Health Policies: Marmot Review, Healthy Lives, Healthy People and Obesity - Essay Example

? HEALTH POLICIES (MARMOT REVIEW, HEALTHY LIVES, HEALTHY PEOPLE AND OBESITY) Neo-Liberalism and Obesity Neo-liberalism has a massive impact on prevalence of obesity. Neo-liberalists top the list of obesity cases. United States, United Kingdom, Mexico, Australia and Canada have the highest numbers of individuals suffering from obesity. In comparison to other countries such as Japan that endorse other modes of capitalism, 32% of UK citizens are obese compared to 3% in Japan (Chung & Muntaner 2007, 83). Neo-liberalism focuses on reducing the cost of production at all perspectives, thereby diluting the quality of food produced. Food firms produce large quantities of food using cheap, unhealthy ingredients, thus escalating the rates of obesity (Chung & Muntaner 2007, 89). This is the phenomenon that accounts for the ascending numbers of obese people in England. In this respect, there is need to have policies that stem the impact of this governance and economic mechanism to have a healthier nation. The White Paper attempts to find the solutions to the deep seated problem. Definition of Policies in Health Context Policies refer to the aims and objectives that a party or a government intends to achieve and uphold in the interest to the nation and its citizens. In health industry, policies are made by the government to maintain a healthy society. From 1970s, implementation and drafting of health policies has been based on preventive measures rather than curative measures as was earlier done (Chung 2007, 21). Health sector and stakeholders in the health industry have realized through rigorous studies that curative measures are expensive and yield no marginal benefits. Policies regarding health of the society are drafted and formulated for implementation by the government with wisdom and prudence in provision of superior health management (Erickson & Wilson 1994, 32). A health policy is usually a course of action and a method of intervention selected from among other alternatives to guide the present actions and determine future course of actions in the future. Health policies are high level general plans that embrace the overall goals and acceptable processes within the health sector. Features of Obesity Policies As this work deals with health policies in relation to obesity, it shall discuss some of the pertinent features of a policy in connection with the subject matter. Foremost, a policy must have a decision and an action. The government acknowledges the effect and degree of obesity in the society and makes a decision to curtail its negative effects. According to researches, there is a correlation between obesity and economic status of the affected people. The government acknowledges the fact that obesity is a chronic condition caused by behavioral factors (Boswell 2005, 24). In coming up with the policies to combat obesity, the government makes a decision to deploy means of nullifying all the negative externalities that accrue to social and health effects of obesity. The other feature of policy is action. The process of putting in place a policy to guide the public on issues relating to obesity is not complete with mere decision of the government to curtail obesity. The government must go a step further to take practical actions to curb obesity. The action should be geared towards reducing the costs of obesity treatment. The earlier measures and policies governments placed of curing maladies have been faced out due to their high costs (Borrell 2009, 43). Curative measures have led to elimination of infectious diseases, but not social and behavioral complications such as obesity. An action plan that attempts to provide formidable solution to prevalence of behavioral complications such as obesity involves formulation and implementation of health policy that recognizes intricacies of behavioral complications. Such a policy is geared towards making everyone custodian of his own health. It is a policy that makes everyone responsible for his health, and devolves the responsibilities of maintaining a healthy society from the government and health agencies. As mentioned earlier, health policies are public policies. They have an additional feature that they are established b the government. The governance of every nation has the responsibility of ensuring healthy nationals. In the aspect of government ownership, health policies concerning obesity are accepted and owned by the public. The government formulates and implements policies that are in the best interests of the public and are, therefore, accepted by the public. The public does all that is within its reach to ensure the health policies gain their desired effects. The third feature in this view point of health policies is the fact that they are accepted by business enterprises. The Marmot Review, Fair Society, Healthy Lives According to the Marmot Review of strategic review of health inequalities in England Post 2010, most citizens of England do not live as long as the richer people in the nation do. The poorer section of England suffers more maladies according to the UCL review named Fair Society, Healthy Lives (Boswel 2006, 32). The Professor Michael Marmot led commission researched and concluded that inequalities in the health provision in England are unfair and unjust. The review proposed new ways to reduce inequalities and improve population’s health. The review concludes that even though inequalities in health provision are associated with the poor, premature deaths and illnesses affect everybody below the wealthiest portion of English society. According to the Marmot Review, individuals living in poor neighborhoods and under poor economic conditions die approximately seven years before the rich counterparts in wealthy neighborhoods and economies. Further, those living under poorer conditions spend most of their lives with disabilities in addition to dying earlier. The average difference of life of rich English and the poorest class is 17 years gap (Barker 1996, 32). The review calls for tackling of climatic conditions as one of the core societal measures to curtail health inequalities. Marmot Review recognizes creation of a sustainable future as a compatible action to ensure reduced health inequalities. These include sustainable local community, sustainable food production, active transport and zero carbon house. These have the effect of inducing health benefits to all people across the community. The review reiterates six major recommendations towards eliminating health inequalities in the health sector. These include giving all children the best start in life and enabling all children of all ages to optimize their capabilities and have full control of their lives. In addition, the review recommends creation of employment and work for all. Furthermore, there is a need to ensure healthy standards of living for all English citizens according to the Marmot Review. Additionally, the review recommends creation and development of sustainable places and communities. Finally, Marmot Review recommends strengthening the role and effects of ill-health prevention (Secretary of State for Health 2010, 02). Healthy Lives, Healthy People In reaction to Marmot Review, several reactions came up in the face of support for the revelations that the ULC led commission had made public. The government of England felt obliged to provide solutions to the health inequalities evident in the country. It pondered over the disturbing realities of healthcare in England and drafted a policy to help curtail the disparities. In November 30th 2010, the Secretary of State for Health, by command of Her Majesty, tabled a policy in parliament to help combat the effects of healthcare inequalities. The policy publication was entitled Healthy Lives, Healthy People: Our strategy for public health in England. The main reason for the creation of this document was to put in to action the recommendations that Marmot Review had made. Healthy Lives, Healthy People, hereby referred to as the White Paper meant to provide a radical shift on mannerism of tackling public health challenges within England. It poised a bold step in a bid to reduce lifestyle-driven health complications that were getting out of hand. According to the report, Britain was the most obese nation in Europe as at 2010 (Secretary of State for Health 2010, 02). The country had one of the worst prevalence rates of sexually transmitted diseases in the entire region. In addition, a significant proportion of the English population used drugs and up to 80,000 people perished every year because of smoking. The government therefore decided to tackle poor mental health of the public to save the situation of their deteriorating corporeal health. The publication appreciated the fact that the gap between the rich and the poor was getting larger (Collins 2005, 32). It acknowledged and regretted the fact that difference in economic status of different citizens still caused a difference in life expectancy. The government’s dilemma in creating an environment that would reduce the behaviorally instigated health problems was the inability to promote healthier lifestyles for the people by dictating how they ought to live. In addition, recommending one-size-fits-all situations for provision of formidable healthcare was not viable. This is because health challenges differ from one neighborhood to another. Despite the challenges, it had to come up with solutions to help reduce inequalities in health provision. Thus it came up with Healthy Lives, Healthy People. Conditions for Healthy Lives, Healthy People to Meet the Recommendations of the Marmot Review In order to correct the inequality issues mentioned in the Marmot Review, it is imperative that any policy formulated to help curtail health inequalities addresses the key messages in the review. In particular, the Healthy Lives, Healthy People publication claimed that its primary objective was to ensure healthy living standards for all. In this respect, Healthy Lives, Healthy People had to address all the core responsibilities and plans by the government of the time to ensure healthy living standards for all citizens. This, in particular, refers to quality health their provision for all citizens irrespective of their economic status, ethnicity or gender. The poorest people in England include people with disabilities and those with mental problems. Some of the messages that the Marmot Review placed across that the Healthy Lives, Healthy People had to address to be considered a successful policy in tackling inequality in the English health sector include fairness and social justice of health provision. Marmot Review passed a message that reduction of health inequalities is a matter of social justice and fairness. He noted that the many people who succumb to untimely death in England would have otherwise enjoyed a total of 2.5 billion extra years. He noted that there is a social gradient in health. In relation to obesity, the lower class people suffer more from obesity than the rich. Action needed to be taken to reduce the social gradient in health provision and alleviate the poor from effects of obesity. The Review warns on the ineffectiveness of focusing only on the most disadvantaged of the society as the government attempts to curtail the effects of health inequality (Secretary of State for Health 2010, 02). The report notes that focusing on the groups the government and society deem as the most disadvantaged alone may not yield effective results. In order to reduce the steepness of health gradient, the government and health policies need to focus on all sections of the society. The scale and intensity of the actions of measures need to be proportionate to the level of steepness. The review calls this proportionate universalism. In addition to these, the review reveals that there must be certain benefits observed as a result of implementation of a policy attempting to level the social healthcare gradient. Foremost, there must be increase in economic productivity of various sectors of the society, especially the groups that suffered most before the formulation and implementation of the policy. In the view of the review, obese people must show some economic development and improvement upon reaping of the benefits of the new policies declared in Healthy Lives, Healthy People. Illnesses associated with the poor in England account for massive reduced productivity (Robin, 2009). They contribute to reduced tax revenue, increased treatment cost of obese people and higher welfare payment to the obese. Whereas economic success is an important facet to measure success of a country and policies the government puts in place, it is not the most essential. Sustainability and well being are important social goals in fair distribution of health and wealth. Therefore, tackling climatic changes and inequalities in healthcare production are phenomena that must go together. In addition to the six strategies that must be put in place to ensure a society with health equality, the review says that proper policy would ensure participatory decision making at the local level. The central government is an equally important player in ensuring the policy meets its objectives. In addition NHS and third party partners such as business enterprises have a say in the success of a policy to reduce healthcare inequalities. Extent of Success of Healthy Lives, Healthy People as proposes in the Marmot Review Having discussed the important revelations and messages that Marmot Review puts across, it is now possible to dissect the Healthy Lives, Healthy People with a view to find out how successful it has been in providing quality healthcare to all citizens (Williams, 2012). The Healthy Lives, Healthy People appreciated that policies that existed before to combat serious health issues such as diabetes did not seize opportunities to provide better health for the whole republic with an aim to reduce inequalities. The White Paper provided a new radical approach with core objective of empowering local communities. In addition, the White Paper provided a policy that enabled unleashing new ideas based on evidences of work and enabling professional freedoms. In a bid to consider all citizens in healthcare provision, the policy provided a fair treatment for immigrants into England against future and current health threats (Robin, 2009). These measures are progressive steps towards ensuring all obese people in England get equal medical treatment irrespective of their country of origin, color of the skin, religion or economic status. Healthy Lives, Healthy People was quite successful in its approach to curb the problems of healthcare inequality. According to the policy as laid out by Secretary of State for Health, it took the outline that Marmot Review had recommended for the eradication of disparity in healthcare provision. The policy offers to provide protection to all citizens from health threats. It notes that the endeavors are led by central government and has a strong system frontline. The policy empowers local leaders and encourages wide responsibility across society to enhance everybody’s wellbeing and health. It proficiently tackles a majority of the factors that influence inequality in healthcare. Further, the policy focuses on key outcomes of its endeavors and this enables it to track records of achievement of the benefits that need to accrue to the public according to Marmot Review postulation. Additionally, the policy focuses on the core values of fairness, freedom, responsibility, positive promotion of healthy lifestyle behaviors and adapting environment that promote good health (Rebecca, 2010). All these are imperative for obese people, and are in line with the requirements of an effective policy recommended by Marmot Review. The food industry and societal attitude is to blame for the current situation of obesity in the country. Eating disorder, anarchy that was once thought to affect college girls in rich English families is now a trend for all. Body image is the new craze. It knows no boundaries. It respects no culture. Saloons, anti-aging cream manufacturers and cosmetic surgeons are reaping a fortune out of men and women of all ages. It is a cultural practice that has gone wild (Robin, 2009, p. 39). There is not a single solution to this worldwide disaster other than self discipline. Every citizen of the world needs to be the keeper of his own culture and image, and avoid frantic rush into cultures that may not define his desires. The policy has determination to provide public health with dedicated resources. It places into action a ring-fenced public health budget. According to the policy, Health Practitioners will manage their own budgets. On one side, there is continued engagement with NHS as well as include the local government partners. The decisions and work of public budgets would be distributed to the local authorities under the new policy. In addition, the budget would be transferred to NHS Commissioning Board to cater for particular public health programs (Barbara et. Al., 2005, 32). These developments in budgetary allocations and supervision of health funds mean a lot to people with obesity and fight of obesity. With control of funds in the hands of medical practitioners and local governments, tailoring region-specific plans and frameworks of fighting obesity is possible. As was earlier mentioned, a one-fits-all solution is not possible for health conditions that differ from one locality to the next. Having a closer supervision of use of health funds makes fight of disparities in provision of medical care to obese patients successful. The policy applies Nudge Theory accordingly. The theory is a concept of economics, behavioral science and political ideology that uses indirect suggestions and positive reinforcement to achieve compliance hat is not forced on people (Jane & Andy, 2001). The government and politics of the country at the time used this theory to make the multitudes accept the policy. Being immediately after elections that saw Labor Party carry the day, Labor Party had a great influence in formulation of the policy and convincing the English population to accept it. Politics influenced the creation and implementation of the policy in different faces. Other than the political parties, there was the politics of organizations. In particular, National Obesity Forum initially opposed the policy, but later joined the proponents of Healthy Lives, Healthy People. Conservatisits take a view that Nudge theory that the governments of the time employed in making the public accept the White Paper is flawed. They argue that the framework is not conscious on effects of the policy on wider economic and structural issues. According to them, the White Paper may provide formidable help to those suffering from obesity, but in the long run, economic problems such as poor housing and unemployment may persist. In bringing all of this back down to a level of patient to professional interaction, the ladder theory of integration is necessary to incorporate at this particular juncture. As has been previously referenced, the differentials that exist within each individual are enough to denote the fact that the healthcare professional can and should integrate with their needs at different levels and towards varying extent (Munday, 2011). As the “Healthy Lives, Healthy People” proposal notes, the means through which the healthcare professional should integrate with the patient is not only based upon relevant externalities but also based upon broad metrics that would promote health and longevity throughout the entire life of the individual. Critical Analysis In an effort to make the White Paper operational, the government came up with the Responsible Deal. The Responsible Deal was documented to help the government fight obesity with a collective effort of the food industry, health professionals and charities. The deal contained several voluntary pledges by the government, health providers and food industry aimed at improving the health rating of England citizens (Boseley & TheGuardian, 2011). Most importantly, the Responsible Deal aimed at reducing the prevalence of obesity in the country through involvement of all stakeholders in health industry. Several charities and health bodies refused to sign the deal. The government’s institution of the Responsibility Deal was misguided and totally off the point according to groups that opposed its measures to reduce obesity. Using the Responsible Deal, the government was looking for new approaches to fight obesity pandemic by including food companies like McDonald’s and PepsiCo (Boseley & TheGuardian, 2011). This is a move that did not go well with the ultimate aim of the government to provide long lasting solution for a healthy nation. Upon release of a large volume of scientifically based evidence on the possible causes of obesity and the best ways to provide solutions to the problem by Foresight on obesity, the government took a misguided way to implement the recommendations. There was a massive mismatch between the huge and informative investigation the Foresight presented and the individualistic approach the government presented.teh coalition government sidelined the framework that the Foresight proposed in favor of encouraging individuals to eat healthier, drink less and exercise more (Boseley & TheGuardian, 2011). As the government tries to provide healthy lives for England citizens through the White Paper policy, it fails due to its adamancy to heed technical advice of experts in affected fields. In November 2011, the government disbanded its expert advisory group on obesity. Most members of the advisory group were critical of the decision by the health secretary, Andrew Lansley to fight obesity through the framework he took in his collaboration with food manufacturers (Boseley & TheGuardian, 2011). Most of the group’s members argued in meeting that the responsibility deal with companies like PepsiCo and McDonald’s was a miscalculation of proper healthcare provision. The labeling of fat and sugar reduction by the collaborations would not effectively reduce obesity in the country in the opinion of the disbanded advisory group. According to a British Medical Journal written in April 2011, Geof Reiner and Tim Lang argued that the collaborative efforts between the government and McDonald’s and PepsiCo was akin to publicly endorsed marketing strategy and was unlikely to yield any formidable results towards the fight of obesity (Boseley & TheGuardian, 2011). The policy missed a point in fighting obesity and reducing the effects of the condition on citizens by using shallow and un-thoughtful strategies such as incentives and vouchers provided by food companies to cut down on fat and sugar intake (Boseley & TheGuardian, 2011). This was a temporary fix and could not sustain the desired healthy living of the citizens. Irrespective of the flawed approach the government took in involving the food industry in reducing obesity in the country, the industry still has a massive responsibility to play in curbing the situation. Obesity is a social and behavioral challenge, and food firms need to provide solutions to curtail its effects. In addition to pledging to manufacture healthy foodstuff, food industry needs to work towards ensuring it does not lead the society towards perpetuating obesity (Safe Food Always, 2011). In collaboration with consumer watchdogs, food firms need to restrict TV advertisements of foods with high salt, sugar and fat content (Safe Food Always, 2011). This is more specifically breakfast cereals to children audience. The White Responsible Deal does not provide for penalties on those firms that fail to produce healthy foodstuff. This is a failure that makes it hard to achieve the recommendations and targets of the White Paper as emphases are laid on encouraging firms to remain health-minded, but without any measures to bring unwilling firms on board (Safe Food Always, 2011). Controlled advertisement content, packaging and sports sponsorship companies may only reduce obesity if the approach is thoughtful and oriented towards realizing long term goals. Healthy Lives, Healthy People is a relatively new policy. Determining its success may only be partial as it is merely in the process of taking root in the health sector. The influences of the policy on the health status of people suffering from obesity may not be conclusively said to be successful or unsuccessful. However, the White Paper has been a target of controversial views from its opponents. A good number of people wonder whether the White Paper really addresses the critical political and social problems deep-rooted in the country to provide equality in health provision. It is a matter of speculation whether the Healthy Lives, Healthy People brings anything new to the health sector. There conjecture whether the policy will work towards improving health of England population. A final component that must be referenced is the fact that the article points to the need for a strong local and national framework that can speak to the needs of all stakeholders. Quite obviously, from a theoretical perspective this is very much a social and neo-liberal approach to the issues at hand (Connell, 2009). Although obesity and the impacts that it has on overall health and longevity are merely one part of the issue, albeit a very important factor relating to the future health and wellbeing of stakeholders within society, the need for local and national partners to cooperate and promote a solitary and interwoven strategy is an integral part of encouraging the success of this particular plan in the future.. In the midst of all these doubts, there are possible positive contributions of the policy to fight of obesity. These positive outcomes are only possible if there are wider strategies involving government intervention and regulation. In the opinion of Baroness Neuberger, the policy is very likely to succeed in combating the problems of the obese. This is due to the fact that the White Paper recognizes obesity as a personal problem, a challenge that is most possibly solvable with individual interventions. The two publications are helpful in the healthcare industry as they provide pertinent information regarding how best to provide equal care to all citizens and succeed in preventing social and behavioral complications. It provides the measures that help the individuals take charge of their obese conditions. It requires little government spending, a feature that makes the White Paper a reliable policy to combat obesity. Bibliography Barbra, C., Fox, D. and Scott-Samuel, A. (2005). Towards a politics of health. Health Promotion International, 20, 2, pp 187 – 193. Barker, C (1996) The Health Care Policy Process. London, Sage. Boseley, S., & TheGuardian. (2011, November 16). Obesity advisory group disbanded by government. Retrieved 31 October, 2013, from The Guardian: http://www.theguardian.com/society/2011/nov/16/obesity-advisory-group-disbanded Boswell, C., Cannon, s., Miller J (2005) Nurses’ Political involvement: responsibility Versus Privilege. Journal of Professional Nursing, 21, 1. 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