Health in Greenwich Borough - Case Study Example

Name Grade course Institution Tutor Date Health in Greenwich borough Introduction This report will discuss the social determinants of health in Greenwich borough. The paper will also discuss the relationship between teenage pregnancy and the prevalence of sexually transmitted infections (STI). This will be followed by analyzing how UK and Greenwich are currently addressing this challenge by focusing on the health policies adopted. Demography information of Greenwhich Borough The London Borough of Greenwich is located on the South-Eastern London. It took its name from the historic town of Greenwich in 1965. It has a land cover of 47.36 square kilometers making it the 13th largest borough in London. The census result of 2011 indicated that the borough has a population of around 245, 586 (female population comprising 50%). One fifth of the total population is aged below 15 years, 11 percent are aged 65 years and above. The population is expected to grow by 52, 175 (21 percent) in the next 10 years and 64, 526 (26%) in the next 20 years (Greenwich Council 7. The population of the elderly people has been decreasing over time. The people aged 60 and above comprised of 19% of the total population according to the 1991 statistics. In 2001, the figure of the same age bracket comprised of 16.9% while in 2011 the same group people made up 15% of the total population. The number of the elderly (those aged 85 and above) stood at 7.2% of the 60 years and above population in 2001, it rose to 12% in 2001. The ethnic minorities and the blacks stood at 33% according to the 2010 statistics. There are over 100 languages spoken in Greenwich Borough, the largest ethnic group being white followed by black British (11.1 %) while Asians and Asian British comprise 6.8%. Further, 72% of the total population is people who were born in the United Kingdom. 67 percent of the population is employed while 14 percent of the working age population does not have any qualifications. Social determinant of health According to the World Health Organization, health is defined as a condition of complete physical, mental and social well being of a person without the any state of illness. From this definition, it can be noted that health is related to a state of wellbeing which can be interpreted as a condition of being happy, relaxed and feeling comfortable in one’s current state; this implies that psychological well-being is a key determinant of health (Marmot & Wilkinson 62). A social determinant of health is a condition that greatly influences an individual’s health from a social perspective. The social condition is also to most likely to affect a person’s functionality. For instance, factors such as the quality of education a person receives and the access to that education; this may be as a result of poor housing condition or lack of good transport systems. Other factors may be food availability, workplace stress, disabilities among others; these factors may psychologically affect a person’s health and functionality from a social perspective (Abdesslam 28). WHO goes further and defines health inequalities as the difference in health status or how the health determinants are distributed between different groups of population. For instance, the mobility difference between the elderly class and the younger population or difference in mortality rates between people of different social classes. Health inequalities may result form biological conditions or free choice while other may be as a result of the external environment as well as conditions that are beyond an individual’s capability to control (Hunter, Marks & Smith 44). Social determinants of health should be tracked from pre-conception to birth, growing up to early prevention and from working to the age of growing old. Particularly, early prevention is more important than dealing with the results of already worse health condition in later stages of life. For instance, babies who are exposed to smoking face the challenge of mortality and low birth weight and even heart diseases later in life (Abdesslam 31). Early booking/early scans Just like other Boroughs in London, Greenwich experiences a couple of health issues arising from social determinants of health which lead to inequality. For instance, Greenwich records low levels of early booking as well as few early scans in the recent past. However, the rates have increased after an outreach program to the early African communities that did not value the need for early booking and ante-natal care which are very useful in preventing a new-born baby (Burnett & Peel 606). Babies born in Greenwich are exposed to major health challenges as a result of the lifestyles of the mothers. Particularly, White British mothers have high levels of smoking habits. A research conducted in 2007-2010 indicated that 45% of the White British mothers of below 20 years who gave birth at Queen Elizabeth Hospital smoked at the time of delivery (Sheldon & Macdonald 71). Smoking mothers expose their babies to major health risks. Statistics of 2010 show that 6.7% of the babies in Greenwich were born with low weight of less than 2500g which may cause the baby to die in the first month of birth. Such deaths are highly attributed to smoking among pregnant women. Lack of early screening has also posed a major challenge to the lives of the children as well as the mothers. Screening conducted at Queen Elizabeth Hospital between 2008 and 2009 indicate that there were 361 cases of HIV, syphilis and hepatitis B. such conditions can only be identified through early booking and may help to save the life from infection in the uterus (Scriven & Hodgins 62). Obesity problem has been prevalent in the entire United Kingdom both in adults and children. The lives of children with obesity are faced with many risk factors in their later life like cancer, diabetes, heart and liver diseases. Greenwich has been aware of such risks and is reportedly implementing programs like National Child Measurement Programme which is a school-based initiative meant to keep check on the prevalence of overweight and obesity in young children below six years. In 2010/11, the program recorded a 12.4 percent of reception age children had obesity while 14.9 percent were overweight (Burnett & Peel 607). Such figures indicate that the prevalence of obesity is very high in Greenwich a situation that is very worrying as the graph below indicates. Percentage of Obesity in Reception for Greenwich, its comparators, London and England, 2006/07 – 2010/11 Source: NCMP Teenage pregnancy in Greenwich borough Since 2001, teenage pregnancy in Greenwich borough continued to rise exceeding that national average. In 2001, the 67.8 per every 1000 women under the age of 18 got pregnant in Greenwich while the rate in England and Wales was 42.5. This implies that the Greenwich rates are 50% above the national average. It can also be translated to mean that there were about 100 extra conceptions in girls between 15 and 17 years each year in Greenwich. The target of reducing such early pregnancies is set to 55 percent reduction by the year 2010. In an effort to reduce sexually transmitted infections, teenage conception among young girls has been greatly reduced (Kelly 1644). Sexually transmitted infection (STI) in Greenwich STIs have been very prevalent among young girls in Greenwich. A disease like Chlymydia is mostly diagnosed in girls between the age of 16 and 24 years. Chlamydia testing is being done in some specific pharmacies for girls within this age group. This has prompted Greenwich to come up with National Chlamydia Screening Programme which is meant to screen, test and treat girls for the purpose of reducing its prevalence in 2006 (Burnett & Peel 607). Greenwich health surveys have indicated that patients would prefer services to be provided though community pharmacies. In response to this demand, free emergency hormonal contraception is provided to all girls under the age of 21 through most pharmacies in Greenwich. If pharmacies can provide guidance and advice services to the young girls, the high figures of STIs can be greatly reduced since the service targets the young people. Providing Chlamydia testing services in community pharmacies within Greenwich ensures that the services are accessible to many young people and this will help in reducing infections by ensuring that the is early detection hence early treatment. Boots and Chemists are currently providing free confidential Chlamydia screening in Greenwich (Marmot & Wilkinson 112). Greenwich Village has seen the highest cases of gonorrhea according to some latest statistics by New York review. The rate of gonorrhea infection amongst women in Greenwich increased by 57 percent from 28 per 100,000 to 44 per 100 0000 between 2008 and 2010. This is a large increase as compared to Manhattan where the infection rates increased by 2.1 percent for the same period. Doctors could not understand the factors leading to the high rates of infection but they acknowledged that the rate of testing was increasing and they were in a position to capture more people through testing. Health official also noted that there was lack of adequate education about STIs other than just HIV (Madge 1069). Education For people to live a healthy life, the environment in which the young people are born, develop and grow needs to be healthy. For purposes of building up such a healthy environment, the people need to be equipped with knowledge and skills that are relevant. The process of learning should start with the parents being supported in order to equip them with parenting skills. Schools have a key role to play in offering the students with high quality learning environment where the children can comfortably flourish. In the recent years, Greenwich has witnessed the number of childcare providers and places fall gradually. Ofsted’s summary of registered childcare providers and places indicated that there has been a net loss of 236 places in Greenwich between May 2010 and May 2011 following a 456 places’ loss in the previous year. In addition, education achievement in Greenwich has been low compared to London and national averages. Attainment variations have been recorded at GSCE level between different ethnic groups in Greenwich borough; for instance, Pakistani, Indian, Nigerian and Chinese performed better than others like Turkish, White British and Black Caribbean (Greenwich Council 8). Policies which address chosen problem (disease) The UK department of health is tirelessly working hard to reduce the infection rates of STIs as well as unwanted teenage pregnancies which have been a major problem in UK. Statistics indicate that the conception of girls under 19 has been growing at 12 percent rate, while aborting rates are at around 11 percent. Most of the abortions are done by girls below 19 years. In 1998, the UK health department responded by setting up a Teenage Pregnancy Unit which a 10-year strategic action plan which was mandated to halve the conception rate of under 18 girls. The objective of the program was to ensure that more teenage girls were enrolled in sex education classes as well as getting majority of the teenage girls to work if the were not in school so as to avoid the issue of social exclusion in the society. Greenwich responded well to the problem by lowering the teenage pregnancy rates by 21 percent. This was after actively ensuring that young people were educated on sex and relationship matters, increasing the availability of contraceptives, opening up of more sexual clinics and reducing the chances of teenage girls working with young boys and young fathers (Scriven & Hodgins 77). In 2010, the Greenwich Department of Health emphasized the need to make contraceptives more accessible to and available to all people who needed them. The department further emphasized that the choice on what contraceptives to use should be left to the couples and individuals who needed to use them, the guidelines on how to use the contraceptives were posed on the department’s website. In order to ensure that the young people were comfortable in using the contraceptives, the services needed to be free and confidential. The policy statement adopted by the health department indicated that anyone under the age of 16 should be allowed to use the contraceptives as long as the person is mature enough to understand why there is need to use the contraceptives (Kelly 1645). Clinics and health facilities in Greenwich are required to give out contraceptives including condoms and the doctors are supposed to provide information on how to use the contraceptives. Other health facilities encourage the doctors to provide the teenagers with information on how to use the contraceptives as well as provide them with leaflets that contain usage guidelines; the patient is not allowed to leave the facility if he or she is not satisfied with the information provided. The main aim of the contraceptives is to reduce teenage pregnancy as well as to reduce the rates of STI infection. With majority of the people being able to access the internet, sexual health clinics in Greenwich posts the vital information required by the patients online. Further, the Data Protection Act of 1998 supports the patients rights to confidentiality and access to information about them. Therefore, Greenwich health facilities are required to store personal data about patients in a computer and under no circumstance should such information be made public. This ensures that more people are free to go for check-ups and screening in the health facilities without any fear of their information being disclosed to un-intended parties (Kelly 1646). The National Strategy for Sexual Health and HIV of 2008 is another action plan by the UK government meant to reduce the spread of sexually transmitted diseases though more early detection and timely treatment. According to the Greenwich borough, the aim of this policy is to ensure that the clinics are opened at appropriate times for all people to access the services. The policy also recommends the need to have quick and rapid diagnosis with the maximum time taken by clinics being 10 days. The overall aim for quick diagnosis is to ensure that the spread of STIs is countered on a timely manner (Hunter, Marks & Smith 83). Partnerships Bexley and Greenwich Health improvement 1999/2000 is one of the new partnership programmes which is aim to deliver plans for each priority area. The programs call for all health Authorities in Greenwich and Bexley to have a Health Improvement Programme (HIP). Basically, HIPs are local plans of actions meant to improve and modernize health; they are based on government’s role of providing quality health services, strong communities and quality public services. The Health Improvement Programme brings many health service providers like local authorities, volunteers and health institutions together for the purposes of setting the strategic framework necessary for improving health, reduce health inequalities, and develop high standard services. The programme is action-focused; it aims at setting out high level objectives as well as a summary of the goals to be achieved in delivering quality health (Sheldon & Macdonald 66). The Health Improvement Programme is perceived as work in progress, it is also seen as a means of developing an integrated approach in tackling the health challenges and inequalities. Updating of the programme was suggested to be done every year implying that the programme had a chance of being updated primary care groups and partnership boards in future. The local medical committees represented General Practitioners in the Collaboration Working Group. The working is expected to spearhead the development of proposals for Health Improvement programme (Sheldon & Macdonald 79). Public involvement The local people have been provided an opportunity to air the views. The proponents of public involvement include distribution of leaflets which are printed in many minority languages, tape, Braille and press articles. In addition, the public is allowed to raise its views through listening days and meetings with the local community. The listening days are mainly held in supermarkets and the interest of the public as well as it opinion are noted. The Greenwich and Bexley Councils also ensure that there are racial equality facilitated meetings that takes into account the interests of the refugees and the asylums through interpreters. Specifically, the public’s view on the impact of the STI diagnosis and treatment is sought. The public is also enlightened on the need for early diagnosis and treatment of STIs and why it is important to use contraceptives like condoms (Marmot & Wilkinson 33). Public health provision The Greenwich Department of health is mandated to serve the residents of Greenwich; it has been place for the last 125 years. Specifically, the department is tasked to creating health and safe environment in order to ensure that all the residents enjoy a health life. The department is responsible for protecting, improving and promoting healthy life for Greenwich residents by implementing essential public health provisions. The department monitors the status of public health, enforce laws, investigate cases of public health, develop health policies, educate the public and allocate resources to respond to health challenges facing the residents (Marmot & Wilkinson 37). The Office of Special Clinical Services is specifically established as the primary STI prevention program for Greenwich borough. The office operates in collaboration with Greenwich hospital to conduct risk assessment, referrals, counseling, treatment and testing in order to reduce mortality arising from STI/HIV and pregnancy. The health department has set up many places where young people can easily access free condoms. Specific group of young people targeted is the college students; the college health centre should provide the students with information on why to use condoms and other contraceptives (Sheldon & Macdonald 93). The Greenwich Adult Health Services program has also establish provisions to control the spread of STIs. The program has provisions that provide integrated and comprehensive approach to prevent to control sexually transmitted infections and HIV. The program has components that provide STI prevention awareness to groups of people engaging in high risks behaviors like teenagers. The program offers free HIV testing and counseling to such target groups. Conclusion This paper has analyzed the social determinants of health in Greenwich borough. The report has established the impacts of such social determinants on the health of the people and specifically STI and teenage pregnancy. STIs have been noted as a serious challenge for the Greenwich borough Health Department. However, the Greenwich Health Department is working tirelessly to address the challenge by implementing local and national policies to stop the spread of STIs infection across its people. The report has noted that there are various programs and partnerships that are put in place to ensure that the public is made aware of the serious challenge and that the members of the public are willing to participate in the fight against STI. Works Cited Abdesslam, Boutayeb. Social Determinants, Health Equity and Human Development, London: Bentham Science Publishers, 2009. Print. Burnett, Angela & Peel, Peter. The health of survivors of torture and organised violence. British Medical Journal, 322(7286): 606–609, 2011. Greenwich Council. Greenwich Joint Strategic Needs Assessment: “Where’s the Gap?” The Impact of Deprivation on Health and Well-being in Greenwich 2009-2010 Draft 14.01. London, 2011. Hunter, David, Marks, Linda & Smith, Katherine. The Public Health System in England, London: The Policy Press, 2010. Print. Kelly, Sally. Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial. British Medical Journal, 340: 1642-53, 2010. Madge, Sarah. Demographic, clinical and social factors associated with human immunodeficiency virus infection and other sexually transmitted diseases in a cohort of women from the United Kingdom and Ireland. International Journal of Epidemiology, 27,(6): 1068-1071, 2008. Marmot, Michael & Wilkinson, Richard. Social Determinants of Health, London: Oxford University Press, 2009. Print. Marmot, Michael & Wilkinson, Richard. Social determinants of health: the solid facts, London: World Health Organization, 2003. Print. Scriven, Angela & Hodgins, Margaret. Health Promotion Settings: Principles and Practice, New York: SAGE, 2011. Print. Sheldon, Brian & Macdonald, Geraldine. A Textbook of Social Work, New York: Routledge, 2008. Print. Read More