Impact of the Acheson Report on Health Policy

Impact of the Acheson Report on Health Policy In what way did the Acheson Report represent a radical approach to health policy? How far did it inform New Labours policy on reducing inequalities in health? Introduction: A government commissioned report on health inequalities led by Sir Donald Acheson has been marked as extremely influential in shaping future UK health policies. The Acheson report highlights the area in which health inequalities could be reduced and provides the direction of health policies promoted by the Department of Health. The report focuses on several areas such as poverty that seems to have disproportionate effect on children. Increased benefit levels have been recommended for women of childbearing age, expectant mothers, young children and older people suggesting mothers on income support tend to have inadequate diets. The report also calls for more funding support to schools in deprived areas, better nutrition and the concept of health-promoting schools. Benefit levels for providing nutritional meals to children should be increased and food should be more affordable for fulfilling nutritional needs of children. The report also focuses on smoking and drinking problems urging for restrictions on smoking in public places, a ban on tobacco advertising and promotion, mass educational initiatives, increases in the price of tobacco and the prescriptions for nicotine replacement therapy. The Acheson report also suggests close links between health and mortality rates. The Acheson report has been instrumental in shaping, directing and implementing several changes in the NHS Health policy. Several studies and research reports have been published on the impact and influence of the Acheson report on changes within health care policy. The Acheson report identified three crucial areas on social gradient and health inequalities and suggested that a high priority should be given to the health of families with children; all policies likely to have an impact on health should be evaluated in terms of their impact on health inequalities; steps should be taken to reduce income inequalities and improve the living standards of poor households. The Acheson Report and UK Health Policies The Acheson Report 1998, an Independent Inquiry into Inequalities in Health was similar to the Black Report 1980 and can be considered as a Department of Health review of the evidence on inequalities in health in England. The Department of Health has responded to the Acheson report by taking an official course of action. The Department of Health mentions that tackling health inequalities is a top priority for the Government, and is focused on narrowing the health gap between disadvantaged groups, communities and the rest of the country, and on improving health overall. The strategy for addressing this problems is published in, Tackling Health Inequalities: A Programme for Action that lays the foundations for meeting the Governments target to reduce the health gap on infant mortality and life expectancy by 2010.A programme for action include a three-year plan for tackling health inequalities and to help local organisations improve the way services are delivered to disadvantaged groups. The programme for action in response to the Acheson report is based on Supporting families, mothers and children Engaging Communities and Individuals Preventing Illness and providing Effective treatment and Care Addressing the underlying determinants of health The Acheson report suggests that socioeconomic inequalities in health and expectation of life have been found in England for many years and there have been data identifying differences in longevity by ones socioeconomic position. Inequalities of health are measured in terms of mortality, life expectancy or health status and could be categorised by socioeconomic status, ethnic group or gender. The Acheson report suggested that there are differences in the health status of mothers, babies, people of lower socioeconomic status and people who smoke or drink heavily. The report definitely shows that death rates are falling in England and the rates have fallen since 1896. Thus life expectancy seems to have risen in the last few years although healthy life expectancy has not been rising. In fact the proportion of people with long standing illness has risen from 15 percent to 22 percent (Acheson Report, 1998). The Acheson report thus gave new insights on health policies and identified issues that contribute to an increased rate of mortality and possible ill health. It identified several socioeconomic determinants including income distribution and household below average income, education, employment, housing, homelessness, public sector, transport and health related behaviour. Following the report, the Choosing Health White Paper given by the Department of Health sets out the key principles for supporting the public to make healthier and more informed choices in regards to their health. Through the paper, the Government has provided information and practical support to get people motivated and improve emotional well-being and also provide access to services to encourage people to make healthy choices. The government has also drawn up a food and health action plan that focuses on the ways that better health can be achieved through better nutrition at all stages of life and for different gro ups in society, recognising and addressing different needs, particularly those of disadvantaged groups (Choosing Health, DH, 2004). The government has also set up the Health Improvement Plan and a new NHS plan for tackling health inequalities 81% of people in higher socio-economic groups consider themselves to be in good health now, compared with 61% of people in the lowest groups 76% of people in the higher groups expect to be in good health in 10 years’ time, compared to 53% of people in the lowest groups (DH, 2004). Putting forward the NHS improvement plan, the Government reiterated the NHS commitment that the NHS is motivated to prevent disease and improve health in general. The Government policies are focused on the fact that inequalities in health cannot be accepted and the fundamental objective is to create healthier choices for disadvantaged groups. The NHS Improvement plan was laid down in 2004 to not only counter health inequalities but also provide better quality of care to patients and provide safer and more effective treatment. The NHS Improvement Plan set out modernisation and health plans putting patients and service users first through more personalised care; a focus on the whole of health and well-being, not only illness; and further devolution of decision-making to local organisations. (DH, 2004) According to the Government report and Action Plan laid out in then Choosing Health White paper the nutritional priorities were given as follows: increase in the average consumption of a variety of fruit and vegetables increase in the average intake of dietary fibre to 18 grams per day reducing average intake of salt to 6 grams per day reduce average intake of saturated fat maintaining the current trends in reducing average intake of total fat reducing the average intake of added sugar (Choosing Health White paper, 2004) The Government took several steps to ensure that the recommendations of the Acheson report is considered for any further changes within the NHS. Accordingly major steps have been taken to ensure consumer awareness on the consumption of healthy foods and development of good food habits. Reducing the proportion of fat, salt in the diet has been recommended and retailers and caterers have been asked introduce healthier range of foods and offer such foods in convenient stores, centre locations and in remote areas of the city. In a plan to tackle health inequalities, the Government has focused on many plans including – Offer people personal health plans with support from the NHS. Recruit NHS health trainers to provide advice and support for people to develop their personal health plans. Provide services in the areas of highest need. Offer disabled people the option of taking up a health check. (DH, 2004) Considering the Acheson report on the exaggerated problems of health care among pregnant women and children, the government has also provided eligible pregnant women with vouchers that can be exchanged for fresh fruit and vegetables, milk and infant formula through a new scheme called Healthy Start. A Sure Start scheme is also in place for providing training, guidance and support for early years to children. Practitioners encourage changes in parental behaviour and improve the social and emotional development and physical health of children in the early years. Community Parental Support Projects are also in place that involves training of lead workers in 500 communities. ‘Healthy Schools’ programmes are encouraged to target deprived schools including Pupil Referral Units. The Government has promoted the concept of healthy schools by 2006, working towards a healthy school status by 2009. The concept of Healthy schools, Sure Start and the Concept for providing Parental Support as well as providing people with personal health plans are some of the steps that the government has taken to ensure the promotion of health. Some of the objectives of the Action Plan have been given as follows. Following the Acheson report, the government focus has shifted from the one aimed to meet national targets to a different approach that could be given as follows standards are the main driver for continuous improvements in quality; there are fewer national targets; there is greater scope for addressing local priorities; incentives are in place to support the system; and all organisations locally play their part in service modernisation. (Care Standards Planning Framework, 2004). Research Studies We discuss several studies which deal with the Acheson report. Oliver and Nutbeam (2003) point out that health inequalities has been considered seriously for an approach to improve health care and government policies have been developed to explicitly address existing health inequalities that has become an important issue since Labour has returned to power in 1997. The development of health inequalities policies, have been critically examined to assess how such policies could or should be developed. The authors point out that progress in the development of health inequality policies has been made although the progress is less than expected or ideal. Kisely and Jones (1997) have written on the issues of public health ten years after the Acheson report. They point out that the issue of communicable disease control and the role of public health medicine is of considerable concern in the light of outbreaks and NHS reorganisations. The Acheson report seems to have highlighted several issues in this regard. Yet as Kisely and Jones the Reports findings have yet to be fully implemented. The paper calls for a further review of public health function and should include the removal of the specialty from management costs, and the clarification standardisation of the roles of the Director of Public Health (DPH), CPHM and other members of the multi-disciplinary public health team (Kisely and Jones, 1997). Possible organisational implications for a public health approach have also been suggested. Tarlov (1999) has delineated four conceptual frameworks providing the bases for constructing public policy strategies for improving population health and this include: (1) Determinants of population health. (2) Complex systems: (3) An intervention framework for population health improvement. (4) Public policy development process with two phases of public consensus and policy action. The Acheson report can be judged in this context and has provided both a consensus and a policy framework. Conclusion: The research studies and analysis of the Acheson report suggests that the 1998 Acheson report has been extremely influential in shaping Health care policies in the UK and reducing inequalities in health. Bibliography Primary health care in Londonchanges since the Acheson report. BMJ. 1992 Nov 7;305(6862):1130-3. Tarlov AR. Public policy frameworks for improving population health. Ann N Y Acad Sci. 1999;896:281-93. Blane D. Health inequality and public policy: one year on from the Acheson report. J Epidemiol Community Health. 1999 Dec;53(12):748. Williams A. Commentary on the Acheson report. Health Econ. 1999 Jun;8(4):297-9. Barnes R, Scott-Samuel A. The Acheson report: beyond parenthood and apple pie? J Epidemiol Community Health. 1999 Jun;53(6):322-3. Spencer NJ. The Acheson report: challenges for the College. Arch Dis Child. 1999 Jun;80(6):576-8. Better benefits for health: plan to implement the central recommendation of the Acheson report. BMJ. 1999 Mar 13;318(7185):724-7. Acheson D. Inequalities in health. Report on inequalities in health did give priority for steps to be tackled. BMJ. 1998 Dec 12;317(7173):1659. Oliver A, Nutbeam D. Addressing health inequalities in the United Kingdom: a case study. J Public Health Med. 2003 Dec;25(4):281-7. Kisely S, Jones J. Acheson revisited: public health medicine ten years after the Acheson Report. Public Health. 1997 Nov;111(6):361-4. Also see: DH publications: Choosing Health White Paper, DH, 2004 NHS Plan, DH publication 2004 Acheson Report, DH publication, 1998 Inequalities in health, DH publication 1998 NHS Improvement Plan, 2004 www.dh.gov.uk

Havisham

The ideas the Duffy is trying to convey is the idea the heart brake and physiological damage of a relationship gone corrupt and by a wedding day that was a- boarded ND the devastating impact on the bride who was left standing on her own embarrassed and humiliated by the failure of her beloved to show up. The idea of society expectation has also shrouded upon her since she can't even leave her own house since she is paranoid about society expectation of a classic woman.Society expects a woman to find a man and get married and have children and by her not fulfilled society's expectation she has â€Å"failed† at life's virtue for a woman therefore having a unworthy life by living as a â€Å"spinster† and wasting away thou a husband. Another idea conveyed is the effect of also being alone without a partner â€Å"a lover† to share your life with. This is reflected by Ms Having who has always been alone and never really had â€Å"true love† and the effects of th at how our feelings can go to mutual hatred towards one person whom in their mind destroyed their entire life.The poem is titled Having and not Miss Having. Why? The poem Is titled â€Å"Having† opposed to â€Å"Miss Having† since she doesn't have the honor being labeled a â€Å"miss† due to turning Into a complete monster. She Is not a lady , she's not proper or has the correct virtue for a typical ladles life. She Is an old hag who has wasted away and is nothing more than to be called a spinster. Having creates a harsh , violent and bold statement reflecting her and everything he's become.Where as Miss creates a peaceful , calm and relaxed tone and doesn't reflect her at all. What do you think the poem gains from the images of violence in it? The poem advances with Images of violence from the text since it creates an image of his woman and the extent of her despair and trashed life that took a turn Off cliff and died. The metaphors and imagery shown In the tex t such as † so hard Vive dark green pebbles for eyes† really gives the audience an Intense Image and shows how she hardened from the Inside and has nothing but venom filled In her veins. Opposition. The feelings of Ms Having are mixed due to the confusion inside and the baffling she's had to deal with to come to terms with the â€Å"tragedy'. The feeling consist o darted and evil towards this man shown through † wished him dead† hating this man so much to the extend she wished death upon him. Feeling stretching to her love for him expressed minimally for example † Beloved sweetheart† showing a more inmate and loving tone.Then creating a more somber tone with the loneliness she has by herself â€Å"give me a male corpse for a long slow honeymoon† showing the extend that she wants someone this man so bad that she would replace him with a male corpse since she realizes that no man would ever want her. The reason for these binary opposite is s ince that is what we as humans feel mixed emotions , churned up together creating confusion fore her and us. Sometimes the persona imagines the passionate times she could have had with her lover.Which part of the poem describes this? The poem describes the time she could have had with her lover are shown in many instances like † the dress yellowing† expressing that she has waited for him all these years and that they still could get married and have a fulfilled life together. This is also shown through â€Å"give me a male corpse for a long slow honey moon† expressing that they had the opportunity to go on a beautiful honeymoon together.To what extent does the poem reflect a feminist agenda, or even Duffy own feelings at the time of writing? Address the attitudes and values conveyed. To a minimal extent the poem reflects a feminist agenda since the poem is directed towards her lover but is shown in some instances like â€Å"loves hate behind a white veil† h ere the feminist agenda is reflected is the quote since it undermines the institution of arraign and the idea that it is not worth it , a disappointment and alluding to gay and lesbian rights.Another references is shown through â€Å"spinster† since the meaning of the word is a old had and unmarried wasting away without a husband. Hence showing the inequality between men and woman since the term for a unmarried man is â€Å"bachelor† which is viewed in a positive light and being a good thing whereas woman are considered a disappointment by not get married therefore highlighting the feminist agenda. Havisham The opening line portrays the order of events. â€Å"Beloved sweetheart bastard. † The man she describes was someone special but soon became someone she hated. She has longed for revenge as the reader is told, â€Å"Not a day since then I haven't wished for him dead. † The words â€Å"prayed† also tie in with this deep seated longing for change. The imagery of her eyes being like â€Å"Dark green pebbles† hints to the hardness of stone but also the green is jealousy. She has become trapped by obsession: thinking, praying and waiting for her fiance. The word â€Å"Spinster† is a one word sentence, almost spat out in distaste. Havisham describes her condition â€Å"I stink and remember† the words refer to her smell from wearing the same clothes but also the stench of the terrible thing that has happened to her. The events have changed her and there is real sadness and fear behind the words. Her wedding dress is described as â€Å"yellowing† as she questions how she has ended up in this situation. The final part of the previous stanza merges into this third verse and the disjointedness reflects Havisham's own distress. This stanza hints that sometimes she can feel happy and when she is bed asleep for a moment it as if she is still with her lover, but the strong words â€Å"bite awake† describe the gnawing pain of having lost a loved one. The dream is only a dream and life is difficult to live with. Love is personified and the narrator describes herself as â€Å"Love's hate behind a white veil† Love enjoys hurting her and again this is emphasised with her description of the balloon â€Å"bursting in my face. † Balloons are supposed to be fun like love but in this instance it becomes something shocking ready to spoil her happiness. Havisham also describes at destroying her wedding cake, â€Å"I stabbed at a wedding-cake. † This describes not only her pain, but the pain she would like to inflict on someone else. The imagery of a honeymoon is coupled with the words â€Å"male corpse† this also shows her unfeeling towards men. She doesn't want something living, she wants something dead. The very last word comes out in a stutter when she talks about how a heart â€Å"b-b-b-breaks† this shows sadness and madness at the same time. When she talks about her heart not being the only one that is broken it reminds us of Pip from â€Å"Great Expectations†, she's been hurt and knows how to break a man's heart. In the case of Pip, she wanted to crush his dreams of gaining an education.

My Life in Pink Essay

The story of this sensitively-handled film concerns a young MtF transsexual. It is by turns comic and heartbreaking. Seven-year old Ludovic lives in an upper-middle class Belgian suburban neighborhood. He behaves in a way that is quite natural to him, dresses in a dress or skirt whenever possible, and is quite convinced he will be marrying a neighborhood boy, the son of his father’s boss. His favorite television program is a kitchy girls program about a Barbie-like doll called Pam who lives in a flowery girly pink cartoon fantasy world and has magic powers. Young Ludovic dances Pam’s dance to the haunting song â€Å"Rose†, and like some other girls of his age fantasizes about marriage to a handsome romantic man who will sweep his female love off her feet. The film depicts the difficulties facing a child with gender identity issues and the way the Ludovic himself, the confused parents and family, society, school, other children, and the neighborhood (hostile, hypocritical, and ignorant) handle the situation. Ludovic is seven years old. At first thinks he is a girl, then becomes confused as everyone attempts to disabuse him of this, then tries to find an acceptable common ground (I am a girlboy, or I am a boy but I will grow up to be a girl, or something went wrong and and I should have been born a girl). When he was born, the extra X chromosome accidentally landed in the trash and he got a Y instead! Even an identity as a girlboy is not allowed him by those around him. The only ones who have any understanding of what he is going through are his psychologist and his grandmother who thinks it might be a phase he is going through, but also confronts the situation with some understanding. His sister also sees Ludovich more as he is than as others believe or want him to be. Under increasing pressure from an ignorant community which gives the family the cold shoulder, the parents naturally have difficulty in dealing with Ludovic’s transsexuality, and eventually send him to a psychologist with the intention of â€Å"curing† him, but of course there is no cure – only understanding. Eventually they come to accept the inevitable. The movie, perhaps a larger than life fictionalisation, is a microcosm of the early life experience of a transsexual. The movie deals with homophobia, bigotry, misunderstanding, the retreat of the transsexual into a fantasy life to escape from unthinkable real life, the attempt of the transsexual to hide the condition because of his/her punishment for showing it, and the reaction of the transsexual’s parents, family, and society. Common to the experience, particlarly when the movie was made, is confusion of homosexuality and transsexualism, denial of its existence, the attempt to cure it, the successful discrimination and hostility against the transsexual and his/her family, the realization of the existence of both male-to-female and female-to-male transsexuality, and finally resigned acceptance. The father is fired from his job, and the family moves to a poorer neighborhood, where they find some acceptance and Ludovic meets a young butch girl, perhaps a young FtM transsexual of about the same age. The final relief from troubles is belied by the music which turns somber as the camera pans away from the petit Ludovic, on his own away from the other children. As his pubescent sister says, prophetically, â€Å"it only gets more difficult as you get older†. The final scene dissolves into the haunting theme.

The Effects Of Fracking On The United States And Its...

Introduction With the proliferation of fracking in the United States and its impact on so many different aspects of society from environmental to health and economic impact, it is an important topic that demands more research and along with more community awareness. Another aspect of fracking that is discussed much less than the environmental and public health aspects is that the people that benefit most from the fracking industry usually white affluent individuals do not live in the area that drilling process or waste disposal process happens (Johnston, J. j., Werder, E., Sebastian, D. (2016). It is also important to keep in mind how the elites of society are able to mold and manipulate public opinion to suit their needs (Davis, C., Fisk, J. M. (2014). It has been shown how persistent opinions from elites and media messages can sway public opinion in whichever direction they choose (Davis, C., Fisk, J. M. (2014). This paper demonstrates how the fracking industry not only poisons the environment it poisons communities through creating conflict and negative public health issues. Methods In their research review Charles Davis and Jonathan Fisk (2014) set out to examine public attitudes about the fracking industry, they based their findings on analysis of survey data of 2400 American adults. In their paper Shale Gas Wastewater Management Under Uncertainty Xiaodong Zhang , Alexander SunShow MoreRelatedFracking And The Gas Industry1573 Words   |  7 Pagesrapidly across the United States. High volume hydraulic fracturing, or â€Å"fracking,† is a process in which water and chemicals are injected into shale formations underground in order to release trapped natural gas. As fracking spreads throughout the United States, there are more and more reported cases of contaminated drinking water and illness among citizens living near fracking sites. Even with these cases, it is still difficult for the public to grasp just how dangerous fracking is to the publicRead MoreFracking And Its Wastewater Disposal1489 Words   |  6 PagesDat Ninh T. Drosselmeyer Engl 1113 – 088 14 November 2016 1393 words Fracking and its wastewater disposal are threatening human’s life In recent years, there has been an increasing concern about whether or not should factories keep using Fracking as their main method to extract oil and gas from the underground. Fracking, or hydraulic fracturing can be defined as the process of drilling down into the Earth and injecting high-pressurized water mixture into the ground, creating cracksRead MoreHydraulic Fracturing : A Technique Used For Extract Petroleum And Natural Gas From Deep Rock Formations Essay1508 Words   |  7 PagesHydraulic Fracturing, also known as â€Å"fracking†, is a technique used to extract petroleum and natural gas from deep-rock formations. 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A Healthy alternativeRead MoreHydraulic Fracking : A Short Term Solution1361 Words   |  6 PagesHydraulic Fracking: A Short-Term Solution to a Long-Term Problem Development of infrastructure and market for natural gas, a product of hydraulic fracking, has blossomed in recent years. Interestingly though, hydraulic fracturing, a process that’s been around since the early 1900s, has recently become a topic of significant controversy, especially through the expansion of large reservoirs throughout the United States, including the Barnett Shale, the Marcellus, and the Bakken. However, the unsustainableRead MoreThe Process Of Hydraulic Fracturing1387 Words   |  6 Pageseconomy plus environment of the United States, but due to the large interdependencies and networks of our world today, impacts at a global scale are inevitable. By analyzing each scale individually starting with national, local and ending with global, it will become clear that each scale is interdependent and interrelated with one another. Scales: In our fast-paced and globalizing world, it is important to know how phenomena and processes effect scales within society. Between the global and localRead MoreHydraulic Fracturing: The Future of America’s Energy Essay1285 Words   |  6 PagesHydraulic Fracturing, also known as fracking, is not a novel concept. The hope of being able to access fossil fuels trapped inside layers of shale deep beneath the Earth’s surface was achieved by the process of fracking, developed in 1903 (energyindepth.com). Over the last century, hydraulic fracturing has become an efficient and environmentally friendly way to access the natural gas needed to meet the United States’ high demands. 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Fracking is considered an unconventional technique for harvesting natural gas and oil. Where conventional wells drill straight down and can only collect from more free-flowing deposits, fracking allows for horizontal drilling into shale deposits and uses water pressure to enlarge pre-existingRead MoreFracking : A Better World Essay1289 Words   |  6 Pagesas a society to better the world around us. The vision of a better world differs individual to individual as some view economic growth and the development of a decaying energy sector to be symbols of a better world. To others, a better world is to create a habitat that can sustain our population and basic needs for a healthy lifestyle. One such advancement made in recent years that has brought forth an economic boon was the introduction of hydraulic fracturing – commonly referred to as fracking. With