Revision Guide for Public Health Module

(This guide provides details of what needs to be included in your assignment and how you can approach each question).

Task 1

1.1. What are roles played by WHO, Department of Health (DH) and Local Authorities in identifying levels of health and diseases in the population? Students are required to do this in three levels:

Answer

1. International level WHO.

-Provision of leadership on critical matters of health and engagement in partnerships needing joint action

-Transforming and shaping the agenda of research and stimulating translation, dissemination, and generation of useful or valuable knowledge (Stewart, 2017).

-Articulation of evidence-based and ethical policy options.

-Setting standards and norms, monitoring and promoting their implementation

-Monitoring the situation of health and addressing the trends of health

-Catalyzing change, provision of technical support and building on institutional and sustainable capacity.

2. National level-Department of Health.

Some of the roles of the National level-Department of Health are broadly categorized into three areas which are then broken down to smaller categories. The three broad areas are;

assurance, assessment and policy development (Loveday et al., 2014). At the national level, the government works hard to enforce laws, develop policies, develop partnerships of communities, empower, inform and educate the community, diagnose and investigate prevention and management of diseases.

2. Local level Local authorities like CCGs. Give a clear example here.

Some of the roles of CCGs include; Improving community health, securing services provisions and integrating social and health care locally.

1.2. Explain, using statistical data, the epidemiology of HIV or MRSA and Breast cancer or Diabetes (Type 2) in the UK. Here you are required to:

Define Epidemiology

Epidemiology refers to the study of determinants and distribution of injury, disease and other outcomes of health in the population of humans. Epidemiology is mainly aimed at studying a range of health conditions and the impact of various exposures have on diseases manifestations.

Explain the epidemiology of HIV or MRSA and Breast cancer or diabetes (Type-2). For each of the disease provide little background information of the disease and then use data to show the following:

HIV

Incidence rate (no of new cases)

In the year 2015, a total number of 88,769 people received specialists treatment and cared in the UK. Among the number were a total number of 315 children of ages under 15. The last decade has experienced a great increase in the number of people living with HIV/AIDs. For instance, between 2006 and 2015, there has been an average increase of 73% in the number of people who access HIV care (Quint et al., 2016). In the same year, the number of men receiving HIV treatment was close to two thirds, accounting for sixty-seven percent. On the other hand, the number of women receiving HIV treatment was 27,672, accounting for 33 percent. The number of men was 61,097. Going by the year 2010, an estimated 91, 500 people were living with HIV, and 19-30 percent were not aware of their infection. The mortality rate (people that died of the disease),

A total number of 442 HIV patients died of the diseases for all causes. Prevalence rate (no of people currently living with the disease),

Using the Survey of Prevalent HIV Infections Diagnosed (SOPHID), there were 65, 319 individuals receiving HIV care services in the UK (British HIV Association, 2017). However, there are individuals living with the HIV disease and remain undiagnosed. Therefore, the number of people living with HIV can only be estimated, and the estimation of HPA in 2009 is that a total of 80,800 individuals were living with HIV.

The most recent statistics of 2016 show that a total number of 89,400 are living with HIV in England with 12 percent of those being undiagnosed.

Some people receiving treatment etc. ART, chemotherapy, radiotherapy

A total number of 69,400 people living and diagnosed with HIV received medical care with over 90 percent regularly attending HIV services.

Breast cancer

incidence rate (no of new cases)

In 2010, a total number of 49, 564 women and 397 men were diagnosed with breast cancer. The mortality rate (people that died of the disease)

The number of people that died from breast cancer was 11,433 in 2015, and those who died of the same disease is 11,633 in 2010 (DeSantis, Bryan and Jemal, 2014). Prevalence rate (no of people currently living with, the disease)

In 2015, the number of new cases of people living with breast cancer was 55,122. Statistics also show that a total number of 50,000 women in the UK are diagnosed with breast cancer every year.

Some people receiving treatment etc. ART, chemotherapy, radiotherapy

One or two graphs will be required here to support your work.

1.3 How effective are different approaches and strategies adopted by NHS to control breast cancer and HIV in the UK. Some of the Strategies & Approaches you are required to evaluate include: (EVALUATE 4 AT LEAST)

HIV

Surveillance,

Regarding surveillance, the NHS has been very effective in fighting HIV this is because of the identification of new trends of the disease infections. The identification of new trends of infection is important because the government will be able to create correct measures that will counter the growth of the disease. It would be tragic if NHS created the loophole by fighting HIV based on the old ways of infection. The Some of the emerging trends of HIV infection include infections through homosexual and heterosexual sexual activities.

Screening,

Although NHS has done a lot in ensuring that people take personal initiative in testing for HIV, numerous challenges still present. The government has even gone as far as making HIV screening in many places. Despite such efforts, many people living with HIV are unaware because they are undiagnosed. Therefore, the effectiveness of HIV screening has not been very effective because the rate of infection remains high and increasing.

Immunisation,

There have been great efforts to find the cure and vaccine for HIV. The UK has also made great strides towards reaching this goal. The available preventive drug is PrEP, a pill that is used in the prevention of infection of HIV before a certain time limit. Regarding effectiveness, NHS has also been successful in helping newborn babies from the infection of HIV by infected mothers.

Health education,

During the early years of HIV outbreak, there were great efforts by the government to create awareness of the disease. For example, in 1987, the government ran a massive campaign called, AIDS: Dont Die of Ignorance. However, the recent past has been characterized by minimum awareness programs and hence encouraging such negative stigmas like the discrimination of black people in health care centers (Brydon, 2018).

Breast cancer

Surveillance,

NHS has done quite well regarding the acquisition of information that would be important in the management of breast cancer in the UK. For one, it has given much concentration to the outcomes from patients, understanding that the outcomes are as equally important as clinical indicators. To properly understand the quality of life outcomes of the survivors of breast cancer, NCSI developed a national cancer survey of survivors that was piloted in 2011 (Jordan, 2018). The information from the survey will be important for understanding and providing the needs of cancer survivors and patients to prolong the lives.

Screening

NHS has made great strides in ensuring that as many people as possible are screened and tested for breast cancer. For example, the government has initiated population screening programs that will ensure emancipation of breast cancer testing and treatment. However, the increasing number of people living with breast cancer unknowingly and without diagnosis also shows that the government has not been effective enough in the emancipation of breast cancer screening. However, NHS has not done enough to address the issue of ethical dilemma in breast cancer screening, which might be locking people from participating in the event.

Immunisation,

As part of a wider program of breast cancer prevention, NHS has been at the forefront in fighting cancer with the administration of HPV through HPV immunization programme. Following advice from the Joint Committee on Vaccination and Immunisation, HPV vaccine was introduced into a program called routine childhood immunization programme to all 12 and 13-year-old female children. Although the vaccine fight close to four types of cancers, cervical cancer has been targeted more. Therefore, for the program to be more effective, it would be better to introduce breast cancer-specific vaccination programs to older women. Also, it would be wise to introduce the vaccination program to men because they are also prone to breast cancer.

Health education,

Understanding the importance of educating the people about breast cancer, NHS has applied various ways of dealing with it. For example, it has taken much effort in training and advancing the communication skills of breast cancer emancipators. For instance, The National Cancer Action Team (NCAT) at the moment, provides a course allowing clinicians learn through constructive feedback and role play about the impact of communication styles on patients. Providers and commissioners considered how best to ensure their clinicians have necessary skills of communicating effectively with patients.

So here you are evaluating the effectiveness of the above strategies in controlling breast cancer, HIV or any other diseases you explained in 1.2.

Task 2

2.1 What are the current priorities for prevention and control of diseases and risk factors in the UK?

a. You need to explain Burden of diseases

The burden of diseases means the cumulative or total consequences of a range of diseases or a defined disease/diseases which are harmful in regards to disabilities in a place or community. Such consequences include the cost, social aspects of the societys health.

b. Explain how the burden of disease is calculated using DALY. You have to write the full formula for DALY.

Note: DALY = YLL+YLD

Where YLL =.

YLD=.

DALYs for a disease or the condition of health are normally calculated by summing up the years of life lost (YLD) due to disability and the number of years lost as a result of premature mortality in a population, as a result of a disease or a health condition.

Calculation for DALY is:

DALY = YLL + YLD

YLL means the multiplication of the standard life expectancy at the time of death and the number of deaths. The formula for YLL without the inclusion of other social preferences is;

YLL = N + L

L, in this case, means the life expectancy standard at the death in years.

N refers to the number of deaths.

Estimation of YLD for a particular period is computed by multiplying the average period of the disease duration and the number of cases of incidences in that period and a factor of weight reflecting disease severity from 0, on a scale (Prince et al., 2015). Thus,

YLD = I*DW*L

Where DL= weight disability

I = incident cases number

L= Average case duration before death (years)

c. After determining the priorities, what are the approaches for prevention and control breast cancer or diabetes and HIV or MRSA in the UK? Here you need to explain the levels of prevention.

Prevention Primordial, Primary, Secondary and

Tertiary prevention [Treatment palliative care (the multi-disciplinary approach that includes specialized medical care for pe...