Category: Health Promotion

According to several references, the word health defines as the state of a person’s physical and mental conditions. On the other hand, the word wellness is defined as a process of an individual being aware of their health conditions and trying to make choices and decisions towards a healthy and better life. Some also state that the word wellness is a dynamic action of change and growth of an individual. For an individual to be healthy, he or she must be healthy in not just physical state but also be healthy mentally. Thus, a healthy person is one who can balance his health physically, mentally as well as spiritually. In this modern era, many are unsure of the ways of being healthy in all three dimensions. Based on the many resources available on this planet, there are many effective strategies that can be taken by a person if he or she wishes to be healthy physically, mentally, and spiritually.

The first step to becoming a healthy individual is to be healthy physically. The physical dimension of being healthy refers to individuals who are always physically active and exercise regularly. They also tend to eat according to a balanced diet as well as are aware of how to maintain the recommended body weight. Being physically active means being able to face the demands of our daily lives securely without getting too tired as well as still having enough energy for other activities such as leisure and recreation. There are many strategies as well as steps that can be taken by an individual to be healthy in the physical dimension. Firstly, the individual must be diligent and perform physical activity every day for at least 30 minutes. Some physical activities that can be done include calf raises, squats for thighs, modified push-ups as well as modified sit-ups. According to peoples magazine, calf raises are very beneficial in strengthening the muscles, especially the gastrocnemius and soleus muscles. Squats for thighs on the other hand are beneficial in weight removal near the thigh region. Another strategy to be healthy in the physical dimension is to eat healthy foods and be more in control of the meal portion. Healthy foods are very important as they are known to help in preventing illness. For example, quinoa is known as a superfood that many eat as it contains a high fiber count which is necessary to maintain and keep a healthy digestive system. Besides that, an individual must also practice safe sex to be healthy in the physical dimension. Practicing safe sex is very important as it avoids the risk of an individual getting a sexually transmitted disease which includes HIV. For example, a male individual who uses a condom during sexual intercourse will have a low chance of getting infected by HIV as he has protection. Lastly, an individual that wishes to be physical health can also achieve his goal by maintaining a proper sleep schedule. The Sleep Matters Club state that sleeping helps to maintain a person’s weight and also helps lower blood pressure. The individual must also get his proper sleep time of 7 to 9 hours to get these benefits. Not having enough sleep on the other hand can cause diseases such as obesity, diabetes, and heart attacks to occur more often. With that, it is proven that there are many strategies that can be taken for a person to be physically healthy.

The second step to becoming a healthy individual is to be healthy mentally. The mental dimension of a person’s health can be divided into a broad scope which includes social, psychological, and emotional behaviors. It is very important for a person to be healthy mentally as it can help to reduce stress as well as be able to control and manage the emotions that a particular person faces. There are many strategies that can be done to ensure an individual’s health mentally. Firstly, the best method of being healthy mentally is to always smile. Smiling scientifically releases endorphins that are very beneficial as these hormones are able to brighten the person’s mood as well as being able to make the body more relaxed. Smiling can also reduce stress which is the main villain that prevents a person from being mentally healthy. Besides that, other strategies include performing meditation activities. These meditation activities include taking deep and slow breaths as well as listening to songs and music that are soothing to hear. The benefits of these meditations are they can enhance a person’s self-awareness as well as help them cope with stress and anxiety. Moreover, another way to be mentally healthy is to be more open-minded. The reason being open-minded helps an individual be more mentally healthy is because it can help to develop positive qualities in an individual. Being open-minded also helps individuals to be more confident in themselves. Besides that, another strategy includes having or taking up a hobby. For example, if a person has a hobby in gardening, they tend to learn more new things about their hobby and expand their mental growth. The next way on being a healthy person mentally includes being more social by taking part in or joining clubs or organizations. This is very important as it helps the individual to be more confident when being in public or among other people. Not only that but being in a club can also help to increase your knowledge or even acquire new skill sets that can help in the future. With that, it is proven that there are many strategies that can be taken to ensure an individual’s mental health.

The second step to becoming a healthy person is to be spiritually healthy. Spiritual health involves a person or individual exploring meaning in human existence. There are many factors that are included under spiritual health which includes a person’s religious faith, morals as well as ethics. The reason why spiritual wellness and health are very important is that spiritual wellness can help create a balance in an individual by being able to find a purpose and reason for your life as well as appreciating your life. There are many strategies that can be done to achieve spiritual wellness and health. One of the strategies includes finding a religious belief or faith with which you agree with. Religion is very important as it gives a person many benefits that can be used in life. Benefits of having a religion include gaining courage and inner strength to do something. For example, it was religious belief that became the reason many were motivated to fight against the oppression of Adolf Hitler’s Nazi ideology. Religion is also beneficial as most religions teach their devotees to be good to one another such as the golden rule that states that everyone should treat each other the way they wish to be treated. Another strategy to improve a person’s spiritual health is to be able to practice self-acceptance. Self-acceptance is very important as it helps the individual to feel more compassionate towards them. Besides that, self-acceptance helps an individual to stop judging themselves harshly, especially for mistakes that have been made in the past thus gaining more spiritual health and avoiding stress. Lastly, another strategy to improve an individual’s spiritual health includes being curious. Curiosity is very essential in maintaining spiritual health as it provides many benefits. Curiosity helps an individual to become more self-aware as well as able to solve complicated problems. Curiosity also has been proven to help people to overcome their deepest fears. As an example, a person who is afraid of heights and is curious about bungee jumps will solve his curiosity by taking part in it which directly helps to conquer his fear. With that, it has been proven that there are many ways and strategies for a person to develop his spiritual health.

Based on the information that has been provided, we can conclude that there are many strategies that can be taken to one can take to stay healthy as possible physically, mentally as well as spiritually. It is very important for everyone of any age, religion, and background to live a healthy life so that they can have a better future ahead of them. Each individual must also note that being healthy does not always mean being healthy physically but there are other factors that affect health. It is very important that everyone balance out each factor of well-being so that they can achieve the maximum benefits of a healthy life

The world health organization reveals global life expectancy at birth is 72 years, ranging from 61.2 years in the WHO African Region to 77.5 years in the WHO European Region, giving a ratio of 1.3 between the two regions. These inequalities are prevalent throughout the globe, as shown in the large difference in statistics between the average length of life in third-world countries and in many Western countries today. In England alone, people in richer areas have approximately 19 more years of good health than those in the poorest areas. While the average life expectant has overall increased there are ‘stubborn inequalities’ between different parts of the country says public health England. Those in the most deprived areas have higher death rates for heart disease, chronic respiratory diseases, and cancer, partly because of smoking and obesity problems. Children are twice as likely to be born with low birth weight and more than three times as likely to suffer tooth decay. However, studies have estimated that only 20-30% of one’s lifespan is related to genetics the rest is due to individual factors such as access to health care, hygiene, diet and nutrition, exercise, and lifestyle. Based on this is it fair to claim that money can buy good health, or can one be healthy on a budget?

‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’ World Health Organisation, 1948. In 1986, the WHO further clarified that health is: ‘A resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.’ meaning that health is a resource to support an individual’s function in wider societyMental, and physical health is the two most commonly discussed types of health. A healthful diet, exercise, and screening for diseases can all enhance a person’s health, say health experts. In 2015, the population of the United States (U.S.) spent an estimated $3.2 trillion on healthcare costs. The source goes on to quote the WHO, ‘The higher a person’s socioeconomic status (SES), the more likely they are to enjoy good health, a good education, a well-paid job, afford good healthcare when their health is threatened. People with lower socioeconomic status are more likely to experience stresses related to daily living, such as financial difficulties, marital disruption, and unemployment, as well as social factors, such as marginalization and discrimination. All these add to the risk of poor health.’ This shows that the world health organization recognizes that there is an affiliation between one’s wealth and their health.

The correlation between one’s health and their wealth is further shown via an experiment conducted by the School of Public Health, University of Minnesota. Food pricing is an essential component of the eating environment. The experiment examined lower prices and point-of-purchase promotion on sales of lower-fat vending machine snacks in 12 work sites and 12 secondary schools. Price reductions of 10%, 25%, and 50% on lower-fat snacks resulted in an increase in sales of 9%, 39%, and 93%. The second study examined the impact of a 50% price reduction on fresh fruit and baby carrots in two secondary school cafeterias. Compared with usual price conditions, price reductions resulted in a four-fold increase in fresh fruit sales and a two-fold increase in baby carrot sales. Both studies demonstrate that price reductions are an effective strategy to increase the purchase of more healthful foods in community-based settings such as work sites and schools. The experiment conducted makes the data dependable as the results are clear in showing healthier foods being more popular when more affordable, also the experiment was conducted by a trustworthy source (University of Minnesota) adding to its integrity. However, it could be argued that this small-scaled experiment isn’t enough to prove that cheaper healthy foods can help close the health gap between the rich and the poor, the reliability of the source is contentious because of this.

Medicines are chemicals or compounds used to cure, halt, or prevent disease; ease symptoms; or help in the diagnosis of illnesses. Advances in medicine have enabled doctors to cure many diseases and save lives.The cost of health care is rising faster than wages, increasing a dangerous gap between the care consumers need and the care they can afford.Those lucky enough to live in a country with inclusive state-funded healthcare, such as the UK, probably have no idea how much medicines really cost. Some drugs that have been around for ages are very cheap – aspirin, for instance, costs pence, it’s been made by numerous companies competing to undercut each other’s price for decades. But new medicines can cost hundreds of pounds a packet and sometimes thousands. The new breast cancer drug Kadcyla weighed in at a starting price of £90,000 per patient per year in the UK, suggesting medication prices is not only a problem for poorer countries. A case study found in a Telegraph newspaper shows a personal account of Julie Strelley-Jones, who says, ‘The drug is not only keeping me alive- it is allowing me to enjoy bringing up my children’ so when she was told that the NHS could no longer afford her treatment she naturally was “disappointed and angry”. She went on to exclaim “I don’t want to give up. I know these drugs are expensive but why put all this money into researching them if they can’t be accessed?” The strength of this article lies in it being a firsthand account showing recent direct experience, showing evidence of the effects that overpriced medication can have on one’s health, however, the evidence is mainly anecdotal and the article doesn’t have a balanced view (ie the real costs of pharmaceutical industries to produce the treatment). Dr. Manica Balasegaram explores this issue in an article published for Al Jazeera. The doctor states his concerns as ‘if a new drug is developed and nobody can afford it, where is the benefit from it’ as well as providing solutions for the extremely high treatment prices ‘We need to find new ways of paying for research that does not force a choice between developing a drug and making it widely available…This idea is nothing extraordinary; there are already alternative ideas out there – models such as prize funds – that reward new discoveries through substantial financial payouts, paid on the condition that the drug is immediately open to price-lowering market competition. Being in the field for 15 years as a doctor with Medecins Sans Frontieres shows the writer is a credible source, as he is experienced and knowledgeable in the field. The economic argument is assessed however some may say that claims have been exaggerated in order to prove the pharmaceutical industry is desperate to make money. The issue is further explored by World Health Organisation’s former director-general, Margaret Chan. Who, as a final act called for ‘greater equity in the delivery of health care for rich and poor alike’. Clearly showing there is a divide in healthcare between the two counterparts. The article goes on to explain how health inequalities are often aggravated by the high price of medical products but conversely, notes that WHO initiatives have successfully pushed down the prices of vaccines and other medical items. Chan says positive actions by WHO succeeded in ending a yellow fever epidemic in Angola and the Democratic Republic of Congo. She also says measles immunizations over the past 15 years have saved the lives of 20 million children and progress continues to be made in controlling HIV, tuberculosis, and malaria. “The achievement that brought the most joyful headlines, was when WHO published final trial results demonstrating that the new Ebola vaccine confers nearly 100 percent protection… We have by no means defeated this re-emerging disease, but when the next outbreak inevitably occurs, responders will not be empty-handed,” Chan said. This controversially implies personal wealth has little to do with living a healthy lifestyle as the World Health Organisation is actively eradicating disease, (as stated by Chan) not only for the rich and wealthy but also concerned with ‘international public health’. Although the article contains a clear logical argument with a clear counterargument, critics may claim that the success of the WHO has been inflated by Chan to attain a good reputation, or some may even class this as biased as Margaret Chan is expressing all her own efforts and successes to attain political popularity. However, masses more than just medication is needed for a healthy life to be attained. The internet alone has provided at least half the world’s population with free tips on ‘how to live well for less’. As explored in an article by Harvard Medical School ‘the more people cook at home, the healthier their diet, the fewer calories they consume, and the less likely they are to be obese or develop type 2 diabetes’. Not only is cooking at home better for one’s health it also can be cheaper than going out to eat or eating frozen foods (especially for larger families) which is all highly processed food with very little nutritional value. Benefits include knowing exactly what is going into your food as well as allowing one to control their portion sizes as well as additional benefits such as bringing the family together and easily avoiding allergies and sensitivities. Although the article has been produced by a highly credible and well-known source there is no statistical evidence to compare home-cooked food costs and the average cost of eating out. Evidently, there are many reasons why some people live longer than others. Journalist and broadcaster, Julia Hartley-Brewer explain that although there are many factors that affect our health and lifestyles ‘genes, our jobs, our income, our housing, where we live, both our own and our parents’ education… the list goes on. There are, however, two key issues that matter more than anything else: being obese and being a smoker.’ The journalist believes that the problems go far deeper than the pound in one’s pocket as after all cigarettes and fast food are actually very expensive habits. She believes that the truth is that, rich people take better care of their health than poor people do because they have better, happier lives and so want to live for as long as possible. The article shows how good health can be attained without money however it only takes into account middle-class/working-class people from the UK, also this is one person’s account and hence is strongly opinionated. In conclusion, it is obvious that personal wealth does affect one attaining a healthy lifestyle and, if we want the poorest people around the world to live as long as the wealthiest, then we need to stop people from making unhealthy choices and cutting years from their lives. This can be done by increasing taxes on harmful substances such as cigarettes and foods with high amounts of artificial sugars. Leaving people free to eat whatever they want might seem like the easy option, but it is the very poorest who will pay the ultimate price. Also reducing prices on healthful foods is a public health strategy that should be implemented through policy initiatives and industry collaborations, making cheap foods more accessible.

Taking care of our health is important as it is the center of our whole life. Our life is made up of different parts which relies on having good health, this includes physical, environmental, spiritual, social, emotional, intellectual and mental health. It is crucial for individuals to understand how to control and improve their health as well as gain knowledge of why it is important to do so, and this is delivered to the public through health promotion. This essay will be focusing on sexual health and will be exploring aspects and determinants of health, how campaigns deliver health promotion, recent statistics and figures, alongside services available.

According to WHO (1948), “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. This means the condition in which your body is free from diseases, injuries and illnesses, and what state your body is currently in. As mentioned previously, health consists of physical, environmental, spiritual, social, emotional, intellectual, and mental health, which contributes to an individual’s well-being, which is known as the six aspects of health. Physical health consists of exercise, a balanced diet and getting the right amount of rest, which allows the functions of the body to work more efficiently. Mental health also intertwines with emotional, social, and psychological well-being. Absence of depression, anxiety and other mental health disorders are important because if an individual suffers from this, it can have an impact on body weight, socializing, emotional state, and the function of the body. Intellectual well-being is important to help keep the brain active and stimulated. It continuously improves and helps our mindset grow, therefore helping to strengthen the brain. Environmental well-being is to be in a clean and tidy workspace without any mess or rubbish. Being in a happy and positive place will help an individual’s well-being and health. Lastly, spiritual health consists of the mind, body, and soul. This is a way in which individuals cope with pain or difficulties they are going through to help them feel peace and at ease with their life. Having a good spiritual life helps to reduce stress levels and increases positive feelings and outlooks on life.

As discussed, there are a variety of factors that combine to create health. Alongside these factors, there are also determinants of health which is known as the Rainbow Model. The Rainbow Model was created in 1991 by Goran Dahlgren and Margaret Whitehead. Individuals are the focus and the heart of the model, and then branched off are various layers which impact health. These include age, gender, culture, social and community support networks, education, living and working conditions, social and physical environments, health care services, genetics, water and sanitation. Age is one of the determinants of health linked to sexual health. Age is a period that a being or thing has lived of existed for, and unfortunately, we cannot control this. As we age, this affects our health in many ways, for example, the functioning of cells decreases, bone density decreases due to lack of calcium resulting in being at high risk of breaking bones, the immune system weakens and acts slower, and the heart and blood arteries stiffen, meaning it takes the heart longer to fill with blood. Although our health decreases with age, our sexual health improves. According to the website www.letsgetchecked.com, in 2017 there were 400 new diagnoses of STI’s in the 15-24 age group every day, and annually there were 144,000. In 2018, studies show that individuals aged between 45-64 totaled at 32,780 for the year. The cases showed that for men there were 23,943 and for women the diagnoses were 8,837. As statistics show, in 2017-2018, the largest number of STD diagnoses occurred in the age group of 15-24 years. This could be because of factors such as their location, lack of education, beliefs that all STI’s can be treated. or even the worry of being labelled by others.

At the beginning of this essay, health promotion was mentioned, but what does it mean? Health Promotion is a technique of helping individuals to expand power over, and to better their health. This is done by educating the individual about illnesses, how people contract them and how to avoid them. Governments, communities, and individuals are backed up by health promotion to deal with certain health challenges in the public. This can be promoted through the media, posters, leaflets, drop-in clinics and even workshops.

There are many campaigns created yearly to help promote health and give advice. One of those campaigns linked to sexual health is ‘Your Sexual Health Matters’. This campaign releases different campaigns yearly to help raise awareness to individuals regarding their sexual health, promote safer sex and to provide the public with information about certain issues relating to sexual health that affects both the individual and also the wider community. The people behind this campaign and helping to run and fund it is called DCHS, which stands for Derbyshire Community Health Services. DCHS are part of the NHS Foundation Trust and they carry out multiple campaigns yearly focusing on sexual health. As well as having people run and fund the campaign, there are also a variety of partners in ‘Your Sexual Health Matters’. Partners simply means ways in which the campaign is helped to be promoted. Since the time of the coronavirus and the lockdown, partners in the campaign have become more broader than before. These include Royal Mail, the media, Durex, pharmacies, clinics, workshops, hospitals, and schools. Partners are important in a campaign, but so are the services provided to the public. ‘Your Sexual Health Matters’ campaign have a variety of services available for everyone. These include condoms by post, oral contraception (virtual assessments and prescriptions being posted out), postal emergency contraception, STI &HIV testing centers, virtual advice, photo diagnoses and online booking systems for face to face or virtual appointments.

Regarding to sexual health, a few models and theories relate to this subject, one of those is the Health Belief Model. The Health Belief Model was one of the first theories created relating to health behaviors. It was created in 1950 by phycologists that wanted to figure out why people were not participating in programs to prevent and detect diseases. The aim of this model is to motivate individuals to take actions to prevent and detect any disease or illness. The model also has factors contributing to an individual’s decision, this includes modifying factors such as age, gender, education, wealth, location, and health knowledge. The beliefs of the individual also have an impact on their actions and decisions, this includes whether the individual believes they are likely to get the disease or not, if they got the disease will it affect them much, what benefits would they gain and what are the barriers. If a test center is miles away from the individuals house, they might weigh up whether it is worth going all that distance for it or not. All these factors contribute to whether an individual takes part in programs, clinics, or testing, as they weigh up the factors as well their own beliefs regarding the illness or disease.

Lastly, the other theory that links with sexual health is called the Tannahill’s model, which was created by Downie, Fife and Tannahill in 1985. It includes 3 sectors helping to promote health which are health education, health protection and disease prevention. It is designed to help promote prevention or occurrences of disease and illnesses and focus on the final outcome and how this could be prevented, e.g., wearing a condom can prevent STI’s. Health education consists of posters, leaflets, books and media allowing individuals to gain knowledge. Lastly, protection by adhering to laws, policies and advice given out regarding the disease or illness.

In conclusion, according to the website www.assets.publishing.service.gov.uk, statistics show that in 2019 there were 468,342 cases of STI’s (chlamydia), which is a 5% increase since 2018. The statistics mentioned previously for 2017 shows the increase between 2017-2019 was 324,342. Between the different age groups, figures show that between the ages of 15-24 there were a rise of 28% from 13,623-17,443. From the ages of 35-44, there were a rise of 17% from 15,462-18,134. And lastly 65 years of age or above rose by 17% from 344-402. This shows that our age is a determinant that affects our health due to various factors, as the younger age groups have higher risings than the older throughout the years. Taking all the information previously discussed, there are a lot of campaigns, theories, models and services out there to help the public gain more knowledge on what certain diseases are, how these diseases can occur, how to prevent these diseases and where to seek advice and support throughout. Without health promotion, people would not be able to learn about diseases and how to protect themselves and others from them, hence why it is so important to advertise about health.

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The World Health Organization (1948) defines Health “as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”. This meaning suggests that the health of an individual incorporates much more than just the absence of an illness and includes several aspects of a person’s wellbeing. The World Health Organization (2004) describes the state of wellbeing, to be when an individual knows their own abilities, manages the general stresses of life, and can work efficiently to be an effective contributor to their society. This interpretation is supported by Austin (2016) who refers to wellbeing as living responsibly in good health in the social world, and Deighton et al., (2016) who portray wellbeing in children as a sense of confidence: “feeling good, feeling that their life is going well, and feeling able to get on with their daily lives”.

These perceptions are reinforced by the definition provided by the Collins English Dictionary (2020) as the condition of being contented, healthy and successful. In conjunction with the positive characterisation of the key components included in being in a state of health and wellbeing in life, it is understandable why the Scottish Government have placed the promotion of health and wellbeing at the forefront of the Curriculum for Excellence in contemporary Scottish education. Curriculum for Excellence aims to ensure that all children and young people in Scotland develop the knowledge, skills and attributes necessary, to enable them to flourish in life. It strives to instill four capacities in all young people, to become successful learners, confident individuals, responsible citizens and effective contributors (Scottish Executive, 2004). These four capacities are embedded within the varying definitions of health and wellbeing provided.

The key educational policy, Curriculum for Excellence and Getting It Right for Every Child (GIRFEC) approach were introduced to Scottish education, to support children and young people’s health and wellbeing, at the very core (Scottish Government, 2016a). The GIRFEC approach focuses on supporting children and young people to feel safe, loved and respected, to ensure they can reach their full potential. The concept is based on eight wellbeing indicators, which are: safe, healthy, achieving, nurtured, active, respected, responsible and included. These are used to measure a child’s development and identify if they are requiring any additional support or help within a particular aspect of their life (Children in Scotland, 2019). Through the increased focus on health and wellbeing, school staff and teachers have a responsibility to raise any concerns relating to these wellbeing indicators with partner agencies.

As a result of the Schools (Health Promotion and Nutrition) (Scotland) Act 2007, Curriculum for Excellence has placed a high priority to Health and Wellbeing and endorsed it alongside Literacy and Numeracy. These three core subjects should be developed and supported across all features of the curriculum and are established as ‘The Responsibility of All’ teachers (Scottish Government, 2016a). Unlike literacy and numeracy, which can be assessed through attainment, extra emphasis has been placed on health and wellbeing as a curricular area, but also as part of the wider school experience, including ethos, relationships, rights and responsibilities (Spratt, 2018).

Currently within Scottish Education, there is a commitment towards a holistic approach to health and wellbeing. McLaughlin (2015) believes that rather than there being a focus on an attainment driven curriculum of wellbeing, there is also much more consideration towards the “whole child”. Focus is not solely on what each pupil learns academically, but on their overall personal development and attribution of skills and knowledge to help them succeed in life. Horrell et al., (2012) also believe that Wellbeing encompasses more than just the health of a child. It is vital to ensure their mental, emotional, social and physical development needs are met. The Scottish Government strive to address health and wellbeing within 6 key areas:

1. Mental, emotional, social and physical wellbeing;
2. Planning for choices and changes;
3. Physical education, physical activity and sport;
4. Food and health;
5. Substance misuse;
6. Relationships, sexual health and parenthood.

These six areas are interdependent and essential, to equip children and young people with the knowledge, understanding and skills they need to make informed decisions and succeed in life (Education Scotland, 2014). Furthermore, Payler and Scanlon (2018) maintain that incorporating these dimensions within the classroom, is the responsibility of all teachers, to promote the best possible educational experience. Spratt (2018) echoes this belief and describes health and wellbeing as the vital foundation to which all learning can build on.

Mental, Emotional, Social and Physical Wellbeing

Through addressing mental, emotional, social and physical wellbeing, pupils will become more resilient, have greater self-esteem, a better understanding and management of themselves and a higher level of interpersonal skills (Scottish Government, 2016). Harden et al., (2001) acknowledge the importance of mental health throughout life but highlight the significance during school years – particularly in relation to attainment and lifelong learning. As well as increased attainment, Catalano et al., (2002) state that good mental health leads to less involvement with the criminal justice system, lower cost to public services, greater potential and resilience for life. Edwards (2003) implies that poor mental health, greatly depreciates educational attainment, and Graham and Power (2003) indicate that this can then lead to poor career and life opportunities, involvement in crime and substance misuse. These outcomes demonstrate the importance of teachers fostering a positive learning environment and promoting the wellbeing of all pupils (Kyriacou, 1998), with the Scottish Government tackling mental health by placing emotional and social wellbeing of pupils at the heart of education (Weare, 2010). Robinson (2018) strengthens this view, in that establishing positive pupil and teacher relationships, this will instill a sense of security for pupils. Pye (1988) refers to teachers utilising the skills of ‘solicitous tenderness’ to provide pupils with warmth, reassurance and kindness. These techniques will ensure that teachers fulfill their role in creating a happy, supportive and inclusive environment to assist pupils’ learning and development.

Planning for Choices and Changes

Education Scotland (2020) suggest that for pupils’ health and wellbeing to be promoted, children and young people should be provided with opportunities to actively learn about choices, managing expectations and making decisions within real life contexts. James and Prout (1997) emphasise the importance of children being involved in the construction of their social lives, as well as the lives of others, and the society in which they live. Cohen et al., (2004) supports this idea in the educational context, in that when a teacher undertakes their duty of care, they must enable students the opportunity of choice: to explore, take responsibility for their actions, learn to demonstrate creativity and independence. This concept is further backed by Watson et al., (2012) who believe health and wellbeing in schools, is about the development of a pupil’s responsibility and higher order thinking skills. Weare (2010) enhances this viewpoint, in that positive health and wellbeing helps to create concerned citizens, who understand themselves, can empathise with their peers, care about their wider community, and make informed choices. This can only be achieved through empowering children and young people through exercising their choice, self-exploration and learning (Butcher, 2010). The introduction of a ‘Change Challenge’ initiative within the classroom, would provide pupils with the choice to adopt either a physical activity or replacing an unhealthy food option with a healthier item over the course of a week. Pupils would then reflect on the positive impact this change has made.

Physical Education, Physical Activity and Sport

Physical education, physical activity and sport has prospered through the introduction of Curriculum for Excellence. With the curriculum being identified as a site for health promotion, to reduce expenditure on health care, physical education is being used as a vehicle to adopt a more active and healthier lifestyle (Horrell et al., 2012). Since 2009, The Scottish Government introduced the need for a minimum of 2 hours of quality physical education in schools per week. Active Schools was introduced in 2000, becoming a focal point within Primary Schools in Scotland. Their aim continues to be the promotion of physical activity and participation in sport before, during and after school (Scottish Government, 2009). Brooks and Magnusson (2006) indicate the positive impact an active lifestyle can have on the development of children and young people’s health and mental, emotional and social wellbeing. Whitehead (2004) supports this concept that physical education is much more than the learning of sport- related skills for children. It also develops their higher order thinking skills. Lawrence (2018) conveys that competing in sport and physical activity provides opportunities for children and young people to build their character and that sport helps to embed values, such as fairness, respect and sportsmanship. Finally, Eime et al., (2013) highlight that participation helps to tackle mental health issues such as anxiety, depression, feelings of isolation and suicide due to advantages such as forming relationships, teamwork and social skills. These benefits all accentuate the significance of physical education as part of promoting health and wellbeing within the contemporary Scottish education setting.

Food and Health

Health Promotion is a central purpose of schooling. The implementation of Curriculum for Excellence has provided children and young people with knowledge and skills to help them make the correct food choices and to understand the health benefits, if these are sustained (Scottish Government, 2014). Schools have been identified as a fundamental environment to positively influence children’s relationship with food. Not only providing information on the benefits, but also allowing children the opportunity to experiment and taste, which might not be afforded in less advantaged households due to concerns of waste and expense (Burns, 2014). Poor diet has been linked with poorer academic, social and emotional development of children and young people (White, 2017). Children living in economically deprived areas are also at greater risk of health concerns such as obesity and starvation, compared to those living in more affluent areas (Jotangia et al., 2016). In order to address the possible health and academic disadvantages for children and young people, depending on the areas they reside, the Scottish Government introduced the Scottish Attainment Challenge in 2015, which focusses on achieving equity in education and ensuring every child has the same opportunity to succeed (Scottish Government, 2016). Through this, the introduction of breakfast clubs, free school meals and free drinking water were implemented across many schools in Scotland, to improve pupil concentration and attainment in class (White, 2017). This corresponds with Maslow’s Hierarchy of Needs, in that if children’s basic physiological needs are not met, such as food, water etc., then they will not be able to reach their full potential within the classroom environment (Maslow, 1943). This further strengthens the significance of promoting health and wellbeing in the contemporary Scottish education setting.

Substance Misuse

Stead and Stradling (2010) acknowledge schools as having a significant role in a National Substance Misuse strategy. This is due to schools having a duty of care to protect and promote the health and wellbeing of children and young people, and the efficient way schools can reach most of the younger community. Brooks (2010) highlights that early onset substance misuse by children and young people can be a key indicator to future and long term usage, which in turn can lead to alcohol problems, illegal drug use, low educational attainment and involvement in crime throughout life (Viner and Taylor, 2007). Education programmes have been identified as a method in which schools can raise awareness of the potential physical, mental and social damage that alcohol and substance misuse can have on their lives, and the lives of others (Mistral and Templeton, 2010). It is anticipated that these education programmes will positively influence pupils’ opinions, through awareness of the devastating effects that substance misuse can cause. Stead and Stradling (2010) support the idea that the teaching of this topic, can be done by the class teacher, peer to peer through investigation and presentation, but also the inclusion of external agencies, such as health professionals and the police. Therefore, an early introduction and education of the dangers surrounding substance misuse to children and young people, is highly significant in the contemporary Scottish education setting.

Relationships, Sexual Health and Parenthood

Cohen et al., (2004) accentuates the role of education in the early socialisation of children, with the transformation of socialisation in the home to the wider community. Through socialisation, children and young people can develop positive self-esteem, security in relationships, trust in others and learn how to behave and interact with others (Cohen et al., 2004). This perception of education developing the importance of relationships in children and young people’s Health and Wellbeing, is enhanced by Phillips and Soltis (2004) who infer that socialising students to become functioning members of society is part of a teacher’s responsibility. In viewing relationships in line with sexual health, the World Health Organization (2006) state that sexual health is a vital element of wellbeing, which includes the idea of a positive, pleasant and safe sexual relationship. Ingham and Hirst (2010) support this definition of sexual health, which portrays a more positive perception within the wider concept of relationships and wellbeing. The Scottish Government (2016b) also back this use and promotion of sexual health, and emphasise the importance of developing the knowledge, understanding and use of correct anatomical terminologies in children and young people. Education Scotland (2020) also highlight the importance of children and young people comprehending the role and responsibility involved in being a parent or carer. This also relates to the significance of schools developing positive relationships with parents as partners in children’s education, which will increase the prospect of co-operation, and parents being more likely to adopt similar positive approaches to health and wellbeing within the home environment (James, 2010).

Introduction

In this assignment, I am going to explain the different social determinants of health and how they impact population health, explain the importance of public policies, identify sources of public health knowledge, and talk about social circumstances, health, and individual capacity for self-determination. Public health programs are extremely significant to us, these programs promote and protect the health of everyone. Public health programs are remarkable to families as their general point is to improve public health. The most prevalent and momentous public health programs in the United Kingdom include vaccinations, free school meals, and screening programs such as mammography, and cervical screening. Many public policies such as speed restrictions, drunk driving, wearing masks, and no smoking at work are all in place to help with public health and work alongside public health programs.

Public policy; smoking ban

There are many social determinants of health. These are non-medical factors that influence health (Who. int, 2021). Additionally, the term public policy refers to a set of movements the government takes to report matters within society (Ebscohost.com, pg. 1, 2021). All public policies are created to protect the health and well-being of all individuals in society. An example of this is the smoking ban in workplaces where smoking is not allowed in any enclosed workplace, public building, or on public transport in the UK. This public policy impacts health by improving in overall lung function for individuals who used to work in smoke-filled environments. Researchers have suggested that there was an associated reduction in attendance in the emergency room related to breathing problems, asthma, and heart-related problems since the smoking ban was put in place (Myers, 2011). It is very important that people in the healthcare profession promote the benefits of the smoking ban and educate the population on chronic illnesses related to smoking, this is because ‘If you’re working in health improvement or healthcare public health, you may be more involved in the longer-term work of interpreting data on heart disease or lung cancer’ therefore they will have more knowledge on the subject to educate (Public health knowledge and intelligence professional, 2015). According to the WHO ‘More than 170 countries in the world have initiated tobacco control policies and regulations’ (Nilan et al. 2017; WHO 2017). It is evident that this public policy takes the pressure off many public services and programs, for example, Asthma UK is a free program developed by asthma clinicians and health psychology experts to help asthma patients (Asthma UK, 2021), however, due to the smoking ban having such a positive impact on asthma this public health program will not be under as much pressure. However on the other hand, we are not fully protected in some social circumstances as people are still allowed to smoke outdoors in public, also how do we protect individuals with no capacity, for example, children cannot stop parents who smoke inside the house when the child is present, ‘second-hand smoke increases the risk of infections of the respiratory system, middle ear disease, asthma, breathing-related symptoms and declines in lung function among children’ (Tobacco-Free Life, 2016). Nonetheless, further countries need to take crucial steps to decrease tobacco use and save the lives of the billion people who would otherwise die from tobacco-related diseases around the world during this century. Although in the UK most social determinants of health are protected by this public policy, living, and working conditions are not protected from smoking in every country around the world ‘twenty-three states, Guam, Northern Mariana Islands, and Palau do not yet have comprehensive smoke free indoor air laws covering all bars, restaurants, and worksites’ (Anon, 2021).

Public policy; free school meals

Another public policy I would like to discuss is free school meals. Free school meals are a public policy that impacts health by protecting children in poverty from starving. Examples of how this is done include the government paying for the meals of children in school if their home income is low, ‘17.3% of pupils are known to be eligible for free school meals’ (Service.gov.uk, 2019). Several schools offer free school meals (FSM) to students at state-maintained colleges if the child is understood to be from a financially deprived background. According to Gorard, 2012, ‘there were 624,247 KS4 pupils in England in 2007. Of these 84.3% were not eligible for FSM, 12.4% were eligible and 3.3% were still recorded with no FSM data’ (Gorard, 2012). It is essential that schools provide free school meals for those who are in need, to meet the school food standards agency (Department for Education, 2020). However, I am going to discuss how the covid 19 pandemic impacted this public policy. During the pandemic schools had to shut therefore children were missing out on their free school meals, a lot of families were struggling, and a lot of children were starving. It is unfair that different social determinants of health have such a massive impact on children when they are unable to change their social circumstances and living conditions due to their age. It is important that our public figures show the importance of free school meals. Marcus Rashford said: ‘This is not politics, this is humanity’ (Proquest.com, 2020). ‘Marcus Rashford is an ambassador for fare share and has donated 20 million pounds to food, poverty, and community charities to help people fighting with hunger’ (FareShare, 2021).

Vaccines

Another public health program is vaccinations. Vaccinations not only protect your child from deadly diseases, such as polio, tetanus, and diphtheria, but they also keep other children safe by eliminating or greatly decreasing dangerous diseases that used to spread from child to child (Stanfordchildrens.org, 2019), This does not only protect the public, but it also takes the pressure off health services as there will be fewer sick people. On-time vaccination throughout childhood is essential because it helps ‘provide immunity before children are exposed to potentially life-threatening diseases’, (Centers for disease control and Prevention, 2019) so why should some children miss out on this opportunity because of their parents? A lot of parents have reservations about letting their children get the vaccines they are being offered, therefore it is very important that the principal sources of public health knowledge such as doctors and nurses, promote how important it is for everyone to get vaccinated, ‘If you’re working within health protection you may be involved in work on infectious diseases requiring a rapid response for example, providing information to inform the advice given to the public about pandemic flu or norovirus’ (Public health knowledge and intelligence professional, 2015). Some diseases that once injured or killed thousands of children have been eliminated completely and others are close to extinction, primarily due to safe and effective vaccines. According to the CDC parents can protect their children younger than 2 years of age from 14 potentially severe illnesses by getting them vaccinated (The Childhood vaccine-preventable diseases, and vaccine safety: Immunization Schedule, n.d.) Vaccine hesitancy is one of the top 10 biggest threats to global health (WHO, 2019). Vaccine hesitancy is where people with access to vaccines delay or refuse vaccination. Studies show that ‘In 2012, there was a large outbreak of measles, initially concentrated in the Liverpool area, which subsequently spread to surrounding communities in the Northwest of England. Most cases occurred in older unvaccinated children, or infants too young for vaccination’ (Proquest.com, 2017). People who are born and live in more deprived areas have health inequalities and have a lower life expectancy and a lot of this is due to not having vaccinations that are offered to people in non-deprived areas. According to Dahlgren and Whitehead (1991) ‘The broad social and economic circumstances that together determine the quality of the health of the population are known as the ‘social determinants of health’ (Public Health England, 2017). Although the government must spend money on vaccinations every year this is a lot more cost-effective than people not getting vaccinated and the NHS being overwhelmed with people suffering from these preventable diseases. There is an increasing need now for all nurses to become agents of public health and promote health as part of their clinical practice (While 2014).

Government funding

Furthermore, a lot of public health programs would not be able to function if we did not have the government to provide us with the funds. However, it is very important that the public health programs that are available to us are promoted and advertised so that people are aware of them. This can be done through nurses and doctors or even television advertisements. Health experts from the Nuffield Trust, Health Foundation, and King’s Fund say tight spending in recent years and increasing demand for services have been ‘taking a mounting toll on patient care’. They add that there is ‘growing evidence that access to some treatments is being rationed and that quality of care in some services is being diluted’ (Full Fact, 2019). ‘Public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole’ (The Royal College of Nursing, 2020). On the other hand, in 2014, the commonwealth fund declared that in correlation with the medical services frameworks of 10 different nations, the NHS was the best. For example, according to the NHS funding ‘in 201819 prices, health expenditure in England increased from £30.2 billion in 197980 to £130.3 billion in 201819’. Although the government and health services provide us with public health programs to help the health of the population, some diseases are obtained from genetic reasons and cannot be prevented.

However, not all public health programs are supported by the government. According to the King’s Fund, Jo’s Cervical Cancer Trust is the only UK charity that supports people afflicted by cervical cancer and anomalies, and it focuses its efforts on raising awareness and recognition of the condition, as well as ways to avoid it (The King’s Fund, 2015). There is now a vaccine to help protect women from cervical cancer (The man who saved a million lives, pg.25) This vaccine is called the HPV vaccine, and up until 2018 this vaccine was only offered to females ‘In July 2018, it was announced that the HPV vaccine would be extended to boys aged 12 to 13 years in England (NHS Choices, 2021). Jo’s cervical cancer trust states that their Public Health Engagement Coordinators work to increase screening coverage by educating and collaborating with healthcare providers, as well as hiring neighborhood volunteers coverage through preparation and collaboration with healthcare practitioners, recruitment of community volunteers, and close engagement with community organizations. Cervical cancer is entirely preventable, with cervical tests preventing 75 percent of cases. However, what good is cervical screening programs if not every woman avail of them? Some women feel embarrassed to attend these appointments, therefore it is extremely important for not only healthcare professionals to promote the importance but public influencers too. Rebecca Vardy is one of the many women who has been promoting cervical screening in the hope that others will follow in their example, she posted a picture on social media to her 110k followers of her attending her appointment talking about the benefits it will bring (Cervical Screening, 2019). Every year in the United Kingdom, an unprecedented 5,000 lives are saved because of the nationwide cervical screening program saves an estimated 5,000 lives in the UK per year, but participation is declining (Jo’s Cervical Cancer Trust, 2021). In women aged 35-64 years, regular screening is associated with a 95% reduction in cervical cancer (Landy et al., 2016). On the other hand, there is controversy about whether younger females should be offered cervical screening as the programs are only offered to women aged 25, although ‘In the UK, per 100,000 women about 4 people are diagnosed with cervical cancer under the age of 25’ (ClaireCohen, 2014).

Conclusion

Overall public health programs are to help the population in as many ways as possible. Public health professionals try to help the public by educating people on things such as vaccinations. Many people hear false information about vaccinations, for example, many parents think that vaccines can cause autism therefore they do not get their children vaccinated for the many diseases that they could get throughout their childhood. However public health professionals make sure to educate as many people as they can by explaining that studies have shown that there is no link between receiving vaccines and developing Autism. It is evident that we need government funding to avail public health programs for everyone, and without this funding, there would be a lot more people with serious diseases. Furthermore, during my research, I became more aware of how important public policies like free school meals are. Free school meals save so many families in poverty in England and without this public policy, there would be so many children who would starve. There is a public health program out there for nearly everything and we as individuals and as a society benefit from them.

The World Health Organization (1948) defines Health “as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”. This meaning suggests that the health of an individual incorporates much more than just the absence of an illness and includes several aspects of a person’s wellbeing. The World Health Organization (2004) describes the state of wellbeing, to be when an individual knows their own abilities, manages the general stresses of life, and can work efficiently to be an effective contributor to their society. This interpretation is supported by Austin (2016) who refers to wellbeing as living responsibly in good health in the social world, and Deighton et al., (2016) who portray wellbeing in children as a sense of confidence: “feeling good, feeling that their life is going well, and feeling able to get on with their daily lives”.

These perceptions are reinforced by the definition provided by the Collins English Dictionary (2020) as the condition of being contented, healthy and successful. In conjunction with the positive characterisation of the key components included in being in a state of health and wellbeing in life, it is understandable why the Scottish Government have placed the promotion of health and wellbeing at the forefront of the Curriculum for Excellence in contemporary Scottish education. Curriculum for Excellence aims to ensure that all children and young people in Scotland develop the knowledge, skills and attributes necessary, to enable them to flourish in life. It strives to instill four capacities in all young people, to become successful learners, confident individuals, responsible citizens and effective contributors (Scottish Executive, 2004). These four capacities are embedded within the varying definitions of health and wellbeing provided.

The key educational policy, Curriculum for Excellence and Getting It Right for Every Child (GIRFEC) approach were introduced to Scottish education, to support children and young people’s health and wellbeing, at the very core (Scottish Government, 2016a). The GIRFEC approach focuses on supporting children and young people to feel safe, loved and respected, to ensure they can reach their full potential. The concept is based on eight wellbeing indicators, which are: safe, healthy, achieving, nurtured, active, respected, responsible and included. These are used to measure a child’s development and identify if they are requiring any additional support or help within a particular aspect of their life (Children in Scotland, 2019). Through the increased focus on health and wellbeing, school staff and teachers have a responsibility to raise any concerns relating to these wellbeing indicators with partner agencies.

As a result of the Schools (Health Promotion and Nutrition) (Scotland) Act 2007, Curriculum for Excellence has placed a high priority to Health and Wellbeing and endorsed it alongside Literacy and Numeracy. These three core subjects should be developed and supported across all features of the curriculum and are established as ‘The Responsibility of All’ teachers (Scottish Government, 2016a). Unlike literacy and numeracy, which can be assessed through attainment, extra emphasis has been placed on health and wellbeing as a curricular area, but also as part of the wider school experience, including ethos, relationships, rights and responsibilities (Spratt, 2018).

Currently within Scottish Education, there is a commitment towards a holistic approach to health and wellbeing. McLaughlin (2015) believes that rather than there being a focus on an attainment driven curriculum of wellbeing, there is also much more consideration towards the “whole child”. Focus is not solely on what each pupil learns academically, but on their overall personal development and attribution of skills and knowledge to help them succeed in life. Horrell et al., (2012) also believe that Wellbeing encompasses more than just the health of a child. It is vital to ensure their mental, emotional, social and physical development needs are met. The Scottish Government strive to address health and wellbeing within 6 key areas:

1. Mental, emotional, social and physical wellbeing;
2. Planning for choices and changes;
3. Physical education, physical activity and sport;
4. Food and health;
5. Substance misuse;
6. Relationships, sexual health and parenthood.

These six areas are interdependent and essential, to equip children and young people with the knowledge, understanding and skills they need to make informed decisions and succeed in life (Education Scotland, 2014). Furthermore, Payler and Scanlon (2018) maintain that incorporating these dimensions within the classroom, is the responsibility of all teachers, to promote the best possible educational experience. Spratt (2018) echoes this belief and describes health and wellbeing as the vital foundation to which all learning can build on.

Mental, Emotional, Social and Physical Wellbeing

Through addressing mental, emotional, social and physical wellbeing, pupils will become more resilient, have greater self-esteem, a better understanding and management of themselves and a higher level of interpersonal skills (Scottish Government, 2016). Harden et al., (2001) acknowledge the importance of mental health throughout life but highlight the significance during school years – particularly in relation to attainment and lifelong learning. As well as increased attainment, Catalano et al., (2002) state that good mental health leads to less involvement with the criminal justice system, lower cost to public services, greater potential and resilience for life. Edwards (2003) implies that poor mental health, greatly depreciates educational attainment, and Graham and Power (2003) indicate that this can then lead to poor career and life opportunities, involvement in crime and substance misuse. These outcomes demonstrate the importance of teachers fostering a positive learning environment and promoting the wellbeing of all pupils (Kyriacou, 1998), with the Scottish Government tackling mental health by placing emotional and social wellbeing of pupils at the heart of education (Weare, 2010). Robinson (2018) strengthens this view, in that establishing positive pupil and teacher relationships, this will instill a sense of security for pupils. Pye (1988) refers to teachers utilising the skills of ‘solicitous tenderness’ to provide pupils with warmth, reassurance and kindness. These techniques will ensure that teachers fulfill their role in creating a happy, supportive and inclusive environment to assist pupils’ learning and development.

Planning for Choices and Changes

Education Scotland (2020) suggest that for pupils’ health and wellbeing to be promoted, children and young people should be provided with opportunities to actively learn about choices, managing expectations and making decisions within real life contexts. James and Prout (1997) emphasise the importance of children being involved in the construction of their social lives, as well as the lives of others, and the society in which they live. Cohen et al., (2004) supports this idea in the educational context, in that when a teacher undertakes their duty of care, they must enable students the opportunity of choice: to explore, take responsibility for their actions, learn to demonstrate creativity and independence. This concept is further backed by Watson et al., (2012) who believe health and wellbeing in schools, is about the development of a pupil’s responsibility and higher order thinking skills. Weare (2010) enhances this viewpoint, in that positive health and wellbeing helps to create concerned citizens, who understand themselves, can empathise with their peers, care about their wider community, and make informed choices. This can only be achieved through empowering children and young people through exercising their choice, self-exploration and learning (Butcher, 2010). The introduction of a ‘Change Challenge’ initiative within the classroom, would provide pupils with the choice to adopt either a physical activity or replacing an unhealthy food option with a healthier item over the course of a week. Pupils would then reflect on the positive impact this change has made.

Physical Education, Physical Activity and Sport

Physical education, physical activity and sport has prospered through the introduction of Curriculum for Excellence. With the curriculum being identified as a site for health promotion, to reduce expenditure on health care, physical education is being used as a vehicle to adopt a more active and healthier lifestyle (Horrell et al., 2012). Since 2009, The Scottish Government introduced the need for a minimum of 2 hours of quality physical education in schools per week. Active Schools was introduced in 2000, becoming a focal point within Primary Schools in Scotland. Their aim continues to be the promotion of physical activity and participation in sport before, during and after school (Scottish Government, 2009). Brooks and Magnusson (2006) indicate the positive impact an active lifestyle can have on the development of children and young people’s health and mental, emotional and social wellbeing. Whitehead (2004) supports this concept that physical education is much more than the learning of sport- related skills for children. It also develops their higher order thinking skills. Lawrence (2018) conveys that competing in sport and physical activity provides opportunities for children and young people to build their character and that sport helps to embed values, such as fairness, respect and sportsmanship. Finally, Eime et al., (2013) highlight that participation helps to tackle mental health issues such as anxiety, depression, feelings of isolation and suicide due to advantages such as forming relationships, teamwork and social skills. These benefits all accentuate the significance of physical education as part of promoting health and wellbeing within the contemporary Scottish education setting.

Food and Health

Health Promotion is a central purpose of schooling. The implementation of Curriculum for Excellence has provided children and young people with knowledge and skills to help them make the correct food choices and to understand the health benefits, if these are sustained (Scottish Government, 2014). Schools have been identified as a fundamental environment to positively influence children’s relationship with food. Not only providing information on the benefits, but also allowing children the opportunity to experiment and taste, which might not be afforded in less advantaged households due to concerns of waste and expense (Burns, 2014). Poor diet has been linked with poorer academic, social and emotional development of children and young people (White, 2017). Children living in economically deprived areas are also at greater risk of health concerns such as obesity and starvation, compared to those living in more affluent areas (Jotangia et al., 2016). In order to address the possible health and academic disadvantages for children and young people, depending on the areas they reside, the Scottish Government introduced the Scottish Attainment Challenge in 2015, which focusses on achieving equity in education and ensuring every child has the same opportunity to succeed (Scottish Government, 2016). Through this, the introduction of breakfast clubs, free school meals and free drinking water were implemented across many schools in Scotland, to improve pupil concentration and attainment in class (White, 2017). This corresponds with Maslow’s Hierarchy of Needs, in that if children’s basic physiological needs are not met, such as food, water etc., then they will not be able to reach their full potential within the classroom environment (Maslow, 1943). This further strengthens the significance of promoting health and wellbeing in the contemporary Scottish education setting.

Substance Misuse

Stead and Stradling (2010) acknowledge schools as having a significant role in a National Substance Misuse strategy. This is due to schools having a duty of care to protect and promote the health and wellbeing of children and young people, and the efficient way schools can reach most of the younger community. Brooks (2010) highlights that early onset substance misuse by children and young people can be a key indicator to future and long term usage, which in turn can lead to alcohol problems, illegal drug use, low educational attainment and involvement in crime throughout life (Viner and Taylor, 2007). Education programmes have been identified as a method in which schools can raise awareness of the potential physical, mental and social damage that alcohol and substance misuse can have on their lives, and the lives of others (Mistral and Templeton, 2010). It is anticipated that these education programmes will positively influence pupils’ opinions, through awareness of the devastating effects that substance misuse can cause. Stead and Stradling (2010) support the idea that the teaching of this topic, can be done by the class teacher, peer to peer through investigation and presentation, but also the inclusion of external agencies, such as health professionals and the police. Therefore, an early introduction and education of the dangers surrounding substance misuse to children and young people, is highly significant in the contemporary Scottish education setting.

Relationships, Sexual Health and Parenthood

Cohen et al., (2004) accentuates the role of education in the early socialisation of children, with the transformation of socialisation in the home to the wider community. Through socialisation, children and young people can develop positive self-esteem, security in relationships, trust in others and learn how to behave and interact with others (Cohen et al., 2004). This perception of education developing the importance of relationships in children and young people’s Health and Wellbeing, is enhanced by Phillips and Soltis (2004) who infer that socialising students to become functioning members of society is part of a teacher’s responsibility. In viewing relationships in line with sexual health, the World Health Organization (2006) state that sexual health is a vital element of wellbeing, which includes the idea of a positive, pleasant and safe sexual relationship. Ingham and Hirst (2010) support this definition of sexual health, which portrays a more positive perception within the wider concept of relationships and wellbeing. The Scottish Government (2016b) also back this use and promotion of sexual health, and emphasise the importance of developing the knowledge, understanding and use of correct anatomical terminologies in children and young people. Education Scotland (2020) also highlight the importance of children and young people comprehending the role and responsibility involved in being a parent or carer. This also relates to the significance of schools developing positive relationships with parents as partners in children’s education, which will increase the prospect of co-operation, and parents being more likely to adopt similar positive approaches to health and wellbeing within the home environment (James, 2010).

Introduction

In this assignment, I am going to explain the different social determinants of health and how they impact population health, explain the importance of public policies, identify sources of public health knowledge, and talk about social circumstances, health, and individual capacity for self-determination. Public health programs are extremely significant to us, these programs promote and protect the health of everyone. Public health programs are remarkable to families as their general point is to improve public health. The most prevalent and momentous public health programs in the United Kingdom include vaccinations, free school meals, and screening programs such as mammography, and cervical screening. Many public policies such as speed restrictions, drunk driving, wearing masks, and no smoking at work are all in place to help with public health and work alongside public health programs.

Public policy; smoking ban

There are many social determinants of health. These are non-medical factors that influence health (Who. int, 2021). Additionally, the term public policy refers to a set of movements the government takes to report matters within society (Ebscohost.com, pg. 1, 2021). All public policies are created to protect the health and well-being of all individuals in society. An example of this is the smoking ban in workplaces where smoking is not allowed in any enclosed workplace, public building, or on public transport in the UK. This public policy impacts health by improving in overall lung function for individuals who used to work in smoke-filled environments. Researchers have suggested that there was an associated reduction in attendance in the emergency room related to breathing problems, asthma, and heart-related problems since the smoking ban was put in place (Myers, 2011). It is very important that people in the healthcare profession promote the benefits of the smoking ban and educate the population on chronic illnesses related to smoking, this is because ‘If you’re working in health improvement or healthcare public health, you may be more involved in the longer-term work of interpreting data on heart disease or lung cancer’ therefore they will have more knowledge on the subject to educate (Public health knowledge and intelligence professional, 2015). According to the WHO ‘More than 170 countries in the world have initiated tobacco control policies and regulations’ (Nilan et al. 2017; WHO 2017). It is evident that this public policy takes the pressure off many public services and programs, for example, Asthma UK is a free program developed by asthma clinicians and health psychology experts to help asthma patients (Asthma UK, 2021), however, due to the smoking ban having such a positive impact on asthma this public health program will not be under as much pressure. However on the other hand, we are not fully protected in some social circumstances as people are still allowed to smoke outdoors in public, also how do we protect individuals with no capacity, for example, children cannot stop parents who smoke inside the house when the child is present, ‘second-hand smoke increases the risk of infections of the respiratory system, middle ear disease, asthma, breathing-related symptoms and declines in lung function among children’ (Tobacco-Free Life, 2016). Nonetheless, further countries need to take crucial steps to decrease tobacco use and save the lives of the billion people who would otherwise die from tobacco-related diseases around the world during this century. Although in the UK most social determinants of health are protected by this public policy, living, and working conditions are not protected from smoking in every country around the world ‘twenty-three states, Guam, Northern Mariana Islands, and Palau do not yet have comprehensive smoke free indoor air laws covering all bars, restaurants, and worksites’ (Anon, 2021).

Public policy; free school meals

Another public policy I would like to discuss is free school meals. Free school meals are a public policy that impacts health by protecting children in poverty from starving. Examples of how this is done include the government paying for the meals of children in school if their home income is low, ‘17.3% of pupils are known to be eligible for free school meals’ (Service.gov.uk, 2019). Several schools offer free school meals (FSM) to students at state-maintained colleges if the child is understood to be from a financially deprived background. According to Gorard, 2012, ‘there were 624,247 KS4 pupils in England in 2007. Of these 84.3% were not eligible for FSM, 12.4% were eligible and 3.3% were still recorded with no FSM data’ (Gorard, 2012). It is essential that schools provide free school meals for those who are in need, to meet the school food standards agency (Department for Education, 2020). However, I am going to discuss how the covid 19 pandemic impacted this public policy. During the pandemic schools had to shut therefore children were missing out on their free school meals, a lot of families were struggling, and a lot of children were starving. It is unfair that different social determinants of health have such a massive impact on children when they are unable to change their social circumstances and living conditions due to their age. It is important that our public figures show the importance of free school meals. Marcus Rashford said: ‘This is not politics, this is humanity’ (Proquest.com, 2020). ‘Marcus Rashford is an ambassador for fare share and has donated 20 million pounds to food, poverty, and community charities to help people fighting with hunger’ (FareShare, 2021).

Vaccines

Another public health program is vaccinations. Vaccinations not only protect your child from deadly diseases, such as polio, tetanus, and diphtheria, but they also keep other children safe by eliminating or greatly decreasing dangerous diseases that used to spread from child to child (Stanfordchildrens.org, 2019), This does not only protect the public, but it also takes the pressure off health services as there will be fewer sick people. On-time vaccination throughout childhood is essential because it helps ‘provide immunity before children are exposed to potentially life-threatening diseases’, (Centers for disease control and Prevention, 2019) so why should some children miss out on this opportunity because of their parents? A lot of parents have reservations about letting their children get the vaccines they are being offered, therefore it is very important that the principal sources of public health knowledge such as doctors and nurses, promote how important it is for everyone to get vaccinated, ‘If you’re working within health protection you may be involved in work on infectious diseases requiring a rapid response for example, providing information to inform the advice given to the public about pandemic flu or norovirus’ (Public health knowledge and intelligence professional, 2015). Some diseases that once injured or killed thousands of children have been eliminated completely and others are close to extinction, primarily due to safe and effective vaccines. According to the CDC parents can protect their children younger than 2 years of age from 14 potentially severe illnesses by getting them vaccinated (The Childhood vaccine-preventable diseases, and vaccine safety: Immunization Schedule, n.d.) Vaccine hesitancy is one of the top 10 biggest threats to global health (WHO, 2019). Vaccine hesitancy is where people with access to vaccines delay or refuse vaccination. Studies show that ‘In 2012, there was a large outbreak of measles, initially concentrated in the Liverpool area, which subsequently spread to surrounding communities in the Northwest of England. Most cases occurred in older unvaccinated children, or infants too young for vaccination’ (Proquest.com, 2017). People who are born and live in more deprived areas have health inequalities and have a lower life expectancy and a lot of this is due to not having vaccinations that are offered to people in non-deprived areas. According to Dahlgren and Whitehead (1991) ‘The broad social and economic circumstances that together determine the quality of the health of the population are known as the ‘social determinants of health’ (Public Health England, 2017). Although the government must spend money on vaccinations every year this is a lot more cost-effective than people not getting vaccinated and the NHS being overwhelmed with people suffering from these preventable diseases. There is an increasing need now for all nurses to become agents of public health and promote health as part of their clinical practice (While 2014).

Government funding

Furthermore, a lot of public health programs would not be able to function if we did not have the government to provide us with the funds. However, it is very important that the public health programs that are available to us are promoted and advertised so that people are aware of them. This can be done through nurses and doctors or even television advertisements. Health experts from the Nuffield Trust, Health Foundation, and King’s Fund say tight spending in recent years and increasing demand for services have been ‘taking a mounting toll on patient care’. They add that there is ‘growing evidence that access to some treatments is being rationed and that quality of care in some services is being diluted’ (Full Fact, 2019). ‘Public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole’ (The Royal College of Nursing, 2020). On the other hand, in 2014, the commonwealth fund declared that in correlation with the medical services frameworks of 10 different nations, the NHS was the best. For example, according to the NHS funding ‘in 201819 prices, health expenditure in England increased from £30.2 billion in 197980 to £130.3 billion in 201819’. Although the government and health services provide us with public health programs to help the health of the population, some diseases are obtained from genetic reasons and cannot be prevented.

However, not all public health programs are supported by the government. According to the King’s Fund, Jo’s Cervical Cancer Trust is the only UK charity that supports people afflicted by cervical cancer and anomalies, and it focuses its efforts on raising awareness and recognition of the condition, as well as ways to avoid it (The King’s Fund, 2015). There is now a vaccine to help protect women from cervical cancer (The man who saved a million lives, pg.25) This vaccine is called the HPV vaccine, and up until 2018 this vaccine was only offered to females ‘In July 2018, it was announced that the HPV vaccine would be extended to boys aged 12 to 13 years in England (NHS Choices, 2021). Jo’s cervical cancer trust states that their Public Health Engagement Coordinators work to increase screening coverage by educating and collaborating with healthcare providers, as well as hiring neighborhood volunteers coverage through preparation and collaboration with healthcare practitioners, recruitment of community volunteers, and close engagement with community organizations. Cervical cancer is entirely preventable, with cervical tests preventing 75 percent of cases. However, what good is cervical screening programs if not every woman avail of them? Some women feel embarrassed to attend these appointments, therefore it is extremely important for not only healthcare professionals to promote the importance but public influencers too. Rebecca Vardy is one of the many women who has been promoting cervical screening in the hope that others will follow in their example, she posted a picture on social media to her 110k followers of her attending her appointment talking about the benefits it will bring (Cervical Screening, 2019). Every year in the United Kingdom, an unprecedented 5,000 lives are saved because of the nationwide cervical screening program saves an estimated 5,000 lives in the UK per year, but participation is declining (Jo’s Cervical Cancer Trust, 2021). In women aged 35-64 years, regular screening is associated with a 95% reduction in cervical cancer (Landy et al., 2016). On the other hand, there is controversy about whether younger females should be offered cervical screening as the programs are only offered to women aged 25, although ‘In the UK, per 100,000 women about 4 people are diagnosed with cervical cancer under the age of 25’ (ClaireCohen, 2014).

Conclusion

Overall public health programs are to help the population in as many ways as possible. Public health professionals try to help the public by educating people on things such as vaccinations. Many people hear false information about vaccinations, for example, many parents think that vaccines can cause autism therefore they do not get their children vaccinated for the many diseases that they could get throughout their childhood. However public health professionals make sure to educate as many people as they can by explaining that studies have shown that there is no link between receiving vaccines and developing Autism. It is evident that we need government funding to avail public health programs for everyone, and without this funding, there would be a lot more people with serious diseases. Furthermore, during my research, I became more aware of how important public policies like free school meals are. Free school meals save so many families in poverty in England and without this public policy, there would be so many children who would starve. There is a public health program out there for nearly everything and we as individuals and as a society benefit from them.