Understanding Health and Illness

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Understanding Health and Illness 1. The concepts of health and wellbeing Health, defined as the complete state of social, mental and physical wellbeing, is an integral aspect of human life. It encompasses all aspects of life rather than simply the absence of diseases as defined by conventional concepts of health. Health influences a person’s capacity to engage in daily, social and economic activities. Whereas good health enables individuals to engage in constructive activities, ill-health disrupts a person’s life and ruins relationships. The accomplishment of the highest health standards is a fundamental right of every person regardless of social, political, religious, and racial background health. The protection of individual and public health play a significant role in human life.

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Health is perceived differently by the members of the community and professional groups. For instance, the biomedical scientists’ perception of heath differs significantly from ecologists, health administrators and social scientists. These perceptions at times generate confusion regarding the concept of health.

Understandably, health has evolved over than years from a person-centric entity to a global social goal. This evolution has led to the development of various health concepts. The most common health concepts are ecological concept, social concept, biomedical concept and psychological concept (Andazola et al., 2019).

The biomedical concept is the traditional concept in which health is considered the absence of diseases. Health professionals guided by the biomedical theory view the human body as a machine and diseases as machine breakdown (Svalastog, Donev, Kristoffersen & Gajović, 2017). This concept was, however, insufficient since it eliminated the social, environmental and cultural determinants of health. The inadequacy of the biomedical concept led to the development of the ecological concepts where health is perceived as a dynamic equilibrium between human beings and the environment (Andazola et al., 2019). Under the psychological concept, health is considered as a culmination of biological and social attributes. The holistic concept is a combination of all the other health concepts. The holistic model is the most inclusive concept since it recognizes the influence of the social, economic, political, ecological, and environmental process on health. This concept indicates that all sectors of society influence health and wellbeing.

Principles of health and wellbeing

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Promotion of health and disease prevention is an essential aspect of health and wellbeing.

These processes focus on keeping individuals safe and healthy. Health promotion initiatives aim to engage and empower people to embrace healthy behaviors and make positive lifestyle changes to minimize the risk of diseases (Clendon & Munns, 2018). The intervention for health promotion and prevention of diseases must put into consideration the core principles of health, wellbeing, public health, and health promotion, prevention and protection. These principles include rights, respect, dignity, equality, independence, safety, privacy, partnership and confidentiality (Clendon & Munns, 2018). Health promotion activities increase people’s awareness of diseases, thus enabling them to control their health. These activities cover numerous social and environmental interventions capable of protecting the health, safety and quality of life of individuals. Disease prevention initiatives, on the other hand, are specific efforts that focus on protecting people from diseases and death.

Importance of health promotion activities and disease prevention across the lifespan Health promotion activities and disease prevention interventions play a valuable role in people’s lives. These activities help sustain the health, safety and productivity of individuals besides minimizing the risk of death and disabilities. Diseases are significant causes of burden and suffering among people. People use massive resources to treat diseases and restore health (Coviello, 2019). Some diseases, though preventable, may culminate in death if appropriate prevention and treatment measures are not implemented. Disease prevention minimizes the need to use resources to facilitate various treatment processes, besides improving the health and safety of the people. Health promotion activities, including patient education, increase individuals' awareness of the most potent health improvement interventions. People are also made aware of activities such as substance use, consumption of unhealthy diet, alcoholism and noncompliance

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with prescription medications that affect their health (Rubinelli & Diviani, 2020). Health promotion interventions are designed to prevent people from engaging in risky behaviors. People can establish a healthy environment when growth and development across the lifespan are guaranteed.

Significance to nursing practice The concepts of health, the principles of health and wellbeing and health promotion and disease preventions are significant to nursing practice and the standards of nursing. The Nursing and Midwifery Council Nursing makes it clear that nurses must exercise responsibility and accountability, adhere to the principles of autonomy, provide patient-centred care and promote respect, dignity and human right. These practice domains are integral to the health promotion and prevention of diseases. The nurse must think critically and analyze nursing practice besides engaging in professional and therapeutic relationships for the benefits of the patient population.

Nurses need to work with patients, families and the community to ensure these populations are made aware of effective disease prevention and health promotion interventions.

2. The social determinants of health and inequalities in health Social determinants of health Social determinants of health refer to conditions within the environment in which people are born, live and work, learn and play. These conditions determine why some people are healthier than others. These conditions also determine why people who are considered healthy may not be as healthy as they could be (Kelley, 2020). Health is influenced by factors inherent in homes, schools, workplaces, communities and neighborhoods. People are aware that eating healthy foods, exercising regularly, getting vaccinated against diseases and being screened regularly for chronic diseases are important factors that influence health outcomes. People’s

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health is also influenced by social and economic factors, resources’ availability, access to health facilities, social support, proper education, safety, and clean and safe water and food (Kondo, 2020). Other factors that affect people’s health, as highlighted by Lillar (2020), include transportation, social norms, language and literacy, exposure to crime and residential segregation. All these factors constitute the social determinants of health.

Social determinants have huge implications on health outcomes for all people, including vulnerable populations. Literature reveals that over a third of the deaths in the U.K are associated with various forms of social determinants of health. Therefore, health care providers must integrate these factors into care plans to achieve positive health results. The Healthy People 2030 acknowledges the significance of addressing the social determinants of health by creating social and physical environments that promote the health and wellbeing of all people. When providing treatment and care, professionals must assess the patient’s education level, income level and literacy and integrate these factors into the care plan (Kelley, 2020).

Negative social determinants of health have a devastating impact on an individual’s knowledge concerning health and resources, access to health and healthcare outcomes (Kelley, 2020). For instance, individuals from poor backgrounds rarely complete their education. The type of foods consumed by low-income families does not meet the standards set by Healthy People 2030. Literature shows that the likelihood of developing chronic conditions and infections increase with decreased income (Kelley, 2020). Children and future generations are also negatively affected by the environment and other negative social determinants.

Health inequalities Although government agencies have implemented measures to enhance the delivery of quality care services, many people continue to struggle to access healthcare resources. The

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government is far away from achieving health equity. Irrefutably, poor people, immigrants, marginalized groups and ethnic minorities are likely to experience health inequalities than mainstream communities (Smith, Bambra & Hill, 2016). Health inequalities refer to the unfair and avoidable discrepancies in health across populations. These discrepancies are contributed by numerous factors, including the place where one is born, grow, live, play, work and age.

Literature indicates that the common factors that hinder access to healthcare for many include racial and ethnic discrimination, income gaps, unsafe environments, limited access to quality education, and inadequate housing and transportation (Smith, Bambra & Hill, 2016). These factors characterize people living in poor, remote, and unsafe environments. These populations suffer disproportionately from preventable diseases and disabilities due to limited access to health services. A study by Yu (2018) revealed that health inequalities are major triggers for psychological disorders. These findings show that health inequalities affect the health and wellbeing of the people. Howe (2020) noted that to promote health, prevent diseases and improve wellbeing, health care professionals must tackle the health inequalities that have persisted in the system for years. Nurses need to work with individuals and the community to identify obstacles to positive health behaviors such as seeking medical attention and eating healthy foods.

Public health guidance documents and policy Implementing public health policy supporting health equity is a remarkable intervention that can correct the challenges associated with health inequalities and negative social determinants of health. Thomson et al. (2018) pointed out that public policy health interventions can help healthcare stakeholder to establish health inequalities cause and effects. These policies address the underlying environmental, social and economic factors, thus shifting the distribution

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of health risks. Policies also support interventions targeting groups and populations. For instance, vaccination against diseases is free for all children in the U.K. The government-led vaccination programs ensure that no child, regardless of racial, ethnic and socioeconomic background, is denied protection against vaccine-preventable diseases. Other strategies that support health promotion include creating supportive environments, reorienting health services, developing personal skills and strengthening community action.

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3. The issues that impact the health /wellbeing of the individual The current case demonstrates how health is influenced by environmental, social, economic and political factors. The case also reveals how health inequalities impact the health outcome of disadvantaged people. The mode of life of Karim’s family contradicts the standards set by the ODPHP (2021). The ODPHP (2021) identified the social determinants of health that must be fulfilled to attain better health outcomes. These factors include Safe housing, transportation, and neighborhoods, access to healthy foods and physical exercise opportunities, education and job opportunities, access to health services, and language literacy. Migration Data Portal (2020) noted that these factors influence the health of immigrants. Fig 1 below highlights the conditions associated with migrant populations that contribute to health inequalities exposing these people to increase health risks and poor health outcomes.

Fig 1: migration and health (Migration Data Portal, 2020).

The case study indicates that in the current region, Karim does not have safe housing and transportation. The family has does not have a permanent home. They have stayed in various hostels in different regions. Their current one-bedroom house can barely accommodate the family. The family is currently staying in Berkshire, and their house was provided by the local authority temporarily indicating that at a certain point, they will relocate. The house is located far

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away from the nearest recreational facilities. Therefore, Karim and his family cannot engage in regular physical exercises. Noise from the outside is also a major problem for the family. Noise pollution is a potential contributor to psychological health problems facing many people in the region, as highlighted by the Berkshire Heath systems (2018).

Karim does not have sufficient resources to meet the family social and health needs.

Castañeda et al. (2015) noted that financial sustainability is a key social determinant of health.

People use a large amount of money to buy food and pay for medical services and other necessities. In the current case, the burden of providing for the family and the extended family is overwhelming for Karim. He is the only family provider as his wife is a stay at home mother.

Karim does not qualify for professional jobs; therefore, he depends on low paying jobs. His current job as a cab driver does not generate sufficient resources to support the two families.

However, Karim depends on universal credit to supplement his income. Limited work opportunities limit the immigrants’ capacity to overhaul their financial status. The Migratory Observatory (2020) reported that U.K-born citizens are likely to get employment in high skilled settings than foreign-born citizens.

Fig 2: Labor Force (The Migratory Observatory, 2020)

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The geographical location might also have contributed to the health challenges being faced by the family. Community needs assessment performed by the Berkshire Health System (2018) revealed a wide range of social and economic factors that influence people’s health in Berkshire County. The assessment revealed that this region has a huge housing challenge. Only a few people manage to get houses that suit their families. For instance, Karim is staying in a onebedroom house, which is small for a family of five. Although they are waiting for a 2-bedroom house, the local authority informed them that they are not a priority.

Poor housing, limited access to healthcare, poor diet, a lack of social support and physical inactivity has contributed to poor health outcomes in the current family. This information aligns with epidemiological reports showing that immigrants are likely to experience negative social determinants of health and subsequent poor health outcomes than citizens (Castañeda et al., 2015). Data shows that immigrants rarely seek timely health attention due to a lack of funds.

Women and children are the worst affected populations (Castañeda et al. 2015).

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Health risks relevant to the case study The current family situation places Karim and other members at risk of developing

various chronic health conditions. For instance, Karim reported that he had experienced frequent bouts of low mood. His wife is also at risk of developing depression. She has been tearful and feels low. She does not interact appropriately with Karim, and she misses her family in Pakistan.

She is also physically overwhelmed and often breakdown during the daytime. Literature reveals that low mood is a significant symptom of depression and other psychological disorders. The risk factors of depression, as highlighted by Meng et al. (2017), include family conflicts, stressful lifestyle, overwhelming feeling of guilt and inadequacy, low level of education, low income, and poor housing.

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Another health risk presented in the case study is alcoholism. Karim noted that he has turned to alcoholism as a means to escape family problems. Alcoholism increases the risk of health disorders such as liver cirrhosis, hepatitis, kidney disorders, and prostate inflammation.

The risk is higher among people who take large volumes of alcohol regularly. Karim is also at risk of developing lung cancer due to cigarette smoking. The CDC (2021) recognizes cigarette smoking as the greatest contributor to lung cancer. In the current family, Karim also exposes his wife and children to secondary smoke, which increases their risk of respiratory disorders.

Obesity and overweight are significant health risks presented in the case study. These factors increase the risk of hypertension, hypercholesterolemia, coronary heart disease, type-2 diabetes, and stroke (Moini, Ahangari, Miller & Samsam, 2020). Karim reported that he has gained weight over the last eight months. The weight gain is affecting his functionality and ability to sleep properly.

Promotion of health and wellbeing The current family needs support to overcome the challenging issues that are almost tearing them apart. As a nurse, the first intervention to apply to this family is counseling. The couple needs to be enrolled in a family therapy program. Counseling can improve the psychological health of the partners besides healing their troubled relationship. During counseling the nurse should encourage the couple to interact positively and participate in family activities to strengthen their bond and obviate loneliness. Counseling builds a strong platform on which other family issues can be resolved. The nurse can also enrol Karim in a smoking cessation program to eradicate his heavy smoking behavior.

The family consumes junk foods which increase the risk of lifestyle disorders. The nurse, therefore, needs to promote child and family nutrition by encouraging them to consume a healthy

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diet. The family also needs to exercise regularly to boost the physical and psychological health of individuals. The nurse can assist Karin in developing an exercise program for the family. Since recreational facilities are far away, they can engage in simple indoor physical exercises.

Literature reveals that individuals, who exercise regularly rarely, engage in inappropriate behaviors. Karim should embrace a healthy lifestyle to improve his weight, blood pressure and cholesterol levels.

The other health promotion activity applicable to this family is breastfeeding. Health records indicate that Zainab has been partially breastfeeding the youngest child. Breastfeeding is an important practice that boosts the health and immunity of children. The nurse should, therefore. Encourage Zainab to breastfeed her child regularly to support growth and development.

Priority areas for health promotion interventions in the community The priority areas for health promotion interventions that can prevent, protect, promote and improve the health of the individual and wider community in the case study are proper housing, health education, and physical exercise. Karim and other community members need houses that offer adequate housing condition, stability and affordability. Proper housing conditions are associated with improved physical and mental health. Cross et al. (2020) noted that Good quality houses protect families from infectious diseases, depression, stress and other health problems.

Health education is an important health promotion intervention since it increases awareness facilitates behavioral change. Educational programs empower individuals and communities to make rational lifestyle choices (Cross et al., 2020). Facilitators encourage

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individuals to and engage in activities that improve their mental, physical, social and emotional health.

Physical exercise is also an important health promotion for the individual and the community. The case study notes that Karin presents with lifestyle disorders such as overweight, prediabetes, hypertension and high cholesterol levels. The community can be restructured to create more recreational facilities when people can exercise regularly.

Necessary skills As a nurse, one needs various skills to conduct health promotion activities and implement disease prevention interventions successfully. These skills include leadership, effective communication, decision-making, empathy, and problem-solving. Leadership skills enable the nurse to work with individuals and the community to develop health awareness and empower them to make the informed choices. Effective communication is crucial for passing the right health information to the people. Communication is a core aspect of health education. it enables the nurse to engage clients in constructive conversations. Problem-solving skills enable the nurse to identify health risks and implement practical health promotion and disease prevention interventions.

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