Health and Health Care in London - Essay Example

Introduction: Love and lust have played vital roles in transformation of the healthy civilized society into the present perilous condition. The aftermath of the love for narcotics and lust for human body have resulted in many deadly diseases like cancer, AIDs, STIs and STDs, cardiovascular complications and so on. Perhaps, because of the ancestry link with the ancient monkey, man has never felt shy of getting infected by the viral strains from the rhesus monkey. The external manifestation of the internal deficiency caused by the Human Immune Virus (HIV) has crossed many international boarders and have had become concern for the modern civilized world. The most horrifying feature of the United Kingdom's demographic feature can be revealed from its burgeoning public health issues over years. The ever rising population, uncontrolled pollution and the bestiality of human desire has dragged out the so called most civilized master of the medieval world to such a point where the future of the country is a big question for the thinkers and planners. A sizeable portion of the country's resources are being diverted towards combating diseases of modern era. Brief World Scenario on HIV (Source: UNAIDS): In 2007, over 33.2 million people on this earth were reported to have been infected by the HIV out of which 2.5 million were newly infected and 2.1 million people died of AIDS related illness in that year. Globally the Sub Saharan Africa reported 22.5million people living with this deadly disease. It was also reported highest deaths of 1.6 million and new infections of 1.7million followed by the South and South East Asia with 4 million infected people. However the Caribbean region is having second highest adult HIV with 1 percent of adult population infected. (THT Direct 2007) Statistical Overview of United Kingdom: The statistics of the country revealed that HIV has been the fastest growing serious health concern in the UK. Around 89,0000cases of HIV have been reported since 1980s and out of which 17,597 people have already died. There were 7,450 new diagnoses in 2005. The most dangerous information about this disease is that more than 30 percent of the people living with HIV are not aware of their infection. So far as the sexuality of infection are concerned men out numbered women with 2:1 ratio. Anther interesting thing is that 43 percent of all new diagnoses of HIV in 2005 were in London. Near about 30 percent of the HIV diagnoses in 2005 were among homosexual men. HIV has drastically hit the gay community in this country. (UK HIV statistics 2007). The statistical observation of last 17 years data showed that highest numbers of new diagnoses of HIV were among gay men and men who ere having sex with the men except in 1999 when the heterosexuality acquired diagnoses out numbered within UK. However, the diagnoses among gay men have been in steady rise. In other words the number of cases of HIV diagnosed gay men has been increasing alarmingly since 1999. Among all infectious diseases in the country, HIV is the fourth most commonly diagnosed major sexually transmitted infection among gay men. Near about 31, 100 men who have sex with men are HIV positive. When we observe the condition of UK in the Global frame, it is having 45 percent of all HIV cases and 57 percent of all AIDs cases reported. In 2006, nearly 32 percent of new diagnoses for HIV were among gay men. 43 percent of are living with HIV infection. 63 percent of newly acquired infections are in UK. At the end of 2002, approximately 15,400 African men and women were living with HIV in the UK, out of which 31 percent were undiagnosed. (THT Direct 2007) Demographic and Ethnic Overview of London: The number of people needing HIV care in London during 2005 was 22,473 and during 2006 it increased to 23,986. Between 2005 and 2006, 30 percent of people in the region living with HIV remain undiagnosed and the number of people accessing National Health Service for HIV in London has been reported to have increased by 7 percent. Nearly half of all gay men in London with gonorrhea also had HIV as reported in 2005.. . (THT Direct 2007) London Borough of Barnet: The London borough of Barnet was formed in 1965 from the Municipal Borough of Finchley, Municipal Borough of Hendon and the Friern Barnet Urban District of Middlesex and the East Barnet Urban District and Barnet Urban District Hertfordshire. It is surrounded by the Boroughs of Harrow, Brent, Camden, Enfield, Haringey and the County of Hertfordshire. It is having the administrative head quarters of North London Business Park. It is the second largest borough of Barnet situated in North of London covering 86.74km (33.5square miles) split into 21 wards and embracing 3,14,564 people in it which was highest in London as per the census 2001 and ranked 11th among 354 boroughs of the United Kingdom. The average density of population is 3,788 per square kilometer. (THT Direct 2007) Demography: The population of Barnet as per 2001 census increased from 2, 93,663 in 1991 to 3,14,564 in 2001 with increase in males from 1,39,573 to 1,49,781 and females1,54,090 to 1,64,783, respectively. So far as the demography is concerned 22 percent are aged under 18, 25 percent are below 20 and 18 percent are aged above 60 years. The proportion of the population from black and minority ethnic is 18 percent. The borough has an unemployment rate of 4 percent which is below London average of 5.2 percent. It is the prosperous borough compared to other London authorities but there are a few pockets of deprivation. (census 2001) Ethnicity: Barnet is having 11 percent of other white residents and the number exceeds 34,000. Most of these are Jews of central and east European origin. The descended people of Austria and Germany during the reign of Nazis just before World War II constitute the greatest part of this group. Moreover, this white group also includes 3,600 Cyprus born people leaving in Barnet. The diversity index of 0.62 as per the office for National Statistics is calculated as the probability that two people selected by random sampling from a particular area would be from different ethnic groups. Only Bangladeshis fall below the national average. Asians constitute over 12 percent of the population which is about average for a London borough. Only 6 percent of the populations are black and three-quarters of this group are having Black African origin. Out of 39,000 people 27,000 are Indians accounting about 9 percent of all people in Barnet. The Chinese people constituting about 7 percent of the population including that of 2,000 born in the Hong Kong reside in small area of Colindale. Whereas Barnet embraces largest Chinese population in London and about 6,500 Chinese people stay in Barnet. In terms of proportion it is second only to Westminster. These two boroughs among where Chinese people make up more than 2 percent of the local population.(Census 2001 & 1991) Table-1: Ethnic Profile of the Barnet local authority region (National Statistics website) Ethnic group/sub-group Population Percent to Total Population Barnet UK White 232,868 74.0 90.9 British 188,301 59.8 86.9 Irish 10,545 3.35 1.27 Other 34,022 10.8 2.66 Mixed 9,508 3.02 1.3 White and Black Caribbean 1,670 0.53 0.47 White and Black African 1,590 0.50 0.15 White and Asian 3,218 1.02 0.37 Other mixed 3,030 0.96 0.3 Asian 38,795 12.3 4.57 Indian 27,130 8.62 2.09 Pakistani 3,965 1.26 1.43 Bangladeshi 1,445 0.45 0.56 Other Asian 6,252 1.98 0.48 Black 18,859 5.99 2.30 Caribbean 4,113 1.30 1.14 African 13,651 4.33 0.96 Other Black 1,095 0.34 0.19 Chinese 6,379 2.02 0.44 Other ethnic group 8,155 2.59 0.43 Total 314,564 100 100 ( Census 2001, Office for National Statistics) Epidemiology: The HIV in the United Kingdom is growing at a greater pace compared to any other serious health hazards. There was a 70 percent increase in the number of persons diagnosed each year with 6,500 new cases reported over last three years i.e. from 1999 to 2002. In 2000, 3,918 people were found to have been infected with HIV. There was an estimation of a two fold increase in the total number of people living with HIV from 2000 and 2005 which means to 50, 000 persons were estimated to have been diagnosed in 2005. The situation is grim to learn that one third of the people are unaware of their infection and remain undiagnosed. There is a positive correlation between other sexually transmitted infections like Chlamydia, Gonorrhea and Syphilis the cases of which are also increasing sharply. (THT Direct 2007) So far as the mode of transmission of the disease is concerned, since 1999 majority of new HIV infections were reported to have been through homosexuality. Transmission among the gay men is the major route spread. Transmission through injecting drugs accounts for a very small but stable portion of the new infections. The number of deaths associated with HIV infection fell sharply during the late 1990s due to wide spread treatment measures. The current death rate of 400 per year is likely to remain stable. The lower date rate associated with newer treatment methods have led to sharp rise in the total number of new people getting infected annually. In 2000, the total people infected were approximately 24,000 which then increased to 34,000 by the end of 2000 which would increase geometrically by the end of this decade. It is also to visualise that the actual number of people diagnosed of getting infected with the virus is much higher as one third of people are unaware of their status. Social Determinants of Barnet: As per the census report 2001 the following social determinants were observed in the Barnet borough of London in United Kingdom. Familial Status: The Barnet borough was having 89904 (35.8%) unmarried people, 120180 (47.9%) married and remarried people, 22018(8.8%) separated or divorced and 18706 (7.5%) widowed people. Households: There were 39751 (31.3%) one person households, 43853(34.5%) married couple households and7832 (6.2%) cohabiting couple households. Out of 126944 households with residents, 84518 (66.6%) were owner occupied, 3780 (2.9%) were vacant households, 6405(5.0%) were without central heating and 1227 (1.0%) were without bath/shower & toilet. Health: So far as the health issue was concerned 4598 (14.6%) were suffering long term illness, 22938(7.3%) people with normal illness and 28171(9.0%) people providing unpaid care. Employment: In the Barnet borough, 140542 were employed, 7758 were reported unemployed out of which 2343 were long-term unemployed. 6448 students were economically active and 16882 were economically inactive. There were 23035 retired persons and 170069 persons looking after home. Education: The Barnet 80907 (35.5%) people were reported to have degree level or higher qualifications and 44806 (19.6%) were having no qualifications. Transport: 63295 (43.4%) numbers of people were reported to have been traveling by car and 53970 (37.0%) were reported to have been traveling by public transport. The key determinants for HIV can be summarized as follows Fixed Social and Economic Environment Life style Access to services Genes Poverty Air quality Diet Education Gender Employment Housing Physical activity National health Service Ageing Social exclusion Water quality Social environment Smoking Alcohol Drugs Social services Leisure (Barnet Care Trust Report) Policy, strategy and interventions: While formulating the policy frame for HIV issues, the following salient points are to be taken into account.- 1. Sexual health needs of the people infected with HIV are to be taken care of. 2. Mental heath condition of he people are to be diagnosed. 3. Earlier HIV diagnosis should be done. 4. Individual strategies to get rid of STIs are to be adopted. 5. Salvage therapy should be implemented. 6. Awareness generation on HIV 7. HIV prevention in Infected cases 8. Research on HIV cure. 9. Criminal prosecution against forceful dissemination of HIV. 10. State funding for NGO and private sector organizations for anti- HIV activities.. 11. Sexuality education in school and Universities. 12. Foreign policy against immigration of HIV infected persons. 13. Social involvement of HIV infected persons. In the Barnet borough the following HIV-health programs have been initiated. A5 Partnership - the road to better health program: It has been initiated for improving the early detection of HIV/AIDS and trying to reduce their incidence through raised awareness and healthier living. The Aware dressers scheme: The Aware dressers scheme is a joint project between Barnet PCT and a number of storefronts in west Barnet. The volunteers comprise local African businessmen who have agreed to raise awareness of STIs and HIV and distribute literature and condoms to their customers Men's health Program: This program is concerned with the HIV prevention of gay and bisexual men. The Mystery Shopper Project: This project was reported at the Second Joint British Association for Sexual Health and HIV and at the 2004 UK Public Health Conference PHA Annual Conference. HIV-Health Services in Barnet: The address of the major help lines of Barnet are given below National AIDS Helpline Terrence Higgins Trust Direct Helpline A free and confidential helpline providing Information and advice on HIV/AIDS and sexual Health 0800 567 123 (Free phone) Text phone 0800 917 8765 Open 24 hours This helpline supports people emotionally and extends advice about HIV. 0845 1221 200 (THT Helpline) Text phone 0800 521 361, Email info@tht.org.uk Website www.tht.org.uk, Open Mon-Fri 10am-10pm, Sat-Sun 12 noon-6pm Discussion: Human Immune Virus (HIV) has infected 33.2 million people on this earth of which 2.5 million people were newly infected and 2.2 million people died of AIDS related illness in 2007. Around 89,0000cases of HIV have been reported since 1980s and out of which 17,597 people have already died in the United Kingdom. Among the population gay men constitute highest proportion of HIV infection. Near about one third of the people has not been diagnosed for HIV. When we see the UK in global frame, 45 percent of all HIV cases and 57 percent of all AIDs cases are reported here. Moreover, 63 percent of the newly acquired infections are in UK. The number of people needing HIV care in London during 2005 was 22473 and during 2006 it increased to 23986. The London borough of Barnet 6500 people were affected with HIV as reported in 2002.The situation is aggravating due to break through in the medical science and reduction in the death rate. So far as the mode of transmission is considered majority of cases were through homosexuality. The social determinants like family status, household, health, employment, education, mode of transportation, etc. are found to have influence on the HIV on epidemiology of HIV. Policy, strategy and interventions are being made to restrict the ever increasing rate of HIV infections. Mental health and physical health check by experts, awareness about the HIV and AIDS, earlier diagnosis, legal criminal action against offenders and transmitters, development in research, sexuality education in schools and universities, foreign policy restricting immigration of the infectious human beings, funding of private and public participation have a positive bearing on the health of the men in UK in general; and the Barnet borough in particular. Conclusion: The deadly infectious disease spreading like wild jungle fire among the gay men of the United Kingdom in general and Barnet borough in particular ahs perilous impact on the human civilization. It is high time to take adequate socio-economic and technical measures to reduce it and have control; over the situation and to live in a healthy atmosphere. References: THT Direct 2007. ' UK and world wide' The HIV and Sexual Charity for life. Bulletin view. 20 May 2008 < http://www.tht.org.uk> THT Direct 2007. ' London' The HIV and Sexual Charity for life. Bulletin view. 20 May 2008 http://www.tht.org.uk/binarylibrary/stats/11-07/london.pdf THT Direct 2007. 'The Gay Men and HIV-A call to Nation' The HIV and Sexual Charity for life. Bulletin view. 20 May 2008 < http://www.tht.org.uk/binarylibrary/gaymenourcall.pdf> THT Direct 2007. 'Ethniocity' The HIV and Sexual Charity for life. Bulletin view. 20 May 2008 http://www.tht.org.uk/informationresources/professionals /healthworkers Wikipedia 2008, ' London Borough of Barnet' Wikipedia free encyclopedia. View 20 May 2008 http://en.wikipedia.org/wiki/London_Borough_of_Barnet Barnet Census route 2001 'Bulletin' Borough level by statistics. View 20 May 2008< www. May 2005. UK HIV statistics 2007, 'Information resources' HIV in the UK: facts and statistics View 20 May 008. UK and World Wide,2007, Information resources' HIV in the UK: facts and statistics View 20 May 008http://www.tht.org.uk/binarylibrary/stats/11-07/ukandworldwide.pdf Census 2001, 'Population, Place, Families; National Statistics. View 20 May 2008.. Commission for racial equality 2007, 'Diversity and integration' Ethnicity Profile- London. View 20 may 2008. Barnet primary 'Trust, Improving health and well being in Barnet update' View 20 May 2008 Read More