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Transcript of Alcoholism.
Health promotion explored in relation to a case study.
Social determinants which may affect Garys' health
The issue of alcoholism
Gary is one of 167,764 people that received prescription drugs in England in 2011 to try and tackle his alcoholism, this number was an increase of 63% from 2003 figures (Health and Social Care Information Centre, 2012)
Global, National and local strategies to tackle alcoholism
Health promotion and models in motion
X Aged 58
X Lives alone
X Admitted to hospital with alcohol related seizures.
X suffers from depression,
Gary feels unable to manage his addiction to drinking alcohol, due to his poor self esteem, in addition Gary has previously tried to quit drinking without success and feels unempowered.
Fitzpatrick, Stevenson and Sommers (2004) state that with years of alcohol abuse the physiological and psychological well being of a person diminish, furthermore with the addition of prescription drugs there is an increase risk of depression, as in Garys' case.
World Health Organization (WHO, 2005) state that 2.5 million people die annually from alcohol related problems.
North west England has the second highest number of hospital admissions, for harm relative to consuming alcohol and the incidence is on the increase (Department of Health [DH], 2010)
Gary started drinking
as a teenager and lived in a
died at a young
age due to alcohol
Gary lives within walking distance to the local shop and pub, where he meets friends to drink
Gary does not work so he has more time to drink alcohol and less money to spend on alcohol
Gary lives alone and does not
see his family.
All of these factors influence
Garys' health, including where he lives
the lifestyle he leads and his unemployment,
as they are all social determinants of health
(Marmot & Wilkinson, 2003)
Gary suffers from depression
which may affect his alcoholism
HM Government (2012) brought in minimum prices per unit of alcohol to try and reduce the risk of alcohol abuse, in addition campaigns such as change for life were created which is a public health campaign for healthy living.
Hughes and Bellis (2003) report on the strategy Safer Nightlife in the North West of England, which is a strategy whereby organisations, such as the police and primary health care collaborate recommendations to tackle alcohol related problems in the North West nightlife and map out areas of concern. This is aimed to improve community safety and promote health and well-being and prevent alcohol related problems.
WHO (2010) created the Global strategy to
reduce the harmful use of alcohol, which states that the global strategy to tackle alcoholism consists of five aims to support member states.
1- Raise Awareness
3- Technical support
4- Strengthened partnerships
5- Improved monitoring
Naidoo and Wills (2005) state that being unemployed can suggest person is in poverty and in turn may take part in more risk taking behaviours, such as smoking and drinking alcohol, which may lead to poor health as in Garys' case.
WHO (2005) explain that alcohol may be used as a way to relieve the pain of living in harsh socioeconomic circumstances, however instead isolates the person further as can be seen by Garys' own isolation away from family and friends.
Low socioeconomic position
Gary started drinking alcohol as a young teenager and lived in a poor socioeconomic environment. This may have determined problems with alcohol abuse in later life, as Gauffin, Hemmingsson and Hjern (2013) explain poor socioeconomic environment as a young child can predict alcohol related problems in adulthood.
Gary has long term alcohol dependency and has accessed care in the primary and secondary care settings, due to his illness. Health promotion and models for change are necessary, so that Gary can live a healthy and happier life without alcohol. Utilising the information we know about Gary, an appropriate model for health promotion may be the behavioural change approach to make positive changes to his health, rather than a model such as the educational approach as Gary is already informed of the adverse affects of his drinking. A model based around behavioural change is the health belief model (Smarma, 2011).
Which model to use?
WHO (1986) state that according to the Ottowa Charter health promotion is a method of enabling a person to achieve good health and well-being through satisfying needs and achieving aspirations and goals, by controlling the things that determine their health, so by using a model of health promotion to empower and inform Gary he should be able to access health care to become well.
HEALTH BELIEF MODEL?
HEALTH ACTION MODEL?
STAGES OF CHANGE MODEL?
Tones and Green(2010)
Who's there to help?
Government policies are in place so that health care proffessionals' can promote patients' health and well being (DH, 2004)
National Health Service Greater Preston Clinical Commissioning Group (2012) have designed the strategy 'make every contact count' whereby the focus is on;
The intention is to promote healthy living through commissioning shared responsibilities of services in the primary setting to prevent higher than national average hospital admissions in relation to alcohol and reduce the prevalence of children consuming alcohol.
DH (2008) published the national strategy 'Safe. Sensible.
Social. The next steps in the National Alcohol Strategy' which is a tool kit that can be used to achieve aims set out by the government.
Reduce alcohol related
Reduce perceived drunken and rowdy behaviour in local communities.
Reduce ill health and hospital admissions related to alcohol.
(Jahanlou, Lotfizade and Karami, 2013).