due to decreased physical activity or other health impediments (i.e. arthritis) which may curtail their mobility and levels of activity. Leeds Metropolitan University also focused on levels of childhood obesity (Public Health England, 2014). A number of Government initiatives, policies and projects are in the public domain presently, with the effectiveness of these in addressing the issue of obesity being discussed in the next section.
Models of public health
Two of the most prominent and well-publicised projects that target the problem of obesity are the Change4Life programme and the Public Health Responsibility Deal. The Change4Life programme distributes guidance to the population (normally through the medium of advertising or brochures)regarding the importance of healthy eating and sport activities. Through this programme, families are encouraged to collectively change their lifestyle through engaging in an increased amount of physical activity and by decreasing their intake of fat, salt, sugar or alcohol (Department of Health, 2011). Despite the family-orientated nature of this advertising campaign, it paled in comparison with the magnitude of the obesity problems in the UK, ultimately being ineffective.
The Public Health Responsibility Deal was founded after the previously mentioned 2007 Foresight Report as an acknowledgment of obesity as a serious issue in the UK. It is targeted at businesses becoming more aware of their role in influencing the health of the population through being more explicit and less transparent in their manufacturing and labeling of products. Therefore, businesses are encouraged to list the nutritional information on products and menus overtly, as well as reducing the quantities/proportion of fat and salt in their products, which can adversely impact on people’s health if consumed in vast (or even above the recommended amount of) quantities (Public Health England, 2015).
Looking to address childhood obesity in particular, the Government has set strict protocol governing the catering of school meals (traditionally a sensitive and hotly disputed matter). In 2013, following numerous other curriculum reforms (DfE, 2010), The Department of Education announced that physical education would become a compulsory element in the curriculum with children required to undertake a certain amount of activity within a week. Evidencing the importance of this, £150 million of supplementary funding was allocated for this purpose (Department of Education, 2011).
In 2011 an anti-obesity programme was launched by the UK government: Healthy Lives, Healthy People: A call to action on obesity in England. This programme aimed to decrease the national intake by five billion calories a day in an attempt to recreate the population’s “energy balance” (HM Government, 2011). Since this programme was inaugurated, the government has been quiet and non-committal in establishing whether progress has been made towards the decrease in calorific intake.
Implications of above for health and wellbeing
The Government initiatives which were succinctly outlined above had an educative undercurrent underpinning them, such as the Change4Life programme encouraging people to take better care of themselves. The Responsibility Deal also highlights the relevance (and responsibility/duty) of food and drink industry representatives in the process of addressing UK health issues, since they have been the ones who have previously been maligned for promulgating obesity with the aggressive target marketing advertising the convenience of such unhealthy products (Puhl et al., 2012).
Nevertheless, these campaigns were slightly undermined by the fact the correct level of hydration of an individual was not considered at length. According to a study carried out in the UK (Derbyshire, 2013) children have poor hydration habits. Venturing across the Atlantic, a study conducted in the USA revealed that adults who substituted calorific drinks (soda or other calorie-laden treats) for non-calorific drinks, such as water, registered a 2-2.5% weight loss during a six month period, which is fairly significant (Puhl et al., 2012). These studies only provide a cursory glance of the relationship between hydration and weight issues, with a broader outlook on healthy living seemingly being more advantageous than a consistent focus on healthy eating. Perhaps another issue of concern is that the majority of government policies are aimed at individuals who have marginal weight issues but who are not obese and perhaps may never fit into this category (National Obesity Forum, 2014). Equally, what is considered a ‘healthy’ body image could be seen as culturally determined and intertwined with the need to address the psychological/emotional/social needs/aspects of eating as well as their relevance to well-being and achieving contentment and happiness (Maslow, 1970).
Implications of above for contemporary health practice
Healthcare professionals have a crucial role to play in preventing and addressing the issue of obesity as they are ideally placed to identify and influence patients with ongoing weight problems. They are also in the best place to offer treatment for obesity and foresee possible future complications that may arise, such as type-2 diabetes, strokes or cardiovascular problems (Henderson, 2003). Nursing practitioners can also exert an influence over their patient’s diet and physical activity which could prevent later need for referral to secondary care (National Obesity Forum, 2014). The NHS Constitution makes an appeal (or requirement depending on the lens which one is viewing it through) to healthcare professionals “to take every appropriate opportunity to encourage and support patients and colleagues to improve their health and wellbeing” (National Health Service, 2013). For this to be achievable, nurses must be appropriately schooled in how to advise patients as sound interpersonal skills are needed to deal with such matters. Obesity management training should be at the apex of nursing training, with most training presently focusing on the effects/symptoms of obesity, such as type-2 diabetes, heart disease or osteoarthritis (Hyde et al., 2006). Future training will tend to focus on the adage that ‘prevention is better than cure’, empowering patients, engaging communities and developing the NHS into a social movement to be aligned with the demands of the contemporary era (NHS England, 2014).
Department for Education (2010) The importance of Teaching: Schools’ White Paper. London: DfE.
Department for Education. (2011). The Public Health Responsibility Deal [Online.] Available at: https://responsibilitydeal.dh.gov.uk/wp-content/uploads/2012/03/The-Public-Health-Responsibility-Deal-March-20111.pdf (Accessed: 26th May 2015).
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Derbyshire, E. (2012) National Hydration Council.
Henderson, S. (2003). Power imbalances between nurses and patients: a potential inhibitor of partnership in care. Journal of Clinical Nursing: 12, 501-508.
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Maslow, A. H. (1970) Motivation and Personality. New York: Harper and Row.
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Prensky, M. (2001) ‘Digital Natives, Digital Immigrants’. On the Horizon, 9 (5): 1–6.
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Puhl, R., Peterson, J.L and Luedicke, J. (2012). Fighting obesity or obese persons? Public perceptions of obesity-related health messages. International Journal of Obesity. 1-9.
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