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Introduction

Public health in the UK has been a function of a number of parameters that generally affect trends and census figures. To start with morbidity and mortality rates greatly affect population growth and development. In the past the greater UK region had no census figures that are vital is analyses of public health issues. As early as the beginning of 19th century, UK started conducting census. This has greatly helped in interpretation of a number of issues to this regard. Migration especially in the EU bloc has been a serious issue of public health that has been identified. This essay therefore looks at the concept of health in and how the case applies in UK. In addition to these, the essay also looks at the epidemiological trends in UK to demonstrate comprehensively how UK’s public health is affected.   

Main Body

 Human health is at a center of debate globally today. Even with improved technology there is a greatest concern on what people do with their body. A lot of questions are raised by nutritionist on kind of food people eat, time they spend sleeping and some regular practices. The concerns are geared towards ensuring better health. This has prompted nutritionists propose some practices to be followed to guarantee better health. One of requirements as proposed by nutritionists is regular feeding on good and nutritious food. In this regard, a balanced diet and personal hygiene are vital. Nutritionists suggest further that for the sake of good health, regular exercise and enough sleep and rest are inevitable. One must abstain from abusing any drug whether hard or not at all cost. This include over the counter drugs as well. Immunization is a preventive measure that also helps to boost health; thus, is encouraged too. Reckless eating habits, lack of enough sleep and exercise and poor hygiene are highly discouraged. People are encouraged to perform the above stipulated practices in order to remain healthy. For the body to maintain its effective function then it has to remain healthy.

However, defining good health has been somewhat challenging task. Good health has been misconstrued by many people to mean absence of any disease in the body. This is a misconception of the real fact since good heath should be determined by ability of the body to function properly. This does not necessarily mean absence of any disease. This idea is supported by the World Health Organization that puts it clearly that health is a state of complete physical, social and mental well-being, and not merely the absence of disease. It does not mean absence of infirmity. One can be sick but still is healthy as long the body can function effectively. Health put a lot of emphasis on social and personal resources with regard to physical and mental capabilities. To be healthy is; therefore, considered to be homeostasis state of the body which has to maintain constantly in relation to external changes.

There are indicators of good health. These indicators are based on physical, mental or social aspects of health. These three aspects of health are, however; are interrelated as will be realized from discussion hereafter. A person is considered to be physically health when he or she has good appetite and energy to perform some tasks. The person should be capable of maintaining the right body posture as required of human race. One is considered to have right posture when she or he is able to walk in an upright position without any difficulty. The weight of that particular individual should be proportionate to either his or her age and height. In addition the person should have clear and clean eyes and skin. Most importantly, good physical health demands that all organs in the body function normally without fatigue. One that is physically healthy is; therefore, normally attentive and very responsive.

An individual is said to be socially healthy when his or her manners are agreeable with societal norms. The person should not have any problem interacting with people around. In other words she or he should have high self-esteem thus should not feel inferior before other people around. The person should not have questionable character. Such a person is expected to show love to others by helping them and fulfilling some responsibility on their behalf. She or he is endowed with a lot of confident to operate among other people in society.

 Mental health on the other hand implies that one is capable of making sure that emotions do not flare in case of a problem. Such people are in control of their emotions. They are also normally sensitive to recognize prevailing needs of other people. Mental health calls for one to be free from uncalled tensions and anxieties that might lead into high blood pressure. They are also devoid of worries or stress that might result into unnecessary burning of calories and development of stomach ulcers .The person is relaxed and peaceful in mind. Such people have strong abilities to cope up with criticism from different people while at the same time dealing with challenging issues amicably. They are just outstanding in the manner with which they conduct themselves. It is; therefore, mandatory that one must have good social, physical and mental health in order to be considered healthy. The three aspects of health are however, affected by various factors. These factors are classified as inherent and outside factors.

Inherent are inborn factors that we might have very little or no control over. They include age, genetic makeup and sex, just to mention but a few. Very elderly people and infants are prone to illness due to their low immune system. To boost their immune system, it is normally advisable that they be vaccinated against some preventable diseases.  Genetic constitution plays a very vital role in determining health of an individual. Some diseases like breast cancer and diabetes have leaved with us over centuries because they are passed from parents to offspring through genes. A gene which is the basic unit of inheritance, determine the genetic makeup of an individual. Some inheritable disorders are sex linked. Sex linked disorders are carried in sex chromosomes making them to be inherited together. Most of harmful sex linked disorders are carried in X chromosomes. These disorders are normally controlled by recessive genes, thus, they do not express themselves in the presence of a dominant gene. This explains why male are more vulnerable to harmful sex linked disorders such as colorblindness and haemophilia which are both carried on X chromosomes.

Outside factors may result from social class, education and occupation among others. Social class determines way of life and behavior hence affecting illness associated with these norms. Level of education determines the kind of choices people make in life. Some of these choices ranging from nutrition and habit may be useful in preventing some diseases. Some diseases like lung cancer are common among those working in dusty areas like asbestos. Exposure to radioactive materials due to work can spontaneously alter genetic makeup of a person as a result of mutation. Such spontaneous changes can result into disorders like albinism which is then passed from parents to children. Health is monitored using negative indices in a community such as mortality and morbidity rates. Mortality rate takes into account the number of deaths in a specified population size. Morbidity on the other hand, shows rate of occurrence of diseases in a population. This includes report on new cases and the total number of times a disease has existed in a given population per unit time. A population that experience high mortality and morbidity rate may be considered to be less healthy.

Development of public health in UK from 19th century to present is associated to the ever rising population in British towns. This rapid growth has been attributed to migration of people from British rural areas and immigrants seeking either greener pasture or education. Dramatic growth rate in population has in turn put a lot of pressure on the available health facilities which has prompted UK government to improve health facilities. Public health has been improving to cope up with the rising population. This is in line with the government obligation of providing quality health care to her people. So many healthcare facilities have made available in urban centers such as Liverpool, Manchester and London among others. Many health professionals have also been trained to tackle shortages in health sector today. Main emphasis of public health is on entire population rather than individual patient. This emphasis has since 19th century made public health in bridging the gap between individual medicine and greater society. Public health has been praised by its proponents for its greater interest in the society where it functions. This has resulted into improved birth rates and low morbidity rates. The UK experienced low birth rate at the period of World War Two and this has been reflected in the age groups of around 63 years as at 2004.

Demographic Changes in UK

UK has undergone population changes since the 19th century to present the day. Population structure has been affected by a number of parameters and this is a show of how diversified the population is. The UK consists of England, Wales, Northern Ireland, and Scotland before the Act of Union of the 19th century. The Republic of Ireland was part of Great Britain but in 1922 it attained its independence and withdrew from the greater UK. The current constituent of the UK consists of the 4 countries named above. The past population trends of the UK is difficult to explain due to a number of issues. To begin with, the present form UK has been in existence after 1922 and before the Act of Union, UK and Ireland were different Kingdoms run by different administrations. Secondly, prior to the 19th century, there was lack of adequate sources of data to study the population trends especially in Wales, Ireland and Scotland. Only England has sufficient data in the whole UK region. The region has ethnic diversity that includes a number of ethnic groups. The white population constitutes 92.1% while Black British forms 2% of the entire population. The others include Pakistani and Indians who constitute 1.3% and 1.8% respectively. In addition, the population consists of Black Africans, other Asians, among other minority ethnic groups, (Jefferies, 2005, p. 13).

There are two main reasons that lead to population change in a nation. Jefferies note that “A population can change in size via two main mechanisms: natural change; the difference between the numbers of births and deaths and net migration; the difference between in-migration and out-migration,” (2005, p. 2). In a similar way, if the number of birth surpasses that of deaths or there are large numbers of in-migrants than out-migrants, a population will increase and vice versa.  The main focus of this essay is on the consequences of health problems and how it affects population. Health problems subjects a county to economic expend its budget to provision of treatment services besides affecting the workforce of a nation. If majority of the working population underperforms, so is the economy.  

The Great Britain has conducted census after every 1 decade since the 1801 with an exception of period of Second World War. “In 1841 the population of Ireland stood at nearly 8.2 million and just as the case of Great Britain, the Irish census was conducted after every 10 years,” (Jefferies, 2005, p. 3). Since the 19th century, the population of the UK has changed as shown by census results. “Population of England had more than doubled from 8.3 million in 1801 to 16.8 million in 1851 and, by 1901, had nearly doubled again to 30.5 million…2001 population was still nearly six times higher than the population 200 years ago,” (Jefferies, 2005, p. 3).

In Scotland and Wales, the same growth trends were witnessed in the 19th century; 0.6 million in 1801 to nearly 1.3 million in 2001 for Wales and 0.6 million growth for Scotland. The age-sex structure of the UK according to 2004 census figures show that there are more females than males at a comparative ratio of 96 men for every 100 women. There were more children aged below 16 years than the retirees. Those aged 60 and above for females and 65 and above for males constituted an 18.6% while those under 16 years represented 19.5%, (Jefferies, 2005, pp. 10-11).

Trends of migration in the UK have had health problem implications. According to European Academies Science Advisory Council, “The public health implications of migration have received comparatively little attention in EU policy development, but it is important not to generalize about migrants or infectious diseases, (2007, page 1 of 1). Effects of migration in public health in the UK have been associated with mainly infectious diseases unlike other disease like cardiovascular, mental health diseases or obesity. This is because they pose serious and acute threat to public health than the other diseases; for instance Severe Acute Respiratory Syndrome, SARS. It is prudent that a nation’s public health policy does not discriminate against migrants in regard to provision of health care services.

Access to public health facilities should be inclusive of all population constituents because that will reduce health risks posed by migrants to the entire UK population. There are a number of most rated impedances to public health care system that need to be addressed comprehensively if meaningful healthcare is to be achieved. Current screening practices in the entire EU bloc should be improved and information shared across borders. There should be an articulate communication channel to address any health issue that arises. The third issue should be directed at rectifying inaccessible healthcare services for immigrants. The entire EU bloc has to develop a consensus on how to resolve matters of arising cases of infectious diseases that are related to migration. “…the increasing internal movement of goods and people encourage the spread of infection,” (Weiss and McMichael, 2004).

Epidemiological Trends in the United Kingdom

Cardiovascular disease put a great burden of illness not only in   UK but also globally. However, the epidemiologic trends have beenvery encouraging. Morbidity rate from cardiovasculardisease has fallen by at least 50% in most countries from about 1980to 2000. Capewell, (2009) illustrates that, “Some two-thirds of this decline can be attributed toa decrease in adverse events and reflects reductions in theprevalence of major risk factors. The remaining third is attributableto reduced case-fatality rates, owing mainly to treatments. “Mortality as a result of cardiovascular disease fell by 30% in between 2002 and 2005” (Capewell, 2009). The declineis registered to b slightly more for acute myocardial infarction than for strokeand heart failure and hospitalization rates for stroke and heartfailure fell by 27%, whereas age-adjusted hospital admissionrates for acute myocardial infarction apparently fell by only9% (O’Flaherty, Bishop, Redpath, 2007). The true proportion of the rate of cardiovascular disease among the UK population is probably greater but concealed bythe effects of the aging and growth of the population, by diagnosticchanges that have inflated patient numbers and by the countingof episodes rather than of patients (MacIntyre, Murphy, Chalmers 2000). The practice by UK hospitals and Clinics  of recoding diagnoses to maximize income may also have contributedto the apparent 33% decline of in-hospital case-fatality ratesamong patients with acute myocardial infarction. In contrast,reductions in case-fatality rates due to stroke and heart failurewere relatively modest” (MacIntyre, Murphy, Chalmers 2000). An increase in the average age of patientsin UK, as elsewhere, was consistent with a compressionof morbidity, which means that disease commences at a laterage and affects a shorter period of the total life span and itis crucial to note that, most deaths occurred outside of hospital,many among individuals with no prior diagnosis of cardiovasculardisease (MacIntyre, Murphy, Chalmers 2000).  

The evaluation of UK situation, specificto UK and based on data of adequate quality, it is acknowledgedlimitations included its analysis of episodes rather than individuals,leaving open the possibility that a greater reduction in incident-relatedhospitalizations may have occurred but been obscured by an increasein recurrent admissions (Ford, Ajani, Croft, 2007). A lack of information on case mix meansthat severity of disease may have declined as thresholds foradmission to hospital were relaxed. The apparent decline incase-fatality rates may thus have been inflated.The decrease in prevalence rate of cardiovascular diseases in UK is of great significance in health management. In comparison to other European ountries, McIntyre and colleague as quoted by O’Flaherty, Ford and Allender, (2008) found that admissionsfor chest pain and unstable angina increased by about 40% whilerates of myocardial infarction declined by about 30%. In theNetherlands, a study by Koek and colleagues using a similarapproach found that rates of myocardial infarction declinedby 20% Such studies provide valuable information for quantifying trendsin burden of disease and making cautious projections. It isproblematic, however, to assume that rates of hospitalizationrepresent an accurate measure of incidence or that they canbe used to estimate prevalence directly. Puting a clear relationbetween trends in mortality and hospital admission and changesin medical and surgical treatments is also complex (MacIntyre, Murphy, Chalmers 2000). Furthermore,many out-of-hospital deaths among people with no prior diagnosisof cardiovascular disease are always sudden, and therefore amenable onlyto primary prevention.

Trends in cardiovascular disease over the last 3 decades, however,show a striking similarity, Ford and colleagues as quoeted by MacIntyre, Murphy, Chalmers (2000), recently reporteda “43% total decline in deaths due to coronary heart diseasebetween 1980 and 2000. Using a validated and comprehensive policymodel, they attributed about 47% of this reduction to specificmedical therapies”. Among these therapies, revascularizationmade a limited contribution. Koek, de Bruin and Gast, (2000) illustrates that, “a decrease in the prevalenceof major risk factors potentially contributed to two-thirdsof the total decline in mortality rate in UK”. However, this mail stone was offset by an increase in rates of obesity anddiabetes, which were in turn compounded by persistence in theprevalence of smoking (particularly among younger age groups).The rates of hypertension cases that were previously in decline have now, ominously flattened. These adverse trends in seriousrisk factors for cardiovascular disease are worrying, especiallygiven recent similar trends in many other countries.

A stagnant of rates of death from cardiovasculardisease in younger age groups has now been reported in theUnited States, the United Kingdom, Australia and elsewhere (MacIntyre, Murphy, and Chalmers 2000).This stall in progress is occurring in spite of the availabilityof evidence-based therapies for the majority of eligible patients.It is noted that, worsening trends in cardiovascular disease may be even greateramong people in socially deprived groups (Asaria, Chisholm, Mathers, 2007). Due to the fact that ratesof cardiovascular disease increase steeply with age, demographicaging compounded by an expansion in population in most industrializedcountries represents an iceberg of hidden cardiovascular diseasewhich will become visible in the very near future(Asaria, Chisholm, Mathers, 2007)..

The implications of the above epidemiological trends in the United Kingdom form the foundation of analysis of the impact of the cardiovascular disease not only to the population but also to the economic progress of the country and it is prudent to note that cardiovasculardisease will remain the most common cause of death for the nearfuture. Large numbers of individuals with cardiovascular diseasenormally flood hospitals and a given span of time they will be older and thusposemore challenging process of treatment. Therapeutic extension of life expectancywill be correspondingly shorter, forcing us to concentrate moreon improving quality of life rather than just prolonging itslightly.

Clinical Interventions

Prevention awareness campaign as a major clinical intervention in the fight a gaist cardiovascular diseases is vital this because over 80% of prematurecardiovascular disease is avoidable. Medications geared  towards the  reduction of  lipids and blood pressure will help and the  promotion of population-widecontrol of tobacco, cessation of smoking, a healthier diet andincreased physical activity is crucial (Asaria, Chisholm, Mathers, 2007). A big and a significant impact ismade by such interventions at the global, national and provinciallevels, potentially halving the future burden of cardiovasculardisease (Aslan, Critchley, Capewell, 2005). Aslan, Critchley, Capewell, (2005), further explains that, feasible policy; legislative and fiscal measurescould eradicate industrial trans-fats, halve the dietary intakeof saturated fats and salt, make fresh fruit and vegetablescheaper, increase physical activity and render smoking prohibitivelyexpensive. Healthcare professionals and practitioners have an immense responsibilityto support such initiatives, which are aimed at substantially reducingthe costly societal burden of cardiovascular disease in UK. However,tracking the effectiveness of preventive interventions willdemand regular, high-quality monitoring. All health stake holders should therefore look tofrom Statistics on UK cardiovascular disease trend and to other sourcesto provide hospitals and health centers reports on a regular basis. In this case, it will be easy to win the war of these diseases.

Conclusion

It is evident from this essay that public health is affected by a number of issues. Migration trends are crucial in understanding how infectious diseases spread across borders. It is vital to develop policies that are non discriminative in provision of healthcare services to an entire population if public health issues are to be adequately addressed. 

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