Health, Healthcare and Health Policy
Week 1 and 2
The Western scientific medical model of health has a rigid approach to different kinds of illnesses or diseases, as it only seeks and provides treatment or cure to patients, based on their manifested symptoms. It perceives the definition of health as having the absence of diseases or illnesses ( and 2000). This is an incomplete view of health, as many aspects in the psychological, cultural, and social aspects of the individual are being disregarded, placing absolute emphasis on the biological and scientific basis of the disease.
Health is also determined based on social factors. This is because, 1) it determines the meaning of health in different groups of individuals; 2) it influences the mortality and morbidity of individuals; 3) the society influences equality and inequality among peoples; and 4) it influences education, practices, and environment from which individuals exist.
Because health is dependent on societal and environmental factors, the definition of the ‘social model of health’ becomes relevant. This model emphasizes that the promotion of health and well-being of individuals can be achieved through direct efforts of addressing not only the biological and medical factors of individuals, but social and environmental factors of health as well. In this regard, the social model of health provides the realization that both the social and the environmental practices and values of individuals serve as important factors in preserving and promoting health.
One of the important statements that must be taken note off is the statement that says, ‘lay concepts of health coexist alongside scientific medicine’. Lay concepts of health includes both the Western scientific medical model of health and the social model of health, and in this statement, both models of health are being interrelated with one another. This statement means that social and environmental factors play a significant role in the treatment of a disease and in the promotion of health, thus, it must be taken note off in order to provide scientific treatment that would cure physical and biological illnesses. In this regard, scientific medicine is not only dependent on physical and biological symptoms manifested by a patient, but scientific medicine must also be used as a response to the different social and environmental factors that are involved in causing a particular disease or in the promotion of health.
Because health is dependent on different social and environmental factors, inequalities in health are inevitable. Inequalities in health are affected by a variety of factors, including, socioeconomic status, social selection, culture, behavior, and social stratification. The socioeconomic status of individuals significantly affects health, as it describes the material and behavioral conditions of individuals that might cause diseases ( and 2002). Socioeconomic status of individuals can be perceived as including the working conditions, income, educational attainment, and the environment. In this regard, it can be suggested that there are inequalities in health because there is the inevitable existence of social and economic stratification that limits the potential and the opportunity for all peoples to attain good health.
The inequalities in health emphasize the role of the society in determining health and illnesses. As such, several social determinants can be identified, including, age, gender, culture, biological, genetic, and physical conditions, educational attainment, economic status, income, employment and working conditions, social and physical environments, personal hygienic practices or personal behaviors and coping mechanisms, support groups, and health services.
As mentioned, one of the social determinants of health and illnesses is the personal practices. These practices are also affected by risk factors, such as smoking, alcohol, and exercise, and help determine the susceptibility of an individual to diseases or to stay healthy. These risk factors are associated with health because they are social determinants that can be the causes of diseases. Smoking, alcoholism, and drugs cause the deterioration of health, while diet and exercise prolong and prevent illnesses.
Social capital refers to the resources common to a particular group of individuals, which are used in order to achieve particular goals or objectives. In terms of health, social capital refers to the resources being used in order to sustain functional social relations among different individuals, including trust and confidence (cited in 2001). Social capital is a determinant of health because it helps emphasize the significant role the society and the environment play in the promotion and maintenance of health of individuals.
Social factors include developing and adopting the culture being observed in a particular society, and thus, determine the cultural competence of individuals in that particular society or group. Cultural competence entails respect for cultural values, traditions, and customs of particular individuals or groups of individuals, and affects the health behavior of individuals in a variety of ways. This include the willingness and ability of individuals to come up with health interventions and services ( 1998), the collaboration with other cultural groups, the way communication is done, the design of the health intervention, its implementation or its delivery of service, and its evaluation or assessment, whether effective or not. Some groups may vary in terms of health behavior, depending on the culture they belong to, and in how they perceive other cultures and languages. In this regard, communication is the key in exhibiting effective cultural competence.
Week 3 and 4
The definition of health does not only mean the absence of a particular disease or illness, as perceived in the Western scientific model of health, but is the condition of having a complete well-being in terms of physical, cultural, political, economic, and social perspectives ( and 2005).
The principles of primary health care include equity, self-reliance, and prevention ( 1995). Equity involves the provision of equal resources and opportunities for all peoples to be provided with health information and directives. It involves the equal and fair distribution of food and safe water, and the promotion of methods for prevention and control of diseases. Self-reliance focuses on the individual welfare of patients, and emphasizes on the ability and willingness of individuals in the society to participate in certain programs and interventions that would benefit them, such as family planning and immunization. Prevention focuses on the different methods that can be employed in order to avoid diseases and illnesses, and emphasizes on the significant role education plays in providing relevant information to the society. Prevention also employs the provision of certain drugs, such as supplements, vitamins, and other substances that can be used for treatment and for increasing the resistance of individuals to diseases.
The primary barrier to the implementation of primary health care is language or the lack of communication, for without proper and effective communication, a good relationship would not be able to exist between the patient and the medical practitioner. Another barrier is socioeconomic status, as limited financial resources would restrict socially challenged individuals to seek adequate and quality medical help. Third barrier is discrimination, whether, cultural, gender, or economic, which generates biases for both the patient and the medical practitioner in terms of providing adequate information and treatment and violates equality. Fourth barrier is the lack of education and relevant information regarding health and hygienic practices. Last barrier is the cultural and social perceptions of both the patients and the medical practitioners of the concept and preservation of health.
The Alma Ata Agreement emphasizes the agreement affirming the right of all individuals to health, and in order to do so, different factors underlying social, economic, and political factors must be addressed. The declaration of health in the Ottawa Charter is also related to the declaration of Alma Ata, with a particular emphasis on public health policies to build personal skills, enforce community action, support environments, and develop health services for all. From these declarations, different actions and interventions have already been reinforced in different countries and societies to promote health for all peoples. Aside from the continuous provision of information through education, discussion, and lectures, promotion of health is done in the society through disease prevention programs, health education programs, and early detection and administering proper treatment to patients of diseases.
In line with the promotion of health in both the Alma Ata and Ottawa Charter is the response of Hong Kong and its citizens to health and health programs. Such a response is evident in a study made by . (2000), wherein health-promoting schools are being introduced as intervention measures in order to improve the health of students and all the members of the community, and to develop their learning potential. In line with the emphasis on education, health-promoting schools also focus on the overall improvement of education community of children through improving its sanitary facilities, improving school policies, and providing direct interventions for treatment.
Selective primary health care is the provision of treatment or preventive practices to combat selected diseases that cause the increase in mortality and morbidity rates in a certain population. In employing selective primary health care, the prevalence, incidence, morbidity, mortality, and feasibility of control are important factors to be considered. Advantages of using this type of health care include reduction of costs, focusing on certain disease problems, narrow scope, and affordability for developing countries. On the contrary, comprehensive primary health care combines health with the total development of the community, thus, promoting the participation and collaboration of the members of the community, and its use of appropriate tools, processes, and technology. It allows the management of new emerging health problems, without establishing additional structures ( 1994).
Week 5 and 6
The process of developing a public policy involves four stages, namely, genesis of the public policy, development of the public policy, implementation of the public policy, and feedback on the public policy (‘’ 2007). The first stage or the formation of the public policy is being started based on an identified problem or need. An example of an issue or problem in relation to health in a community is the increasing prevalence of helminthes in the digestive tract of children. The second stage of the process is the development of the public policy, which is assisted with the use of the different data gathered or collected from the target population. It is also based on the problem identified in the first stage, and must correspond to the population being affected by the problem. The third stage, which is the implementation of the public policy involves imposing the actual public policy to the target community or communities, and requires the coordination and the cooperation of the whole community. This stage uses a variety of methods and means of communication in order to reach and relate effectively to the individuals concerned. An example of a public policy implemented is the provision of health-promoting schools in China, which would focus in providing relevant information and education to students. The last stage is the evaluation of the public policy imposed in the third stage. Through evaluation, the community would be able to assess the positive and negative impacts of the public policy to the society concerned. If more positive impacts are determined, then the public policy is successful, but if more negative impacts are determined, then changes have to be done to the public policy.
Skills in lobbying and advocacy for a health-promoting nurse are important because such skills would enable them to gain more experiences in their work and provide better services to their patients. Advocacy would enable nurses to argue or fight for an idea or nursing practice, which they believe would provide benefits to patient, while lobbying would enable them to achieve their goals through their efforts. These skills are needed because they are the ones immediately attending to patients, and are the ones more knowledgeable with their physical, medical and mental conditions. Through lobbying and advocacy skills, nurses would be able to promote the health of their patients more effectively, and provide them with better services in the medical premises.
Community participation is the involvement of the members of the community in all aspects of development and implementation of policies, which results of the empowerment of the whole community ( 2000). This results to the continued collaboration and cooperation of the members of the community, enabling members to achieve their goals faster and more effectively.
Benefits of community participation to an individual include openness to individual idea or opinion, expression of creativity and uniqueness, freedom of expression, developing a critical mind, and gaining respect from the community and from other individuals. Benefits of community participation for the community include the generation and collaboration of a variety of ideas and opinions, cooperation within the community, sharing of resources and needs, expressing wants through a unified goal, direct provision of solutions for conflicts and problems, and developing teamwork and effective communication. Benefits of community participation in health public policy include a health public policy that caters to all the needs of the individuals in the community, generating a public policy that is fair and justified, and creating a health public policy that promotes and improves the well-being and growth of individuals.
In the promotion of health in a community, different types of needs of individuals must be taken note off, namely, felt needs, expressed needs, normative needs, and comparative needs. An example of a felt need is the need for women to reduce their weight in order to stay fit and healthy, and as such, women may engage in vigorous exercise and strict diets. An example for an expressed need is to increase the number of healthcare centers and clinics in an area, which would increase the rate of providing health care for patients in a certain community. An example for a normative need is to implement public health strategies that would reduce the incidence of children and adults killed due to leptospirosis, which are based on the findings of experts. An example of a comparative need is when community X needs to have their own fitness gym because community Y already has one.
Accessing relevant information about a certain community can be done in a variety of ways. This can be done through accessing information using the Internet, using the archives and other reading materials in the community’s library, and accessing information based on the information shared by the oldest resident in the community.
References
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