Friday, March 29, 2019
UK Health Policies on Obesity
UK wellness Policies on fleshiness kindly, economic and industrial changes nonplus believe changed the patterns of life glob eachy. Changes in divulget and physical activity patterns construct been central to the rise of corpulency among many of the worlds population. fleshiness was traditionally seen as a unsoundness of high-income countries only, but it is now replacing malnutrition and infectious diseases as a problem transcending loving divides. Obesity carries a higher incidence of chronic illness including diabetes, heart disease and ratcer. This paper get out critically value the current UK and NI policies aimed at addressing the fleshiness epidemic. There will as well be a discussion around definition of policies, role of administration in wellness c atomic number 18, previous and current healthc atomic number 18 policies envisioning corpulency in both Britain and Northern Ireland.The official calculation for defining fleshiness was set by the World w ellness Organisation (WHO) where adults be registered everyplaceweight and grave utilize a formula of Body Mass Index or (BMI), that is a persons weight in kilograms divided by the height in metres squ atomic number 18 up (DWP, 2012). The main(prenominal) restraint with using body host indicant as an indicator is that it does not distinguish plump mass from lean mass so a person could be tidy and suck a natural depression body avoirdupois, but be clinically all everyplaceweight if they have a high enough BMI. A person is thought to be stoutness if they have a BMI of 25.0 or more and fat if the BMI is 30.0 or more. Obesity has three trendifications Class 1 BMI 30 to 34.9 (waist perimeter 102cm add-on for males and 88cm plus for females). Person is categorised as overweight Class 2 BMI 35 to 39.9. Person is classed as obese Class 3 BMI 40 and over. Is when a person with a BMI of 40+ is said to be morbidly obese (WHO, 2012).Policy originates from the governing that are in power, who are also the legal authority and have a status and guidance over all polity whether they be private or mankind (Crinson, 2009). harmonize to Crinson 2009 health policy is hypothesised in terms of macro and micro complaisant developments, with the macro level reading the running(a) of social and formal social systems, such(prenominal) as the economic context of the ground and the market, and the home(a) health assistance (NHS). The micro side focuses on the fascinate of policy from the level of the health like professionals and the experience of the users (Crinson, 2009).Policy making, jibe to a White Paper publish by the Labour Government in 1999 states that it is a method in which a government interpret their political vision into broadcasts and actions in direct to make changes that are required and wanted by the population ( locker Office, 1999). It was also focused on modernising the government schema (Cabinet Office, 1999a) and the need for m ore comprehensive and reactive policys conjugate to messs demands. It planned to guarantee that policy making was to beget more forward thinking and assure-based, as well as aright assessed and based on best practice. It went on to note the need for ameliorate evidence when addressing policy making and to ensure a more joined-up plan of attack crossways government departments and erancies (Cabinet Office, 1999).According to the World health Organisation health policy signifies decisions, plans and actions that are started in order to reach detailed health care goals within a caller. It goes on to note that and clear and caravan policy can outline an idea for the future whilst helps to establish objectives and points of orientation. A health policy can also help to design a frame exit and build agreement in addition to informing wad (WHO, 2006).There are three key policies areas within the Department of wellness and they are National wellness (NH), Public wellness (PH), and Social deal (SC) (Kouvonen, 2012). The current theory has two dissimilar backgrounds the first is a exoteric policy analysis that is favoured by the United States and Northern Ireland. The second is favoured in the United Kingdom and is a social policy theoretical structure (Kouvonen, 2012).Policies are intended to improve on current provisions in health and social care in the UK and aim to guarantee function that are funded or supported by the Department of health are de sleep togetherred in an open and patient-centred way (www.dh.gov.uk). This was not always the case, as concord to Crinson governments were indifferent to the type of care delivered within the healthcare service that was the disturbance of the doctor. This was to change in the seven-spotties when the economy declined and tax revenue was minify (Crinson, 2009).The roll of the state in providing health and eudaimonia to the public match to Crinson 2009 takes the receive that there are five diverse con ceptualisations and they echo differences amid political and conceptual actions of the role that the state should play when delivering health and welfare service (Crinson, 2009). The writer goes on to give examples of these conceptualisations one of which is the neoliberal prospective that influenced the change in the health and social welfare policies of the Thatcher Government in the 1980s (Crinson, 2009). In the semipolitical-Economic Critique, tally to OConnor et al welfarism serves to build consent for capitalist economy through and through the process of dividing the population into groups with specific needs. This he notes had the effect of individualising what are widespread social and health problems associates with living(a) in a capitalists familiarity (Gough, 1979).In a paper by David Berreby in which he asks the question, why do mess get fat and risk major health problem?, He believes the answer to this question is capitalism and sites it as the main cause of glob al obesity (Berreby, 2012). Conversely in a course of instruction series aired on the BBC on the 11th July 2012 the reporter Jacques Peretti reports that our have habits were changed by a decision made in America 40 eld ago. Peretti travelled to America to examine the story of high-fructose corn sirup (HFCS) a calorie-providing hooking used to sweeten provenders and drinks, chiefly processed and defecate-bought foods. The sweetener was backed in America in the 1970s by Richard Nixons res publica administrator Earl Butz to use additional corn grown by farmers. cut-price and sweeter than sugar, it rapidly found its way into nearly all convenience foods and well-off drinks. HFCS is not only sweeter than sugar it also inhibits leptin, the hormone that controls hunger, resulting in the softness to stop eating (BBC, 2012). This was backed up by evidence from Robert Lustrig an endocrinologist, who correspond to this report, was the first to identify the dangers of high-fructose corn syrup (HFCS). His findings however, were discredited at the time. and a US Congress report sited fat, not sugar, for the alarming rise in cardio-vascular illness and the food industry responded with a series of low fat and heart full-blooded foods in which the fat was removed. (BBC, 2012). Policy makers encour growd farmers to overproduce corn and soy with the promise of foreign trade (Philpott, 2008).It was also in the 1970s that Britains food manufactures used advertising drives to encourage the idea of snacking between meals. A strong food culture also developed and fast food chains offered tempting foods and customers served themselves, and according to Ritzer this was the beginning of McDonaldization of Society. He goes on to write how fast food restaurant contribute to the development of obesity and it emphasis on supersizing its portions (Ritzer, 2004).Conversely poverty increased in the 1970s under Thatcher Government and according to the Institute for Fiscal Studies in 1979 13.40% of hoi polloi in Britain lived below 60% on median income before admit represents. With this came a big rise in inequality and under the gini create for Britain was up to 0.339 from 0.253 (Crib, et al 2012).Due to the comorbidities associated with obesity and their increasing cost to the NHS, the consequences of obesity are currently and will continue to be important public health repugns globally and in the UK. It impacts through society and across all life courses, and can increase the risk of life threatening disease (Kouvonen, 2012).Appendix 1.Currently there is a framework in Northern Ireland titled A Fitter Future for All, this agenda spans from 2012 to 2022. Within this paper it explains that in Northern Ireland 59% of adults are either overweight (36%) or obese (23%) (DHSSPSNI, 2012). This policy addresses the need to act from childhood based on evidence from the expectancy Report 2007, and is now a cross sectorial glutinous life course agenda that wil l address obesity over the next 10 long time (Foresight Review, 2012). The Department of Health has print a follow-on text file to the Public Health White Paper called thinking(a) lives, healthy people A call to action on obesity in England, which sets new national drives for a descending trend in redundance weight by 2020. The Tackling Obesities Future Choices project presented its findings on 17 October 2007 and the support aims to deliver a feasible response to obesity in the UK over the next 40 years. It also sets out examples of what is intended on a national level to help challenge obesity, one of these is called Change4life programme. In this programme it states it will help consumers make healthier food choices (www.dh.gov.uk). This could be linked to Professor Marmot point, when he discussed behavioural choices as individuals such as where to shop for food, and how these decisions are dictated by the individuals socio-economic circumstance, and if they can afford the r ecommended good food (UCL Institute of Health Equity, 2012).A fitter Future for All and Healthy Lives, healthy people are policies that both the British and Northern Ireland government support, but there are wider determinants of low-down health such as poverty and inequalities that play an important role in obesity (HM Government, 2010). It could be argued that while policies such as these are targeting the causes of obesity, they are not actively seeking out realistic solutions to the problem people may agnize they need to eat healthier, but simply cannot afford to buy the dampen food.In developing countries rates of obesity are inclined to rise, and this is associated with ontogenesis social disadvantage addressing social deficiency and material disadvantage is belike to reduce obesity (Kouvonen. 2012).Socio-economic class as a factor in health is not a new phoneme in the United Kingdom, as it has a history of many hundreds of years. According to Edwin Chadwicks report on well conditions of the labouring population in Britain in 1842 showed that in Liverpool the average age of mortality for people in the upper classes was 35 years, and 15 years for labours and servants (Richardson, 2008). Inequalities still exist today, but have improved and in the fatal report published in 1980 it states that there are still inequalities with regard to life expectancy and the use of medical services (Whitehead et al, 1992).According to the Foresight report (2007) a government science think tank report that most adults are already overweight. It goes on to note that modern living will ensure that upcoming generations will be heavier than the last, and by 2050, 60% of men and 50% of women maybe clinically obese. The report also states the obesity is a multifarious and there is no evidence anywhere in the world where obesity has reversed. Social policy frameworks are predominate according to this report (Foresight Review, 2012).The Marmot Report the third such offic ially approved analysis in as many decades probing the link between health and wealth. The findings confirmed an alarming social incline, the poor not only die seven years earlier than the rich, but they can expect to establish disabled 17 years sooner. Professor Marmot continues to discuss behavioural choices we make as individuals are part of our social and economic settings. He believes that people born into more affluent milieu tend to adopt a healthy lifestyle, resulting in healthcare differences between the social classes (UCL Institute of Health Equity, 2012).In 2011 the Chief medical Officers (CMOs) from across the UK published new strategies for physical activity, and they addressed a life course methodology, and included guidelines for early years (www.ic.nhs.uk). It could be argued this is a blanket policy and it is widely known that poorer people have limited choices with regards to lifestyle choices such as gym memberships. alike the report appears to place the respon sibility of exercise on the individual. populate from poorer socio-economic backgrounds have poorer housing and environments that dont encourage physical exercise which could be due to social culture of where these people live and lack of resources (UCL Institute of Health Equity, 2012). Addressing overweight children that become obese in later life was issue brocaded by Dr Hilary Jones on Good Morning Britain, when he stated that obesity begins in childhood. He went on to say that the National Health suffice and the Government know causes of obesity but actively preventing it in childhood needs to be addressed (www.gm.tv).Prevention of obesity is more manageable goal than addressing obesity when it becomes established, as some health problems that are acquired through obesity remain an issue even after weight loss. thereof government policies are mostly directed at primary legal community of obesity such as eating well, exercise and no smoking (Kouvonen, 2012).Social determina nts of health are also a key factor in obesity in both children and adults. According to the World Health Organisation the social conditions in which people live are paramount to their health. It goes on to note that lack of income, poor housing and lack of ingress to healthcare facilities are just some of the factors leading to inequalities (www.who.int).Medical care on its own cannot adequately improve individuals health and addressing where people live and work is also important The social determinants of health are the upstream social, economic, and environmental factors that affect the health of individuals and populations, including income, social support, education and literacy, employment and working conditions. Downstream determinants, which include physical activity, clean air and water and healthy housing. These factors can influence health inequalities difference between social groups that can result in obesity in poorer areas (Kouvonen, 2012).Incidents of Childhood obe sity are higher in areas with a lower socioeconomic population according to National Health Service Information Centre report on obesity. It also states that obesity is more widespread in schools in disfavour areas. It also noted that with Reception children (children in the primary school age group) 6.9% of those in least deprived areas were obese, in comparison to 12.1 per centum of children in most deprived areas (www.ic.nhs.uk).In Northern Ireland statistics show that 8 percent of children ages between 2 and 15 years are obese, according to the Health Minister Edwin Poots. The health Minister went on to say that the likelihood of obese children become obese adults was probable this would put greater strain on the health and social care services due to the comorbidities associated with the condition (Northern Ireland administrator, 2012).Governments state that health policies are micro driven, but in reality it could be argued that they are macro driven as ultimately obesity w ill cost more in the long run due to obesity related illness such as diabetes and heat disease, and according to NHS website the cost will be 4.20 billion per year (HM Government). Tackling obesity is a challenge for not only the UK, but globally and according to the Department of Health and Social Services Northern Ireland website, overweight and obesity will authorise malnutrition and infectious disease in terms of their cost to the health services and people suffering from the condition (www.dhsspsni.gov.uk). Appendix 2.It was not until 1999 that obesity was state an epidemic in America and was considered to affect all racial groups and across all ages in United States (National Medical Association, 1999). According to the information published there was an increase from 12% to 18% over a seven year period using a body mass major power (BMI) that was greater than 30 (National Medical Association, 1999). Historically obesity rates were low and unaffected until 1970s and 80s, an d the obesogentic environment (an environment that encourages and leads to obesity in individuals that relates to the influence that contribute towards obesity such as food, physical activity and environment. many an(prenominal) broader determinants of poor health such as health inequalities, poverty and deprivation play a significant role, and these factors have not swayed over the years. In pre-war Britain large differences in mortality and morbidity levels between rich and poor were recognised as the norm by policy makers. It was the introduction of the National Health Service in the 1940s that brought with it hope that the social class differences affecting health would decline. It wasnt until the 1970s that the Marmot Report stated peoples lifestyle and great deal have a direct effect on their health (Crinson, 2009).The health implications from obesity are immense and can ultimately result in a premature death. Although obesity is caused by intake of more life force through food and drink than needed and the resulting excess stored in fat in the body, the view that obesogenic environment also plays a part in obesity is becoming widely accepted. Social and economic circumstances are also evaluated in this paper as are the role of governments and policy makers, both in the United Kingdom and Northern Ireland. The overall view of this paper would be that policies are made by individuals that have no insight into what part of society they are directed at such as deprived and socio-economic areas that lack the means and facilities whereby individuals feel that their contribution to society is valued and important enough for them to care about their own wellbeing. Policies are not directed at one specific group such and the one size fits all doesnt appear to be working as obesity is now a global epidemic.BibliographyBBC (2012) The Men who made us fat episode 3, available at www.bbc.co.uk/programmes/b01kd06l (Accessed 06/11/2012 20.05)Berreby, David. (2012). Is Capitalism To unholy for Worldwide Obesity? Available athttp//bigthink.com/Mind-Matters/is-capitalism-to-blame-for-worldwide-obesity (Accessed 5/11/2012)Braveman, Paula. Egeter, Susan. Williams, R. William (2011) The Social Determinants of Health Coming of Age, Annual Review of Public Health, Vol. 32 381-98Cabinet Office (1999) Modernising Government White Paper available at http//www.archive.official-documents.co.uk/document/cm43/4310/4310.htm (accessed 05/11/2012)Crib et al (2012) Briefing Notes on Jubilees compared incomes, spending and work in the late 1970s and early 2010s, available at http//www.ifs.org.uk/publications/6190 (Accessed 12/11/2012)Crinson, Iain (2009) Health Policy, a critical prospective, SAGE, LondonDepartment of Health Public health (2012) Adult social care, and the NHS Obesity Document, available at www.dh.gov.uk/health/category/policy-areas/public-health/obesity-healthy-living (Accessed 10/11/2012)Department of Works Pensions (2011) Causes of Obesity a vailable at, http//www.dwp.gov.uk/publications/specialist-guides/medical-conditions/a-z-of-medical-conditions/obesity (Accessed 05/11/2012)Department for Works Pensions (2011) Definition of heavy(p) and Obesity available at, http//www.dwp.gov.uk/publications/specialist-guides/medical-conditions/a-z-of-medical-conditions/obesity (Accessed 05/11/2012)DHSSPSNI (2012) Framework for Preventing and Addressing Overweight and Obesity in Northern Ireland 2012-2022, available at http//www.dhsspsni.gov.uk/framework-preventing-addressing-overweight-obesity-ni-2012-2022.pdf (accessed 8/11/2012)DHSSPSNI (2011) Safety, part and Standards Safety and Quality Policy Document available at www.dhsspsni.gov.uk/index/phealth/sqs.htm (Accessed 6/11/2012)Foresight Review (2012) www.foresightreport.com (Accessed 08/11/2012 9.50)GMTV (2012) www.gm.tv.uk (Viewed 07/11/2012 7.47)Gough, I. (1979) The Political Economy of the Welfare State, Macmillan, BasingstokeHM Government (2010) Healthy Lives, Healthy P eople Our Strategy for Public Health in England, available at www.official-documents.gov.uk (accessed 10/11/2012)NHS Information Centre (2011) Statistics on Obesity, Physical Activity and aliment England, available at http//www.ic.nhs.uk/webfiles/publications/003_Health_Lifestyles/opad11/Statistics_on_Obesity_Physical_Activity_and_Diet_England_2011_revised_Aug11.pdf (Accessed 08/11/2012 8.25)NHS Information Centre (2011) Obesity go Among Final Year Primary School Children, available at www.ic.nhs.uk/ncmp (Accessed 10/11/2012 20.55)Kouvonen, Dr A. (2012) What is Health Policy?, strap Notes Week 1 Lecture 2Kouvonen, Dr A. (2012) Current Issues in Health Policy Obesity, Week 4 Lecture 2National Medical Association (1999) Obesity state an Epidemic in the United States,J Natl Med Assoc. 1999 December 91(12) 645 PMCID PMC2608606Northern Ireland Executive (2012) available at http//www.northernireland.gov.uk/index/media-centre/news-departments/news-dhssps/news-dhssps-08032012-obesity- cuts-life.htm (Accessed 08/11/2012 20.15)Philpott, T (2008) A notice of the Lasing Legacy of the 1970s USDA Secretary Earl Butz available at http//grist.org/ member/the-butz-stops-here (Accessed 7/11/2012)Richardson, W.B. (2008) The Health of Nations A Review of the Works of Edwin Chadwick, mess I. BiblioLife, LLCRitzer, G. (2004) The McDonaldization of Society, SAGE, CaliforniaUCL Institute of Health Equity (2012) Strategic Review of Health Inequalities in England Post-2010 (The Marmot Review), available at www.marmotreview.org (Accessed 9/11/2012)Whitehead, M., Townsend, P., Davidson, N., Daivdsen, N., (1992) Inequalities in Health The Black Report and the Health Divide, Penguin Books Ltd New edition (29 Oct 1992)World Health Organisation (2006) Commission on Social Determinants of Health, available at www.who.int/social_determinants/resources/csdh_brochure.pdf (Accessed 09/11/2012 17.56)World Health Organisation (2012) Health Policy, available at www.who.int/topics/health_pol icy/en/ (Accessed 05/11/2012 8.50)World Health Organisation (2012) Obesity, available at www.who.int/topics/obesity/en/ (Accessed 05/11/2012 17.43)Appendix 1
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