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9PUBLIC HEALTH AND HEALTH PROMOTION RESPONSES

Public Health and Health Promotion Responses

Public Health and Health Promotion Responses

Introduction

Health promotion deals with raising the health status among people and the community at large. In the health context, promotion involves improving, advancing and placing health status of people higher on both personal and public level (Naidoo and Wills, 2010). With various socioeconomic determinants of health being outside a collective control, the primary aspect of health promotion aims to empower individuals to have control over parts of their lives that impact their health (Vos et al., 2010). On the other hand, public health can be defined as all-arranged measures to prevent diseases and disabilities, prolong life and promote general health of people. Public health and health promotion activities aim to offer conditions where people can be healthy and focus on the whole population and not on an individual level. They are concerned with total system in addition to eradicating particular diseases. In the modern times, there are various responses in public health and health promotions that are aimed at preventing diseases, injuries, disabilities or any other health conditions at the same time enabling people take responsibility of their health in order to improve it. The public health and health promotion responses outline steps and procedures for strengthening public health system to have the ability to respond to and protect the public against health dangers (Naidoo and Wills, 2010). This paper will highlight three responses considered to be fundamental in public health; two Australian and one international. The two Australian public health responses that will be discussed in the paper include the asthma and dental health responses while the international response involves the prevention of micronutrient deficiency diseases globally.

Public health response to micronutrient deficiency conditions

In the beginning of the 20th century, what was termed as vital amines now called vitamins were considered a public health problem with regard to the widespread of deficiency diseases that could be reduced by fortification of salt with iodine or even flour with vitamin B. With time, more micronutrient deficiency diseases have emerged including those involving folic acid and vitamin D (Scrinis, 2013). Due to this, fortification of various foods with essential trace elements has grown to be a major part of public health practice in responding to micronutrient deficiency conditions. Continuing reduction in the new micronutrient deficiency diseases like goitre and rickets have been a huge help to people especially to child health across the world. In spite of the iodization of salt as recommendation by World Health Organisation, iodine deficiency impacts more than 1 billion people including approximately 50% of the European population. The failure to control and eradicate iron and vitamin D deficiencies also has implications for clinical health services and affects a nation as a whole especially with increasing long life of the population (Scrinis, 2013).

Food fortification as a means of preventing micronutrient deficiency conditions has occurred due to cooperative efforts of the governmental and non-governmental agencies and the food industry (Preedy, Srirajaskanthan and Patel, 2013). In addition, public health education with regard to micronutrient deficiency problems are now supported by the widespread use of the internet that play a fundamental role in passing information on the importance of vitamin supplements including vitamin D to people having vitamin deficiency, supplements for the larger population to prevent cardiovascular diseases, asthma and other conditions and vitamin D fortification of milk (Preedy, Srirajaskanthan and Patel, 2013). Nevertheless, food fortification has been a subject rife with controversy. For instance, many people especially from North America widely accept the concept of fortification of flour with vitamin B complex and iron and milk with vitamin D. there is no clinical epidemiological evidence of negative effects on the account of such measures.

Folic acid fortification of flour in North and South America has reduced the prevalence of neural tube defects since 1998 yielding economic and social benefits in return. A good number of countries in Europe also support the fortification of flour with folic acid in an aim of preventing neural tube defects alongside fortifying their milk with vitamin D (Preedy, Srirajaskanthan and Patel, 2013). According to a research done in the United States by the Centres of Disease Control and Prevention, between the period of 2004 and 2008, the amount of flour being fortified increased from 89 to 97% in the country. In addition, the amount of fortified flour in the African regions increased from 26 to 31 per cent, in European regions from 3 to 6 per cent and in South-East Asia Regions from 16 to 21 between 2004 and 2008 (Preedy, Srirajaskanthan and Patel, 2013). Vitamin D deficiency is considered a global pandemic that negatively affects the public health. However, in many European countries, there lack efforts to recommend it. In addition, the fluoridation of water supplies is considered by the general population and the United States Centres for Disease Control and Prevention as one of the major achievements of health promotion and public health of the 20th century.

Australian Public health response to asthma

Asthma is a serious problem not only in Australia but across the globe and affects both the adults and the children (Samour and King, 2012). Asthma often occurs more in affluent communities than in poor ones and therefore, in Australia, the levels are very high compared to the range of other countries. There are evidences that show that asthma is becoming increasingly common and severe in Australia with time. Defining asthma, it is an inflammatory condition affecting the air passages making them prone to narrow to a great extend in response to triggers such as exercise, cold weather, tobacco smoking, and dust among other factors (Samour and King, 2012). Asthma is very common among those with asthmatic parents, infants whose parents smoked while pregnant and those with allergic features such as eczema and fever. It is the major cause of disability and hospitalisation in Australia and its attack is fatal. Therefore, it is considered a public health issues that need to be addressed.

In 1996, more than 700 Australians died from asthma. And between the period of 1987 and 1996, the prevalence and death as a result of asthma increased significantly (Samour and King, 2012). Although asthma is not the major cause of death in Australia, its great prominence as a health promotion and public health problem can be seen in the statistics presented from National Hospital Morbidity Database. For instance, in 1995 and 1996, asthma was established to be the most common reason for hospitalisation among children. Overall, across all ages, it was ranked seventh with over 61,400 admissions ahead of other serious illnesses. Asthma in Australia has been noted to becoming more common today (Samour and King, 2012). The prevalence of asthma in Australia is higher than in other countries such as England, Germany and United States. The public health response to asthma is on account of the increase in the incidences and revolves around a National Asthma Campaign. Australia National Asthma Campaign was established in 1990 as a result of the coalition of health organisations and health professionals (Vincent, 2010). By use of variety of public health education strategies ranging from mass media to use of the internet, the campaign was aimed at improving the healthcare management of asthma and increasing population awareness of the issue. In addition, the Thoracic Society of Australia together with New Zealand came up with a six-step Asthma Management Plan which was highly promoted to practitioners across Australia.

From its establishment in 1990 to 1993, the campaign was dedicated to primary school children in eastern Australia using survey method in the period of two years (Vincent, 2010). Asthma was no less common in 1993 compared to 1990 and the incidence of troublesome cough had risen over the period. Nevertheless, it was found out that use of preventive medication, greater monitoring of lung function and less use of inhaled bronchodilator increased. This showed that the campaign was succeeding as it contributed to the reduction in asthma deaths even though its high levels are yet to be reduced (Vincent, 2010).

Australian’s Public Health Response to Oral Health

Dental health problems is a public health issue that need to be addressed (Artemis, 2013). Between the period of 1977 and 1993, there has been reduction in the level of dental decay among children in Australia. Such improvements in the oral health in children are the starting point for additional improvements in dental health among adults in Australia. Oral health is defined as the absence of disease in the mouth. Oral health is a general expectation of all Australians. Within the Australian population, there is a group of people at high risk for developing dental problems (Artemis, 2013). This is because; there is a huge general health, cognitive, functional and financial problems among older group of people. These problems are linked to the development of complex oral diseases like dental caries and present many barriers to accessing adequate dental care.

In Australia, children and adults have enjoyed oral health care ranging from the control and prevention of dental problems (Artemis, 2013). Public health response to oral health in Australia involves water fluoridation as a means of preventing dental caries and other oral diseases in the country. Water fluoridation involves the artificial addition of fluoride in water supply as a means of reducing tooth decay and other dental problems. The caries prevention and control strategies and responses reflect the delivery of dental care by Australian organisations and wider public health activities. In the 1940s, the level of caries in Australia was unacceptable. This was established as a result of other high rate of dentally unfit recruits during the Second World War (Artemis, 2013). The country also established that, among the industrialised societies, it was ranked the first country having the highest level of caries among 12-year old children. According to a research done among children in New South Wales in 1955, 12-years old children had 9.3 teeth with dental caries, 1.3 teeth missing and 3.1 filled teeth.

Capital cities in Australia developed a strategy aimed at fluoridating water supplies in 1964 and since then, water fluoridation has become the most successful public health dental health initiative for Australia. The periods between 1964 and 1971, six capital cities started fluoridating their water supply. Cities such as Melbourne were not fluoridated not until 1977 (Oral health in Australia, 2013). Currently, most Australian states have access to fluoridated water supplies. The different climatic conditions in Australia require a variation in fluoridation of public water supply. There was a recommendation by the public health that water be fluorinated to amounts ranging from 0.6 to 1.1mg/L taking into consideration the climatic variations in order to balance the prevention and control of dental caries and at the same time the occurrence of complicated dental fluorosis. It is evident that there is a huge reduction in dental health problems such as dental caries experience since 1970. Caries experiences among 12-year old children have reduced from 8 teeth to 5 teeth between 1965 and 1977. This decrease is substantial as caries experiences reached 1.01 by 1995 (Oral health in Australia, 2013). This campaign is still active in Australia today as it ensures that people across the country are exposed to good amount of fluoride and can yield benefits from its role in preventing dental health problems regardless of age and socioeconomic status.

Conclusion

Public health and health promotion offer an organisational framework and concept for every country whether developed or developing. The capacity and capabilities for public health to controlling and preventing occurrence of diseases and illnesses is well proven. For instance, the responses to the growing asthma in Australia as a public health issue have brought about many benefits. Over the years, the asthma deaths have decreased significantly in the country. Also, the fluoridation campaign in Australia as a means of preventing and controlling dental health issue such as dental caries has proven to be effective in reducing the occurrence and prevalence of the diseases in the country. In addition, public health response with regard to the prevention of micronutrient deficiency diseases revolves around food fortification and public health education across the globe has essentially led to the improvement of the public health as the public is now aware of the problem and prevention is in action. The general goal of the public health and health promotion responses is the health for all at possible achievable levels. This can be witnessed by the three responses mentioned in this paper.

References

Artemis, N. (2013). Holistic dental care : the complete guide to healthy teeth and gums. Berkeley, Calif: North Atlantic Books.

Naidoo, J. & Wills, J. (2010). Developing Practice for Public Health and Health Promotion. London: Elsevier Health Sciences UK.

Oral health in Australia. (2013). Dental Abstracts, 58(5), 238-239. http://dx.doi.org/10.1016/j.denabs.2012.09.015

Preedy, V., Srirajaskanthan, R. & Patel, V. (2013). Handbook of food fortification and health from concepts to public health applications. New York, NY: Humana Press.

Samour, P. & King, K. (2012). Pediatric nutrition. Sudbury, MA: Jones & Bartlett Learning.

Scrinis, G. (2013). Nutritionism : the science and politics of dietary advice. New York: Columbia University Press.

Vincent, C. (2010). Patient safety. Chichester, West Sussex: Wiley-Blackwell.

Vos, T., et al., (2010). Assessing Cost-Effectiveness in Prevention (ACE–Prevention): Final Report, University of Queensland, Brisbane and DeakinUniversity, Melbourne.