Assignment Task
LO1: Discuss how research is used in generating knowledge and understanding in predicting opportunities for health promotion, protection and improvement during the lifespan continuum
LO2: Identify potential stages of human growth and development
LO3: Demonstrate a systematic method of identifying healthcare needs
LO4: Explain how health might be promoted and protected within a given population
To complete your 3500-word Health Needs Assessment (HNA) please follow these 4 steps:
STEP 1
Summarise the profile for a local geographical area; exploring factors impacting upon the health of the people living within this area (LO1)
STEP 2
Identify and justify your choice of target population (LO2) (Which group of people are of most interest to you?
Identify a target population of people you wish to focus upon, based on a human life stage (e.g. infancy; toddlerhood; childhood; adolescence; adulthood; older adulthood) . You need to be able to justify your choice of target population in relation to evidence including, national and local drivers, life-course approach / early intervention theory and stages of human development.
STEP 3
Identify and justify three health related needs of your target population (LO3) (What needs are most important?)
Identify and justify three health related needs within your chosen target population. Your choice must be based upon health inequalities, exploring how the identified needs impact on the chosen target population.
STEP 4 (LO3; LO4)
(Which is the most important need and what is being done locally to tackle this need?
Finally, using strength of evidence, you must prioritise one of the three health-related needs (from step 3) for your target population. Then identify health promotion opportunities/initiatives which exist locally in your chosen geographical area and explain how these initiatives promote and protect the health of your target population by using health promotion theory.
Example of STEP ONE
Introduction to geographical profile summary
This is a summary of a geographical profile of Cornwall. The characteristics of the population will be presented to include population number, age, gender and ethnicity distribution. It will examine the factors impacting upon health including deprivation and poverty. Finally, the health status of the population will be explored focussing upon mortality rates, lifestyle choice and mental ill health.
Population Characteristics
Cornwall’s estimated population is 565,968 (Office of National Statistics, 2018). This figure has risen by 10% over the last decade (Court, 2017). Cornwall has an older population than the national average with 24.3% aged 65 years, compared with 17.9% in England (Public Health England PHE, 2018a). The percentage of the population under 18 is 19.1%; which is lower than the national average of 21.3% (PHE, 2018a). Cornwall is therefore a predominantly older population. There are 15, 884 more females in Cornwall than males; with the largest number of females aged between years 50-54 (PHE, 2018b). Cornish people were granted ethnic majority status in 2014 (Ministry of Housing, Communities and local Government, 2014); and in 2018 92.18% recognised themselves as Cornish (PHE, 2018c). Only 1.8% of Cornwall’s population recognise themselves as from a Black or ethnic minority (PHE, 2018c) making Cornwall a predominantly white population.
Factors Impacting upon Health
Cornwall’s Index of Multiple Deprivation Index (IMD) ranking is currently 83 out of 317 (Ministries of Housing, Communities and Local Government, 2019). This is an improvement from 2015 when Cornwall IMD ranking was 68 out of 326 (Ministries of Housing, Communities and Local Government, 2015). Compared with 2015, 24% of Cornwall’s 326 neighbourhoods are relatively less deprived; 8% are relatively more deprived and 68% have not changed (Cornwall Council, 2019). Camborne and Penzance are the two most deprived towns; and the primary types of deprivation in Cornwall’s worse affected neighbourhoods relates to income, employment, education, skills and training and health and disability (Ministries of Housing, Communities and Local Government, 2019). Research shows deprivation increases the risk of poor general and mental health (Stafford and Marmot, 2003). Currently, in England, people living in the least deprived areas of the country live around 20 years longer in good health than people in the most deprived areas (PHE, 2017). Deprivation is the consequence of a lack of income and other resources, which cumulatively can be seen as living in poverty (Mack, 2016). Child poverty as an issue is growing in Cornwall (Pearson, 2018), although only 16.2% of children under 16 years are living in low-income families, which is 0.6% lower than the national average (PHE, 2016). Child poverty in some areas of Cornwall is double the National average (Pearson, 2018). The Marmot Review (Marmot, 2010) suggests child poverty leads to premature death and poor health outcomes in adulthood so reducing child poverty will improve health outcomes and increase life expectancy and break the intergenerational cycle of poverty (Cheng, Johnson and Goodman, 2016). Closing this gap and reducing health inequalities is one the biggest challenges faced in public health (PHE, 2017).
Health Status of the Population
Life expectancy of men and women living in Cornwall respectively is 79.8 years and 83.3 years (PHE, 2017). Both of these are above the national average of 78.7 years and 82.75 years respectively (PHE, 2017). The highest cause of death in those under 75 years is cardiovascular disease (CVD) which affects 66.7 per 100, 000 people. This is better than the national average of 71.7 people per 100, 000. (PHE, 2018d). The majority of factors influencing CVD risk can be attributed to an individual’s lifestyle choices (Chiesa et al 2016). PHE (2017b) explains there are a number of different physiological and behavioural risk factors for CVD, including smoking, high cholesterol, high blood pressure, poor diet, harmful drinking and physical inactivity. The optimal dietary pattern to reduce CVD is one promoting whole grains, fruits and vegetables, legumes, nuts, fish, poultry, and moderate dairy and heart-healthy vegetable oil intake; this pattern will likely reduce the CVD risk by about a third (Anand, 2015). Although PHE (2015) estimates 57.3% of people in Cornwall at age 15 years eat five fruit and vegetables a day which is average the national average of 52.4%. Considering physical activity as a risk factor PHE (2018e) note 21.1% of adults in Cornwall are inactive but 46.8 % of people walk at least 5 times per day however, this is lower than the national average of 50.6%. In relation to the risks associated with smoking; the number of adults who smoke in Cornwall 13.8?tter than the national average of 14.4% (PHE, 2018e). This risk has reduced as the percentage of smokers in Cornwall has reduced over the last 10 years (Cornwall Council, 2019).
Mental ill health is an area of concern for people living in Cornwall. The suicide rate for males living in Cornwall is 21.9 per 100, 000 compared to only 14.9 per 100, 000 in England (PHE, 2018f) 7.1% of females commit suicide which is also above the national average (PHE, 2018g). It estimated those suffering from common mental health disorders aged 65 years and older is 11.4 per 100, 000 marginally higher than the national average of 10.2 per 100, 000 (PHE, 2018h). Poor mental health impacts on individuals and their families, through lost income, lower educational attainment, quality of life and a much shorter life span (WHO, 2013; Kang et al, 2015). Poor mental health in childhood and adolescence is further associated with a broad range of poor health outcomes in adulthood, including higher rates of adult mental illness, as well as lower levels of employment, low earnings, marital problems and criminal activity (Royal College of Psychiatrists, 2010). Although Dementia is a neurological disorder there is an interface between dementia and mental ill-health (Regan, 2016). People with dementia of any type have a high incidence of major depression (Kitching, 2015). Despite Cornwall’s older population, the rates of dementia are better than the national average with an incidence of only 3.23% of the population compared to 4.33%.
In summary Cornwall is predominantly an older white British population with little ethnic minority representation. The increasing rate of deprivation and child poverty is impacting upon the health of this population. A reduction in inequities is also necessary in relation to CVD which results in the highest death rate in under 75 years (PHE, 2018d). Inequalities exist in relation to mental ill health especially the rate of suicide in men, which is higher than the national average (PHE, 2018f).