7016CPD | Contribution of Nursing to Public Health Report Example Sample

Introduction

The goal of the public health is to enhance health and wellbeing of the populations by means of prevention, health promotion and reducing health disparities. Nurses are the key players in the realization of these objectives since they are one of the highest health care providers and have direct contact with people, family and communities in healthcare facilities. Nevertheless, nursing practice has been traditionally oriented on treatment of illness with no consideration of the wider social and environmental influences that determine morbidity. More and more public health scholars suggest that medical workers need to embrace an upstream perspective, which is concerned with preventing diseases by controlling the causes of health issues instead of merely treating the effects of the existing ones (Marmot, 2020).

Obesity is one of the most relevant modern problems in the global public health. It is linked to a higher incidence of chronic illnesses including diabetes, cardiovascular and cancer among others. Obesity in the United Kingdom is an issue that has grown of significant concern in the last few decades, becoming a significant strain on the healthcare systems and health of the population (Public Health England, 2020). The solution to obesity should be a holistic social and environmental determinant of health that accommodates behavioural, social and environmental determinants of health.

This report critically examines why and how the nursing practice needs to be more upstream in their approach to the health population with obesity as the health issue of choice. It describes the main theories and concepts of public health, discusses epidemiology and social determinants of obesity, and evaluates the role of nurses in the solution of health inequalities. Other issues in the report are the significance of community health needs assessment and community-centred practice. Lastly, it recognizes the challenges that nurses can encounter during the implementation of upstream strategies and two viable suggestions that can be applied to build the nursing role in the population health.

Public Health Concepts and Models of Health

Various theoretical health models support public health strategies because they determine how health issues are perceived and dealt with. The biomedical model is one of the traditional views on health which considers health as disease absence. This model is based on diagnosis, treatment and medical intervention. Although biomedical solutions play a crucial role in the clinical care, they tend to be ineffective in dealing with the overall determinants that dictate the health outcomes of a population.

By contrast, the social model of health places importance on the fact that social, economic and environmental determinants of health like income, education, housing and employment, determine health outcomes (Dahlgren and Whitehead, 2007). This view acknowledges that structural factors are the cause of health inequalities which are beyond individual influence. This means that successful public health strategies cannot be limited to individual behaviour only and should target these expanded determinants.

The theories of health promotion also emphasize on the need to empower people and communities to assume the responsibility of their health. The Ottawa Charter on Health Promotion provides a number of tips and tricks to enhance the health of the population, such as the establishment of conducive environments, building of community action and formulation of healthy public policies (World Health Organization, 1986). The principles are in line with the upstream strategies of public health which are more about preventing disease before it appears.

As a nurse, one needs to be aware of such theoretical understandings by ensuring that they influence the planning and execution of healthcare interventions. To enhance population health, nurses in the field of public health should be able to transcend the scope of the conventional clinical functions and interact with the general determinants of health.

Downstream, Midstream and Upstream Public Health Approaches

The metaphor of downstream, midstream and upstream can be used to understand the public health interventions. This comparison explains that the issue of health can be solved at various levels of prevention.

Downstream interventions deal with disease treatment once it has taken place. Clinical management of obesity-induced conditions like diabetes, hypertension or cardiovascular disease may form part of the downstream methods in the case of obesity. Hospital nurses or those in a clinical environment are usually engaged at this level to treat patients by dealing with symptoms and providing patient treatment plans.

Midstream interventions are designed to change the behaviour of individuals that predisposes them to health challenges. In the case of obesity, the midstream interventions can take the form of health education programmes, weight management services and lifestyle interventions which are directed towards promoting healthier diets and more physical activity. Patient education and health promotion programs are often one of the key roles that nurses play in the provision of these interventions.

Nevertheless, according to many public health experts, it is not only enough to focus on downstream and midstream interventions, which will help in solving complicated health issues like obesity. Upstream strategies aim at dealing with the social, environmental and policy determinants of health inequalities. Some of them include the control of unhealthy advertising of food, enhancing access to healthy foods and making the surroundings healthier (Kickbusch, 2015).

As a public health strategy, the upstream interventions can best enhance the health of the population since it considers the causes of the disease instead of merely treating the symptoms.

Epidemiology and Social Determinants of Obesity

Epidemiology gives useful information as to the cause and spread of health issues within populations. Obesity has emerged to be a significant social issue in the United Kingdom. According to recent statistical data, one out of four adults in the UK is said to be obese (Public Health England, 2020). There is a high prevalence rate of obesity, especially in people who live in socioeconomically disadvantaged communities.

The unequal spread of obesity emphasizes the need to know the social determinants of health. Poverty, poor access to healthy foods, poor neighbourhoods, and lack of access to physical activities are some of the factors that determine the risk of obesity. The people in the deprived cities could have fewer opportunities to access affordable healthy food, and the promotion of unhealthy food practices is possible due to the presence of fast food restaurants in the areas.

Education is also significant when it comes to health behaviour shaping. Less educated people can have fewer access to health information and they can not take part in health promoting activities. These reasons help in contributing to the health disparities that are evident among various groups of people.

To solve these social determinants, there must be a concerted effort of various sectors, such as healthcare, education, urban planning, and governmental policy. The nurses in the public health sector should thus cooperate with the other professionals in order to work on these wider aspects that determine the health outcomes.

Community Health Needs Assessment and Community-Centred Approaches

Community health needs assessment is a tool needed to determine health priorities of certain populations. With the help of epidemiological data, health professionals can draw tendencies of the disease and which health problems are subject to specific interventions.

To the nurses, community health assessment can give them useful information on the needs of the populations to which they serve. This is done by collecting data concerning health behaviours, social determinants and local health care facilities. By knowing these factors, nurses can be able to develop interventions that will suit specific communities.

The community-based methods are especially significant to deal with the complex public health problems like obesity. Increasing the participation of the community members in health intervention design and implementation can enhance the effectiveness and sustainability of the programme. The involvement of the community assists in ensuring that the interventions are culturally relevant and sensitive to the needs.

The nurses can also be involved in community-based public health programs by teaming up with other organisations, schools and leaders in their local community. The partnerships have the potential to produce favourable conditions that can support healthy behaviours and enhance population health outcomes.

Challenges for Nurses in Adopting Upstream Approaches

Despite the fact that the upstream approaches encapsulate considerable promise of enhancing the health of the populace, there are various challenges that nurses might encounter in an attempt to incorporate the upstream approaches in practice.

The traditional orientation of healthcare systems towards treatment, as opposed to prevention, is one of the key challenges. Healthcare services are commonly designed to deal with how to cope with illness instead of dealing with the social factors that lead to disease. Nurses are therefore likely to get fewer chances to be involved in upstream public health endeavors.

There is also a major obstacle in terms of workforce pressures. The shortage and workloads in most healthcare systems are also putting a strain on nurses, which may constrain their time to perform health promotion and community-related activities.

The other obstacle is associated with the multiplicity of the social determinants of health. Issues like poverty, housing and education are outside the conventional boundaries of the healthcare services. The nurses are thus expected to work with individuals in the other sectors to make sure that these wider determinants are addressed.

Lastly, inadequate training in the area of public health and health promotion may cause some of the nurses to not participate in the upstream public health efforts fully. There is thus need to reinforce education and training on concepts of public health to assist the nurses to increase their roles in population health.

Recommendations

Recommendation 1: Strengthen Public Health Training for Nurses

Healthcare organisations ought to increase education and training on health promotion in the nursing programmes. This training is supposed to be based on social determinants of health, health promotion strategies and community involvement. Enhancing the understanding of the nurses on the concepts of public health will ensure that they will take a more proactive role in the disease prevention.

Recommendation 2: Integrate Community Partnerships into Nursing Practice

The healthcare organisations are advised to promote collaboration between nurses and community organisations, schools and local authorities to deal with the upstream determinants of health. The community partnerships can facilitate the creation of interventions that can facilitate healthy living environments and decrease the inequalities in health.

Conclusion

Obesity is a multi-faceted issue in health that cannot be controlled either through clinical therapy or individual behavioural modification. Better prospects of population health outcome are provided by upstream public health practices that deal with the social determinants of health.

The nurses are very important in promoting the upstream approaches to public health due to their direct contact with the people, families, and the communities. Nurses can play a great role in disease prevention and health promotion by incorporating the theory of public health, evidence in epidemiology, and community-based strategies to address them.

Nevertheless, there are a number of issues that need to be resolved to enhance the role of nursing in population health. These are the workforce strains, inadequate training and healthcare frameworks that focus on treatment rather than the prevention. By combating these challenges by offering education and community-based collaboration, nurses will be able to embrace more effective upstream strategies in enhancing the health of the population

Reference List

• Dahlgren, G., & Whitehead, M. (2007). Policies and strategies to promote social equity in health. Stockholm: Institute for Futures Studies.
• Kickbusch, I. (2015). The political determinants of health. British Medical Bulletin, 114(1), 5–14.
• Marmot, M. (2020). Health equity in England: The Marmot Review 10 years on. London: Institute of Health Equity.
• Public Health England. (2020). Health matters: Obesity and the food environment. London: PHE.
• World Health Organization. (1986). Ottawa Charter for Health Promotion. Geneva: WHO.

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