Theory and Practice of Community Development - Essay Example

1. Introduction The available literature argues that the British community work has evolved from two main traditions: town-down and down-top approach. The top-down approach was the central tenet of the early settlement movement while bottom-approach tries to address a local issue through policy change. An important aspect of the UK community work is the development model which was initially used in the North America in the early 1960s. The model was used by the colonial masters to integrate the black people into subordinate positions. In the recent past, the theory has been used to address issues such as social exclusion and health improvement. This paper seeks to examine ways through which community can be involved in the eradication of poverty in the Bournemouth area. 2. Background According to the available literature, obesity is a growing health concern in the modern world. The effects of obesity to the victims and the larger community are well established. The prevalence of obesity among children and the adults is a major health challenge in the United Kingdom and other countries. According to the World Health Organization, for the past few decades the prevalence rate of obesity has tripled in the European countries. In the UK alone, the obesity prevalence rate in adults has increased by three-to-four fold since 1980s. The future trends of obesity in the country are well captured in a report titled, tackling obesities: future choices, where the government predicts that by 2050 60% of the entire population will be obese (Puhl & Brownell, 2001). The condition is caused by dietary, genetic, psycho-social and environmental factors. In particular, intake of foods rich in fats is known to be a major cause of obesity. The condition is associated with negative outcomes such as chronic conditions and discrimination. The affected victims also experience low esteem, emotional distress and depression. The condition also weighs down on the national economy and leads to negative social consequences. Obesity also adversely affects the productivity of the victims and they may end up loosing their jobs due to continued absenteeism. On a worse note, the death of the victims from obesity-related illnesses negatively impact on the productivity of a nation. The House of Commons Health Select Committee estimates the economic costs of obesity to be £3.3 -3.7 billion but this figure will increase to £45.5 billion by 2050. The obesity is also associated with employment costs and in 2002 alone, the economic consequences were estimated to be £10 billion. In 1998, the cost of treating obesity was estimated at £9.4 million while cost of lost earnings due to premature mortality was estimated at £827 million. These figures explain the seriousness of the situation in the country and in response the government has undertaken various initiatives. Within the United Kingdom, obesity prevalence rate varies on the basis of sex, age, ethnicity and socioeconomic class. Generally, women tend to be more obese compared to men and individuals tends to grow overweight as they age. It is also widely accepted that, persons in higher-economic groups have less prevalence to obesity than those from lower socio-economic groups. The prevalence rates of obesity vary according to the region. In England, the obesity prevalence rates are higher in women than men and those in semi-routine jobs are more likely to be obese compared to their counterparts in the managerial professions. The available research further suggests that ethnic minority groups such as Black Caribbean and the Irish men are at a greater risk of becoming obese compared to the general population. The data obtained from the Department of Health, Social Services and Public Safety, indicates that more than half of the adult population in Northern England is Obese. The Department further established that in Northern Ireland men were more likely to be obese that women. The situation is different in Scotland where women are more obese than men. Data collected from the Scottish Health Survey suggests that obesity prevalence rates vary according to the socio-economic status. In this regard, men and women employed from rich families are less likely to be obese than their counterparts from disadvantaged backgrounds. The Scottish Health Survey further established that age also influences the prevalence rates in both men and women. Obesity peaked between the ages of 55-64 while the young ones were least likely to be obese. These results indicate the need for the obesity-reduction programs to target the elderly in the population. Given the seriousness of the matter it has become increasingly important for the government to develop effective programs. In the past, the UK government has made ambitious attempts to reduce the menace and a perfect example can be found in 1992, when the Health of the Nation initiative was launched. At the same time the government has initiated a population-wide specific strategy targeting at-risk population. The government seeks to tackle obesity by introducing proper diet and nutrition and by encouraging physical activities in school. The government has developed different set of objectives depending on the country. For instance, in England, the government launched the Choosing Health: Making Health Choices Easier policy to reduce the prevalence of obesity in the country. A similar policy dubbed, investing for Health, was launched in Northern Ireland to encourage the population to make wiser choices in regard to what they eat and the lifestyles they adopt. In Scotland, the government is currently implementing the Improving Scotland: the Challenge policy document with the aim of reducing the menace in the society. However, in Wales, the government is yet to establish an effective obesity reduction strategy 2.1 Childhood obesity Countries have been registering rapid increase in childhood obesity. In the UK alone, childhood obesity among 5 to 10 year old boys increased by 300% between 1972 and 2002. Over the same period, obesity prevalence rates among the young girls increased by 500%. The associated health outcomes of childhood obesity are similar to those of adults. Just to illustrate further, children suffering form obesity are at increased of high blood pressure, hypertension, dyslipidaemia, hypersinsulinaemia and diabetes. Childhood obesity is also associated with mechanical problems, exacerbation of asthma and various psychological problems (Chaskin, 2001). Children who develop obesity may lose confidence and are predisposed to depression, eating disorders and low esteem. Given the consequences associated with childhood obesity it is important for various agencies to encourage the youngsters to maintain health weight and carry out regular exercises. By doing so, children suffering from obesity will increase their confidence, and will face less incidences of bullying, social insulation and lifestyle related diseases. The available literature indicates that children are at a greater risk of becoming obese if one or both parents are already obese. In England, the obesity prevalence rates among children increased substantially between 1995 and 2005 (Sihlongonyane, 2009). The data available from the Office of National Statistics further indicates that children in higher age groups are at a greater risk of becoming obese than their counterparts in lower age groups. The available data also indicates that children from poor backgrounds are more likely to become obese that those in the least deprived areas (Wolff, 2001). In the Northern Ireland, the problem of child obesity is a serious health issue in the country. According to the data retrieved from the Department of Health, Social Services and Public Obese, a fifth of the boys and 15% of girls are obese. In Scotland, more boys are obese than girls while in Wales, the obesity prevalence are 22% and 17% for boys and girls respectively. 3. Childhood obesity at the Bournemouth Located on the south coast of England, Bournemouth is the largest settlement at the Dorset and has a population of almost 200,000 people. Located in Southwest of London, the city neighbors Poole and Christchurch and its population is predominantly white. The problem of childhood obesity in Bournemouth is well captured in the Daily Echo. In an article titled, Disappointing rise in child obesity figures for Bournemouth youngsters the Audit Commission (2011) observes that childhood obesity is on the rise. The report follows an investigation that was conducted by the National Child Measurement Programme. The results of this initiative indicate that the number of the obese children in reception year in the area increased by 0.2%. The obesity prevalence rate among the six year old increased by 18.2%. The exercise which was conducted between 2012 and 2013, further found out that the percentage of the overweight children in these age groups is also on the rise. The results indicate the need to adopt a different strategy, because it seems the government-programs seems not be working. To address this challenge Wilding (2007) believes that the government should reduce the consumption of carbonated drinks in schools. This recommendation is supported by a study which was conducted by Wilson (2006) in the South West England. The study used a sample population of 644 children all aged between 7 and 11 years and was conducted in six junior schools. In this study, the researchers advised the children against consuming diet carbonated drinks. The education program was conducted in sessions of one hour with the help of teachers and other participants. The program incorporated several components including: music competition, presentation of art and a quiz. In the end, Wilson (2006) concluded that the program should be replicated in schools around the country, with the help of the teachers and others stakeholders. 4. Methodology To assess the problem of childhood obesity in the city, secondary sources of data were used. A literature review was conducted to determine the obesity prevalence rates and obtain other relevant information that would help us to complete the research. Secondary sources were particularly useful in analyzing the problem and identifying potential solutions. Besides using secondary sources, the participant observation methodology was used to gather data from the community. During the course of the research, important data was collected from the obese students, and suggestions were sought from the community members on how to improve the situation. Using the participant observation technique, gave the researchers a perfect opportunity to experience first-hand what was happening in schools. The researchers travelled to the following schools: Bethany Junior school, the Bourne Academy, Bournemouth school, Christ the King Catholic Primary Church, Corpus Christi Catholic Primary Church, Elm Academy, Healthlands Primary School, Hill View Primary School, King park Primary School, Malmesbury Park Primary, and Muscliff Primary school. 5. Community Profile A number of initiatives have been conducted to evaluate the extent of the childhood obesity in the Bournemouth. One such initiative was undertaken by the Child Measurement Programme and found out that the percentage of the obese children in the area has increased significantly. The Bournemouth’s population is estimated to be 183,500 with 5% of the entire population being short-term migrants (Audit Commission, 2011). A fifth of the population is aged between 0-19 and childhood obesity rates in the area are significantly below those in England. A higher number of the obese children are found in the deprived areas. 6. Environment The community lives in an environment which prescribes to the modern culture. By growing in such a culture, children too assume negative dietary habits. Graph 1 The prevalence rates of obesity within the Bournemouth area are well reflected in the graph above. From the graph it is obvious that the obesity prevalence rates have increased since 2007. According to the members of the local community, the environment in school does not support healthy living. One of the reasons given by the respondents is the withdrawal of the Healthy Schools Programme. Currently, only a few schools are working towards Healthy School Status. There is also a failure by the local community to support various initiatives that have been launched to address the problem of the obesity. According to the teachers who were interviewed in the process, there is clear lack of parental involvement. To explain their point, the respondents pointed to the Change4Life program that had been developed to promote healthy eating. The campaign which was launched in 2009 encouraged the young children to eat well, move more and live longer. Although the program is already running, the students still carry out unhealthy lunches and the blame squarely rests with the parents. The parents need to come up with more health recipes and encourage the students to adopt more healthy styles. The rising prevalence factors could also be attributed could also be attributed to lack of leadership from the parents. Walking through the area, one can clearly notice that a good number of adults are obese and so it becomes hard to convince the children to adopt a different lifestyle. This means that the parents and the other members of the community must lead by example. Another key challenge in the reduction of obesity at Bournemouth area is lack of accessibility. After interviewing the students, the research established that only a few number of students lived within the walk-to-school threshold. This information is reflected in the graph shown below. Graph 2 7. Resources The community has a sizable population which means that it has the necessary human capital to effectively implement the interventions listed below. There are many schools in the area and so the program will help many affected young persons. 8. Raising awareness and mass media campaign The entire populations in the area need to be sensitized about the negative consequences of childhood obesity. In particular, the parents will be provided with information which they will then use to induce behavioral change in their children. The available literature suggests that mass media is effective in raising awareness, providing the target population with knowledge, changing attitudes and contributes immensely to behavioral change (Geoghegan & Powell, 2009). The population in the area will be advised about the importance of: i) Improving vegetable and fruits intake. The campaign will be similar to the ‘five-a-day’ program which was established in 1994 to improve the intake of fruits and vegetables in the general population. ii) Meetings will be arranged in the entire areas to provide the public with obesity-related information. The public awareness campaign will also be extended to schools, where there are many junior children. iii) Besides disseminating to general population and the children, the campaign will also target the parents. The available evidence suggests that there is a distorted perception of what qualifies as normal and excess body weight. In this regard, some of the parents in Woods (2004) are not able to recognize whether their children are obese or not. iv) The general population will be educated about the dangers of consuming too much. The available evidence suggests that increased consumption of sodium-containing food produces a progressive increase in thirst. The young children are forced to consume sweetened beverages and that is why they end up becoming obese. At the same time, evidence suggests that more than half of total fluids that children consume are in form of soft drinks. Consequently, there is need to for the children in the area to reduce the volume of the soft drinks that they consume. v) This intervention will use the mass media tools and also the social media platforms. Already, social media platforms are being used in marketing and have been found to be effective in encouraging the target population to make dietary changes. Already in Wales, there is one such program by the name, Health Challenge Wales. 9. Improving cooking skills and adult health literacy There is a possibility that the mothers in the area cannot differentiate which foods are healthy and which are not. For this reason, community programs will be put in place, to improve the mothers’ cooking skills. The community program to improve the mothers’ cooking skills will be similar to the ones used in Wales and Scotland. The cooking programs will particularly target those living in poor backgrounds and low-income groups. On the other hand, improving adult health literacy will help the parents to make good diet choices and they will be able to advice their children about what foods to eat and which foods to avoid (Newman et al, 2003). 9.1 Execution and evaluation The cooking program will be conducted during public meetings where the participants will be introduced to fruit salad recipes during the first week. In the following week, the participants will be allowed to cook and taste some of the healthy recipes. In the 3rd and 4th weeks, the respondents will be educated about the sugar levels in different foods. In the 5th week, the participants in the cooking programme will be evaluated accordingly. 10. School based interventions Since school-going children are adversely affected by obesity and obesity-relate illnesses, it will vital to initiate school-based programs (OFSTED, 2010). Through such programs the children will be able to learn about what they should eat and what they should not. The specific details of the program are discussed in the sections below. 10.1 Health schemes Health schemes are increasingly being used in schools to promote healthy living and a perfect example can be borrowed from Swansea where 85 primary and 13 secondary schools are involved in the initiative (Department of Health, 2003). Students are encouraged to join the schemes, where they learn about health eating and how they can exercise safely. By adopting a similar program, schools in Bournemouth will be able to promote positive attitudes in children while encouraging students to take charge of their lives. Some of the similar programs that have been initiated include Health Promoting Schools in Scotland and Health Promoting Schools in Northern Ireland (Thomson, 2012). 10.2 Limiting access to junk foods and soft drinks Increasing consumption of junk foods and soft drinks increases one chance of becoming obese. Aware of this fact, this program will entail improving the nutritional quality and standards of school meals. This initiative has already been used in Scotland where it has registered huge success. In England, a similar school feeding program has been introduced, but its success was impeded by the lack of parental involvement. Consequently, all schools in the Bournemouth will be required to develop ‘health lunchbox policies’ with the help of the parents and the general population (Sallah, 2011). That way, the parents will be able to decide what their children consume in schools. 11. Measuring weight and height Knowing how to measure weight and height, will be a noble step towards eradicating childhood obesity in the Bournemouth area. One such initiative already exists in England, but its implementation is impeded by the lack of the parental involvement (Ledwith, 2005). Learning the measuring skills will enable the parents to monitor the health of their children. The involvement of the healthcare professionals will particularly be important in helping the general population to measure their heights and weights. Meetings will be held at the local level, during which the medical professionals will assist different persons especially those from the lower socio-economic groups. During such meetings, the healthcare professionals will also provide the target population with information about healthy behaviors. 11.1 Plan execution and evaluation All children will be weighed by the school nursing teams with the consent of their parents. The results will then be sent to the parents with details of their child’s result. The parents will also be furnished with information on how address the problem and where to go for more help. The success of this intervention will be based on the feedback received from the parents. 12. Improving the environment and promoting a pro-cycle culture As indicated by the available literature, the percentage of students walking to school in the area is very low (Graph 3). Graph 3 To address this challenge it is very important for the local community to create an enabling environment in order to motivate the students to cycle to schools. Indeed, walking or cycling to school provides the students with a perfect opportunity to reduce weight in the society. As established earlier, walking to school may be challenging for most students but the schools in the area need to do more by encouraging active travel. One of the challenges facing this intervention is the rising rates of car ownership. To ensure that this intervention works well, it will be pivotal to come up with a reasonable walking or cycling distance. The execution of this intervention is based on the evidence gathered from the nine local authorities in the South West. 12.1 Planning, Execution and evaluation Figure 1 The active travel program will encourage the students to meet the targets stipulated in the graph above. The program will particularly be implemented in schools where a large number of young students do not live more than a mile away. 13. Conclusion Reducing childhood obesity is the objective of every government and this milestone can be achieved by implementing health-oriented policies. The UK government has developed some country-wide policies to eradicate obesity but the success of such program has been impeded by lack of community involvement. The outcomes of this research justify the need to involve all the stakeholders especially the parents. Improving their cooking skills will help them to prepare healthy recipes and guide their children in adopting a healthy lifestyle. A key component of the obesity reduction is active travel. The commitment of the parent and the local authorities is required in order to create the right environment for walking, riding bicycles and making the right choices. Reference List Audit Commission (2001). Going Places: Taking People To and From Education, Social Services and Health Care. Portsmouth: Holbrooks Chaskin, R., 2001. Building Community Capacity: A Definitional Framework and Case Studies. Urban Affairs Review, 36(3), 291-323. Department of Health, 2003. Tackling Health Inequalities. A Programme for Action. London: The Stationery Office Geoghegan, M., and Powell, F., 2009. Community development and the contested politics of the late modern agora: Of, alongside or against neoliberalism? Community Development Journal, 44(4), 430-447. Ledwith, M., 2005. Community Development; a critical approach. Bristol: The Policy Press Newman, T. et al. (2003). Do community-based arts activities result in social gains? A review of the literature. Community Development Journal, 38(4), 310 – 322 OFSTED., 2010. Inspection of safeguarding and looked after children services Herefordshire. London: HMSO Puhl, R. and Brownell, K., 2001. Bias, discrimination, and obesity. Obes Res, 9(12), 788-805. Sallah, M., 2011. Module Guide: Theory and Practice of Community Development. Leicester: De Montfort University Sihlongonyane, M., 2009. Community development as a buzz-word. Development in Practice, 19(2), 136-147. Thompson, J., 2012. Professional Field Practice Handbook. Leicester: De Montfort University Wilding, J., 2007. Treatment strategies for obesity. Obesity Reviews, 8, 137–144. Wilson, L., 2006. Patient Counseling and Education: Should Doctors Be Doing More? Ann. Intern Med, 144(8), 621. Wolff, T., 2001. Community Coalition Building – Contemporary Practice and Research. American Journal of Community Psychology, 29(2), pp. 165-172. Woods, K, J., 2004. Political devolution and the health services in Great Britain. Int J Health Serv. 34(2):323-3 REFLECTIVE PRACTICE Example: The moments I shared with the obese children and the community Interpretation The community profiling exercise revealed details that are important in addressing the challenges which face the entire community. Working together with the victims gave me a rare opportunity to examine their thoughts and understand things from their perspective (Thompson, 2012). Prior to conducting this exercise, the community believed that childhood obesity is more prevalent in high-income earning families than low-income earning families. However, after conducting this research it became apparent that childhood obesity is a serious problem in the disadvantaged communities. Prior to conducting this exercise, I had a feeling that the participants were not going to respond. Indeed, there was a feeling in the community that childhood obesity could not be eradicated. There was also a perception that the victims deserved it, and there was no way the community could help. The community profile challenged the local community to address the problem of childhood obesity. The secondary information gathered from different sources helped me to convince the community about the seriousness of the problem. After discussing the underlying issues with the victims’ parents, they developed a sense of urgency to address the problem. For instance, one parent volunteered to walk his children to school while others promised to actively participate in the programs. Consider The whole exercise gave me an opportunity to apply and question my personal values. It is well established that ethics should guide our behaviors and this project gave me an opportunity to pursue the most appropriate choices depending on the prevailing circumstances. Just to illustrate, it was important to involve all the participants regardless of their economic and ethnic background. Throughout the project, I ensured that equal representation was maintained and the voices of all the members were heard. Another key concept in community development is self-determination (Ledwith, 2005). According to this concept, the community members have the leeway to discuss their concerns, assess options and draw their own conclusions (Sallah, 2011). To ensure the community members were actively involved in the entire process, sometimes I was forced to revise my schedule in order to accommodate everyone. Likewise, I was forced to travel to as many primary schools as possible in order to interview the students and evaluate the effectiveness of the current interventions. Knowing the characteristics of the local community helped us to pick the most effective interventions. Just to illustrate, after talking to the respondents I realized that most of the students did not live near schools and so they were forced to use automobiles. After learning this, I realized there was need to involve the parents so that they could provide us with alternative solutions. Some of the solutions such as walking seemed unrealistic given that some of the students travelled for very long distances to school. It is after examining the available options that the idea of cycling to school was eventually born. In order to ensure, this intervention was implemented successfully, it became important to create an enabling environment and motivate the parents to participate in the idea. Sharing these ideas with the stakeholders ensured the final results were acceptable to all. References Ledwith, M., 2005. Community Development; a critical approach. Bristol: The Policy Press Sallah, M., 2011. Module Guide: Theory and Practice of Community Development. Leicester: De Montfort University Thompson, J., 2012. Professional Field Practice Handbook. Leicester: De Montfort University OFSTED. (2010). Inspection of safeguarding and looked after children services Herefordshire. London: HMSO Sallah, M. (2011). Module Guide: Theory and Practice of Community Development. Leicester: De Montfort University Thompson, J. (2012). Professional Field Practice Handbook. Leicester: De Montfort University Newman, T. et al. (2003). ‘Do community-based arts activities result in social gains? A review of the literature.’ Community Development Journal, 38(4), pp. 310 – 322 Thomas Wolff (2001) “Community Coalition Building – Contemporary Practice and Research,” American Journal of Community Psychology, 29(2), pp. 165-172. Geoghegan, M., & Powell, F. (2009) Community development and the contested politics of the late modern agora: Of, alongside or against neoliberalism? Community Development Journal, 44(4), 430-447. Sihlongonyane, Mfaniseni Fana(2009) ''Community development as a buzz-word,” Development in Practice, 19(2), 136-147. Chaskin, Robert J. (2001) “Building Community Capacity: A Definitional Framework and Case Studies,” Urban Affairs Review, 36(3), 291-323. Read More