Politics of health is an even more complex topic such that it is not easily understood (Borrell, Espelt, Rodriguez-Sanz, and Navarro, 2007). In his book, The Health Gap: the Challenge of an Unequal World, Michael Marmot (2015) argues that health is politics. He says that one does not need to appeal to any particular political ideology or economic theory to argue the case for greater welfare and social support to improve the health of society. Health policy is defined as decisions, plans, and actions undertaken to achieve specific health care goals within a society (Harrison and McDonald, 2007). With the challenges, inherent in the health sector, increased mortality and low life expectancy, the medical practitioners have an important duty in policy advocacy. According to Harmer, Lee, and Petty (2015), the nursing profession has a big role to play through assuming leadership duties in advocating for health policies, research, analysis, developing policies, implementing, and evaluating them, (p. 799). The Healthy Lives, Healthy People: Our strategy for public health in England was launched in 2010 in response to Professor Marmots article Fair Society, Healthy Lives (Department of Health, 2010). The aim of this policy is to improve protection for the public from serious health threats, thereby helping them live longer, healthier and more fulfilling lives. This essay will discuss this policy in relation to the health of people with diabetes, explore the political ideologies underpinning the policy, as well as analyze the impact of the policy on the client group selected and its implication on the nursing practice.
Health policy refers to the decisions, plans, and actions that are undertaken to achieve certain health care goals within a society (World Health Organization, 2014). According to the WHO, an explicit health policy ought to achieve several things such as divine a vision for the future, outline priorities and the expected roles of different groups, as well as build consensus and inform people. Health policies are categorized into several groups including global health policy, public health policy, mental health policy, health care services policy, health insurance policies, and other policies related to public health (Ovseiko and Crinson, 2010, p 335). HLHP policy was built on Marmots Fair Society, Healthy Lives review which outlined the health inequalities that existed in England as well as proposed the most effective evidence-based strategies for reducing the inequalities from 2010 (The Marmot Review, 2010). Health inequalities as outlined in his review are placed centrally in Englands new health system as laid out in the 2010 White Paper, Healthy Lives, Healthy People. The policies in the White Paper, as outlined in The Marmot Review (2010) are in relation to alcohol, obesity and smoking, the early years of a child, fuel poverty, cardiovascular disease, the downturn in economy, mental wellness, insight for local administration, healthy hospitals, chronically neglected groups, and the function of public health professionals in handling health inequalities.
This Paper Policy document is not only a health policy document but a political one too. This is because the initiative was from the government and the implementation process for the policies in the paper is monitored by the government. Additionally, the policy was structured around the then coalition government between the Conservatives and the Liberal Democrats which resulted from the 2010 general elections failing to provide an overall majority for any of the countrys three major political parties. This coalition introduced a neoliberal ideology concerning HLHP (Kerr, Byrne, and Foster, 2011). Neoliberalism emphasizes on minimal state intervention in economic and social affairs, giving the public and the local government the space to get intensively involved in such matters (Hervik and Thurston, 2016). This is the heart of the White Paper document. According to the Secretary of State for Health, Healthy Lives, Healthy people policy would end central control for public health and leave room for the local government and communities to manage it. The central government would, however, fund the locals to innovate and develop their ways of improving public health in their area (Department of Health, 2010). All these efforts were to be coupled with partnerships with other industries such as the technology sector to promote healthy living, from voluntary sector and employers to incentivize the people to be more active, to installation of new phone apps that help people lose weight. Through proper implementation, the policy aimed at reducing health threats right from infancy, dealing with obesity, mental health, tobacco control, sexual health, pandemic flu preparedness, health protection and emergency preparedness, in addition to many of the wider determinants of health (Healthy Lives, Healthy People, 2010). These efforts would ensure that diabetes is prevented right from the early years and properly managed for the people suffering from diabetes.
Liberalism as an ideology in the UK started at the beginning of the twentieth century. It stood for personal liberty, liberated markets, and democracy in politics. The origin of liberalism emanated from the Liberal Party which has significant influence on the UK politics. Liberalism also stood for state intervention in society with the aim of empowering individuals. This empowerment is seen through the Healthy Lives, Healthy People initiative. Socialism is another ideology in the politics of UK. This developed as a response to the inequalities connected with industrialization. Socialism advocated for economic and social reforms that empowered the people. Politics in this ideology are considered democratic.
Diabetes is one of the major health concerns in England. Data provided by Public Health England (PHE), shows that 3.8 million people aged over 16 years had diabetes in 2015, making up 9% of the adult population. This number consists of both diabetes types 1 and 2 individuals. However, of this number, 90% carry diabetes type 2 which is largely preventable or manageable by lifestyle changes which also provide additional benefit for health and well-being (Shah, Langenberg, Rapsomaniki, and Denaxas, 2015). The likelihood of contracting this type of diabetes heavily leans on increased weight as the main cause, although family history could also be a cause. A healthy lifestyle is at the core of HLHP policy. Obesity, which is a cause of diabetes, is one of the primary issues that are emphasized by the policy. The Secretary of State for Health noted that there would be technological innovations involved such as introducing new phone apps that would assist people in healthy lifestyles such as physical exercise to maintain a healthy body weight. Such initiatives as cited by Secretary of State for Health ed. (2008), are preventive measures to keep the citizens away from contracting the disease. Additionally, through funding to the local communities, the poor are empowered to seek health care in the affordable hospitals. The report indicated that people who live in the poorest areas are likely to die seven years earlier compared to those living in richer places and take up to 17 additional years struggling with illnesses. With the Healthy Lives, Healthy People policy, the government aimed at bridging this gap by providing the poor people same opportunities as the rich as far as public health is concerned (The Marmot Review, 2010).
In addition to empowering the poor as the rich in the fight against health threats, and in this case diabetes, the policy would utilize public health as the approach as its results are by far greater than those of health care (Shah, Langenberg, Rapsomaniki, and Denaxas, 2015). In England, the major advancements in life expectancy resulted from public health rather than health care. Tackling diabetes is vital to the future of the health service in England. According to the Public Health England (2016) data, type 2 diabetes costs the government 8.8 billion pound each year. Public health would be a perfect approach to the efforts of trying to cut these costs (Mockford, Staniszewska, Griffiths and Herron-Marx, 2011). Public health is defined as the science and art of promoting and protecting health and well-being, preventing ill health and prolonging life through the organized efforts of the society (Van den Broucke, 2012, p.80). Public health is built on three domains which include health improvement, health protection and health services. Health protection will be achieved through the policys initiative of promoting a healthy lifestyle. Health protection also includes emergency preparedness. This would work well for the diabetes patients in situations when they are in need of insulin. To wrap up, a report by Public Health England, (2015), had data from the Office for National Statistics showing that health care services contribute only a third of the improvements that could be made in life expectancy. Changing peoples lifestyles and eliminating health inequalities contribute the remaining two-thirds. Many big threats to health such as diabetes are related to public health, making it the ideal avenue to approach the issues.
Healthy Lives, Healthy People policy has a huge implication on the diabetic people in England as well as on the nursing practice. To begin with, the government through the policy employs the nudging theory to task the people with the responsibility of ensuring their health and well-being (Cohen, 2013). In line with this theory, the government offers support in the form of funding and procedures to push the people into taking up the task. With this being the case, the people are free to pick up the initiative or neglect it altogether. With the people taking up the responsibility, they can diagnose illnesses when and as they happen, thereby reducing chances of severity and eventual death. However, though nudging theory is widely used, there exists no scientific prove of its efficacy. To add to that, the Public Health England (PHE) is a public health service on the policy that unites a wider family of professionals whose role is to spend time on improving peoples lives and tackling inequalities. With the body of professionals around, people with diabetes can access professional care either on health issues or professional guidance on healthy lifestyles. Additionally, with the HLHP policy implementing the evidence-based approach (Brownson, Chriqui, and Stamatakis, 2009) suggested by Marmot (2010), which addresses social determinants of health such as conditions in which people are born in, grow, and live, the plan will be able to reach the people who needs help more, first and fast thus ensuring that lives in critical conditions are saved first.
The government recognizes that though the policy leaves the mandate of public health on the people, individuals have the right to choose what to do and what not to. Even with the information and resources disposed on the people, the decision to implement or not lies with individuals (Secretary of State for Health., 2008). Therefore, people are free...
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