WORKING THE WAY TO HEALTH INITIATIVES, The Natural Environment
Introduction
Environmental issues generated a concern for the impact of environment on health (Bomar 2003, p. 535). This is important because of the different health issues in the UK, particularly about inactiveness, which commonly result to obesity and lead to other chronic diseases such as cardiovascular diseases. As a matter of fact, over a fifth of adults in England are classified as obese, and this figure is rising between 1990 and 2000. While, the number of obese children is rising in all age group, and it is estimated that obesity accounts for around 30,000 deaths in England every year (Cornwall n.d.). Growing medical evidence showed that access to the natural environment help to improve health and wellbeing, at the same time, prevent disease and helps people to recover from illness. Thus, experiencing nature in the outdoors can help tackle obesity, coronary disease and mental health problems (Natural England n.d.).
Furthermore, environmental factor is considered as one of the most important health determinant because there are different studies which show that contact with the environment has healthy benefits. Aside from that, different issues about the environment, particularly pollution, have a great impact on the health of the people. The said factor is considered as one of the most important motivation of walking the way to health initiatives and the natural environment to focus on walking in order to motivate the people to become more physically active.
What is Health Education?
The American Association for Health Education (AAHE) considered health education as a social science that draws from the biological, environmental, promote health and prevent disease, disability and premature death through education-driven voluntary behavior change activities. Thus, it is considered as a development of individual, group, institutional, community as well as systematic strategies in order to improve the health knowledge, attitudes, skills and behavior, with the main purpose to positively influence their health.
This is important because it help to improve the health status of individuals, families, communities, states as well as the nation, therefore enhances the quality of life for all people, at the same time, reduces the costs that individuals, employers, families, insurance companies, medical facilities, communities, the state and the nation would spend on medical treatment (AAHE n.d.).
What is Health Determinant?
The European Centre for Health Policy (ECHP) (1999) defined health determinants as the personal, social, cultural, economic and environmental factors that influence the health status of individuals or population (cited in WHO 2009)
Tackling the main health determinants is of great potential for reducing the burden of disease and promoting the health of the general population. Health determinants can be categorized as: personal behavior and lifestyle; influences within communities which can sustain or damage health; living and working conditions and access to health services; and general socio-economic, cultural and environmental conditions (European Commission n.d.).
Health Education, Health Determinants and Walking the Way to Health and The Natural England Initiative
The Natural England is an independent public body whose purpose is to protect and improve England’s natural environment and encourage people to enjoy and get involved in their surroundings. The said organization works with people like farmers, town and country planners, researchers and scientists, and the general public on range of schemes and initiatives. The organization supports the Walking the way to Health to get sedentary people out on short local walks by supporting a network of more than 525 led walk groups across England. The organization offer support and advice, training for walk leaders, public liability insurance, an accreditation quality mark, evaluation and free materials in order to help promote walking (Natural England n.d.).
The National Step-o-Meter Programme
The National Step-O-Meter Programme (NP) is being delivered by Natural England with partnership with the Department of Health which aims to promote and enables the effective use of pedometer via clinical practice. The aims of the said programme are:
- To increase levels of walking in sedentary, hard to reach and ‘at risk’ groups;
- to increase use of Step-O-Meters across the NHS as a motivational tool;
- to increase awareness of the Chief Medical Officer’s recommendation that every adult should undertake at least 30 minutes of moderate activity on at least five days a week;
- to demonstrate how incremental increases in daily step counting through goal setting can be used as an effective and realistic introduction to physical activity (Natural England n.d.).
Based on the said aims and objectives, it can be said that WHI and Natural England, covers all of educational objectives. Primarily, cognitive because it enables to make sure that people fully comprehend the initiative by promoting abilities in thoughts, understanding and cognitive skills (Contento 2007, p. 525). On the other hand, affective because it enables the people to participate in the attitude-changing walking by promoting changes in attitude, feeling or emotion. Above all, psychomotor because the primary aims of WHI and Natural England is to promote healthy walking or to promote improvement in physical or manipulative skills (Contento 2007, p. 525).
Because of the fact that walking is free and requires no special equipment or training, health professionals define walking as the nearest activity to perfect exercise (Morris & Hardman 1997 cited in Ramblers 2009). Furthermore, almost everyone is capable of walking, and everyone can almost walk anywhere, because it can be easily combined with walking for other reasons such as walking to work, school or shops visiting a place of interest and walking a dog (Ramblers 2009). Because of that, it can be said that the initiatives is targeting the normative need. Need refers to the relationship between the problems and the responses that are available (The Robert Gordon University n.d.). On the other hand, normative need pertains on the need which is identified according to a norm or set standard; such norms are generally set by expert (The Robert Gordon University n.d.). Experts are saying that, walking sociably with friends or in a group can help to improve mental health and quality of life. Aside from that, there are different evidences which show that by simply spending time in the outdoors and in contact with the natural environment has a positive effect on mental health (Pretty et al & Seymour 2003 cited in Ramblers 2009).
Health Determinants and Social Inequalities
Socials and economic aspects have a great impact on implementation of any health promotion. Inequalities are considered as an important factor in health promotion, particularly with the issue of economic status or condition. In that case, WHI, and the partner organization, enables to remove the negative impact of social inequalities by pushing walking as a primary exercise or solution to physical inactiveness. This is because of the fact that unlike most other forms of exercise, walking is free and requires no special equipment or training, it is safe and low-impact with a low risk of injuries and accidents, people can enjoy different surroundings a they walk in different places and different seasons, above all, people don’t need to concentrate on the walking itself, leaving them free to enjoy the surroundings, at the same time, improve the social well-beings by chatting to companions or just relax (Ramblers 2009).
As a result, because there’s no need to spend extravagant amount of money and effort, people, regardless of their social and economic status or condition can cooperate or join the initiatives. This is because of the fact that being physically inactiveness is connected to social and economic condition because those people with lower income and living in rural areas have a minimum access to different facilities that can help them to become physically active. This is also connected to the issue of diet, where in those minority group is experiencing obesity and overweight, because they are lacking from financial and information support regarding healthy eating and healthy lifestyles.
The Beattie Model
Health promotion represents mediation between people and their environment. Therefore, the role and actions of health promotion involves looking at the total environment, which enhances health. Thus, health promotion activities not only include improvement in food, income, housing and building of skills but also on the process of creating supportive environments which result in personal and community empowerment (Dines & Cribb 1993 cited in Thomas & Stewart 2003). The said factor can be achieved via education; legislation as well as community based social actions. In connection, Beattie (1991), offer an analytical model, which enables us to critically analyze the different approaches that are used by successive governments. The Beattie model has four quadrants, each quadrant express the means by which professional may promote health. Significantly, each quadrant is infused with its own philosophies, beliefs and values and outcome measurements with connection to health promotion. Thus, the approaches can be directed at an individual or at population level (cited in Thomas & Stewart 2003).
WHI occupies the quadrant D of Beattie’s model of health promotion or the community development. It focuses on empowering or enhancing the skills of a group or local community (Naidoo & Wills 2000, p. 106). Thus, it is characterized by groups of people who have the same health concerns or similar circumstances coming together in order to take action in order to improve health prospects (Blackie & Appleby 1998, p. 185). Therefore, it can be said that WHI serve as an advocate of walking for those people from majority and minority groups. Thus, create a collaborative approach in order to remove any risks that are connected with physical inactivity and focus on walking as the community development action. The main advantage of quadrant D is that it enables the people to work together and participate in the activity, as a result, the initiative will be more attractive to the people, because it’s a social activity, which given them the chance to work together and fight health problems. Therefore, working together to achieve healthy lifestyles, will serve as a motivation for those people to overcome different barriers that are connected to physical activeness. On the other hand, the main disadvantage is that the campaign will primarily tackle on the needs of the people as a group, setting aside those individual factors that are also important in promoting health. Furthermore, it will use the radical political ideology, that is directly connected to the results from different ideas and studies of different individuals and groups about walking and its impact on healthy lifestyle, therefore, it will assume that all of the people are capable of walking, overlooking the fact about other important aspects that are connected to health such as disabilities.
Ethical Assessment
Like what have mentioned in the first part of the paper, health promotion focus on working in order to develop health or the people, therefore, it is important to consider the fact that in order to come up with any initiative that is connected to health promotion, it is important to take note that different decisions and plan to be implemented will affect the lives of each individual who belong to the target of a specific program. In that case, it is important to focus on the different ethical issues that are related to the WHI. Ethics is considered as a philosophical discipline that focused on moral values, with differentiation between what is considered to be right and wrong (Jonas & Lawrence 1996, p. 554).
Because of the fact that the initiative use community development, it is important to consider the basic principles of biomedical ethics, primarily the issue of respect for persons by autonomy or recognizing free will and human rights, dignity and freedom (Jonas & Lawrence 1996, p. 555). Because WHI is integrated on the setting of community, it is vital the health development will be both people and communal-centric, which mean that it must thrive that all of the members of the community will have the access to the health initiative. In that case, autonomy is considered as the main advantage of the initiative, because it enables the people to have a voluntary action regarding joining the activity or program. Therefore, it leaves no distinct group or subgroup to be abandoned, as well as the fact that the activity can be done during free time for the walker because it only requires 30 minutes. As a result, it makes the walker to be comfortable and relax, at the same time, give him or her more energy, lessen stress, help them to have healthy sleep, maintain strong heart and lessen abnormal blood pressure and help them to manage weight. On the other hand, the said initiative will have a problem regarding beneficence or the principle of doing good (Jonas & Lawrence 1996, p. 555). This is because of the process that is needed in order to know if a person is capable to walk or need some support. Therefore, it will need medical examinations that will result to additional cost. However, this will not affect the activity because it will be supported by the government and other important organization.
Evaluating Health Activity
As of now, the initiative had been able to show success in the implementation of activities that are related to physical activeness of people. There is more than 90% of Primary Care Trust in England that are involved in the project, with more than 9,000 loan pack distributed which is equivalent to total of 90,000 Step-O-Meters. It had been able to train more than 8,000 frontline health professionals and about 200 cascade trainers.
This has been done because of effective evaluation which is considered as an important aspect in health promotion. This is because it helps to focus on the concepts of efficiency and cost-effectiveness that is subject to the development of new initiatives (Thorogood & Coombes 2004, p. 28). The initiative is being evaluated by Outdoor Health Questionnaire which focuses on the development of the programs that are being implemented. The data are collected individually by using a standard at levels of local, regional and national. The questionnaire is consists of information including the screening data, demographic data including contact information, age, range, gender as well as ethic group. As supporting information, supplementary information was also asked about their performance on physical activeness. Thus, it can be observe that the said evaluation method is effective in knowing him outcome of the initiative because it enables to analyze the different changes in terms of level of physical. Even though, this activity may not instantly show the changes in terms of physical activities, it can show the different changes in terms of behaviors regarding the health walking and inactiveness in physical terms in the long run. On the other hand, the main disadvantage is that the evaluation is focusing on self-evaluation, thus the data gathered cannot be considered as 100% reliable, because respondents might overrate themselves.
Conclusion
Based on the different information gathered, it can be said that the initiatives towards health walking is a successful health promotion. This is because, primarily, it enables people to be more aware regarding the negative impact of physical inactiveness, and the positive impact of walking. Furthermore, it also helps to remove any inequalities because walking can be done and applied by most population in everyday life, without any hassles. This is because is already a part of our daily habit. On the other hand, the main disadvantage is that it tend to generalize the population, therefore individual needs will not be catered, primarily the issue of physical and intellectual disabilities.
References
AAHE, What is Health Education, American Association for Health Education, viewed 27 April 2009, <http://www.aahperd.org/aahe/template.cfm?template=publicatio ns-jobs.html>
Blackie, C & Appleby, F 1998, Community Health Care Nursing, Elsevier Health Sciences
Bomar, P 2003, Promoting Health in Families: Applying Family Research and Theory to Nursing Practice, Elsevier Health Sciences
Contento, I 2007, Nutrition Education: Linking Research, Theory and Practice, Jones & Bartlett Publishers
Cornwall, The Health and Well Being Strategy for Cornwall and Isles of Scilly, viewed 27 April 2009, <http://www.cornwallandislesofscilly.nhs.uk/CornwallAndIsles OfScillyPCT/StayingHealthy/HealthAndWellbeing/WellbeingFiles/StrategyCornwall/AccessToLeisureAndRecreation.pdf >
European Commission, Health Determinants, viewed 27 April 2009, < http://ec.europa.eu/health/ph_determinants/healthdeterminants_en.htm>
Jonas, S & Lawrence, R 1996, Health Promotion and Disease Prevention in Clinical Practice, Lippincott Williams & Wilkins
Naidoo, J & Wills, J 2000, Health Promotion: Foundation for Practice, Elsevier Health Sciences
Natural England, Health and Natural Environment, viewed 27 April 2009, < http://www.naturalengland.org.uk/ourwork/enjoying/health/default.aspx >
Ramblers 2009, Walking Is the Nearest Activity to Perfect Exercise, viewed 27 April 2009, < http://www.ramblers.org.uk/info/factsandfigures/health.htm>
The Robert Gordon University, An Introduction to Social Policy, viewed 27 April 2009, < http://www2.rgu.ac.uk/publicpolicy/introduction/needf.htm>
Thomas, S & Stewart, J 2003, ‘Optimizing Health Promotion Activities’, JCN Online, vol. 19, no. 1, viewed 27 April 2009, <http://www.jcn.co.uk/journal.as p?MonthNum=01&YearNum=2005&Type=backissue&ArticleID=750>
Thorogood, M & Coombes, Y 2004, Evaluating Health Promotion: Practice and Methods, Oxford University Press
WHO 2009, Glossary of Humanitarian Terms, World Health Organization, viewed 27 April 2009, < http://www.who.int/hac/about/definitions/en/index.html>
Credit:ivythesis.typepad.com
0 comments:
Post a Comment