Assess and discuss the impact the following environmental and attitudinal determinants have on health in terms of planning, implementation, and the evaluation of health interventions:
- Demographic distribution of populations
New Zealand’s demographics consists of the gender, ethnicity, religious and economic backgrounds of the people. Currently, New Zealand has a population of over 4.4million people. Over 76 percent of New Zealanders or Kiwis largely live in the urban areas of The North Island which consists of the five largest cities. New Zealand is also considered an ageing country with about 635,300 elderly people (65+ years old) On June 2013, according to Statistics New Zealand, these five largest cities namely, Auckland (Auckland Region) have an estimated population of 1,529,400, Christchurch (Canterbury Region) with 566, 100, Wellington (Wellington Region) with 492, 500, Hamilton (Waikato Region) with 418, 500 and Tauranga (Bay of Plenty Region) with over 278,000. Over one-third of these people live in Auckland alone. The Auckland region is also said to be fastest growing accounting to 46 percent of New Zealand’s population growth. 87 percent of Maoris live in North Island although about less than a quarter only live in Auckland. According to Statistics New Zealand, the life expectancy of infants born in 2008 was 78.4 years for males and 82.4 years for females. It is also said that the life expectancy at birth will have increased from 80 to 85 in the year 2050 and infant mortality rate will decline. On December 2013, it was registered that there were 58,717live births and 29,568 deaths in New Zealand. There were also2,461fewer births and531fewer deaths compared with 2012 and the total fertility rate was 2.0 births per woman.
New Zealand has an ageing population. This is one of the obvious demographic changes and is evident by datum presented previously. The other two are the decline in fertility and the ageing of the baby boom generation. With these, there are numerous implications to be considered. Here are some of them:
- Growing number of rest homes and retirement village.
- Decline in physical and mental function of elderly.
- Chronic diseases which affect most elderly thus needing more long-term health care.
- Age-related diseases such as cardiovascular disease, DM, COPD etc therefore, increased demand for acute health care services.
There are a lot of social implications that may affect the health of each individual. Even in the most prosperous countries, people who are less well-off are likely to be more susceptible to diseases and illness and may be more prone to stress as compared to those who are well-to-do ones. These facts are not just considered health differences in social injustice, but are also it has raised scientific awareness to some of the most vital determinants of health standards in modern societies.
It is believed that people’s lifestyle and their living conditions strongly affect their health. There are numerous studies that show that the life expectancy and susceptibility to illness are high further down the social ladder. Several factors may be considered as to why such occurrence is rampant even on the most affluent countries. One of the most common and important factors is stress and may also influence some of the other major issues such as unemployment and social exclusion. Circumstances which make people more apprehensive and unable to cope maybe damaging to the health and may be fatal if not given much attention. Insecurities, low self-esteem and loss of control over work and home life may also be damaging to the health. Such circumstances accumulate in life which may not only affect a person’s physiological health but may affect a person’s mental health as well.
Unemployment is considered to be one of the most important and common issues with regards to social matter influencing the health of a person. Like what was mentioned a while ago, stress plays a major role with regards to unemployment. The health effects of unemployment are linked to both its physiological consequences and the financial problem it brings, especially debt. Numerous people who are unemployment undergo prolonged stress due to the fact that they also have their own families to consider, not just themselves.
Although there are medical responses to stress with use of drugs, attention should be focused on knowing what causes stress and how to control them. Government should recognise that the welfare programs should focus both on the psychosocial and material needs. They should support families with children and promote coping through rehabilitation and education.
Culture in its broadest form refers to the acceptable norms, practices and behaviours within the identifiable groups in the society. The most obvious cultural groups are those based on ethnic identity, in New Zealand, that would be the Maori people, but other societal groups based on, for example, social class, religion, age (e.g. young people), occupation (e.g. nursing), location (e.g. urban) and leisure-time activity (e.g. sport) also have their own distinct culture. Individuals may be subject to a number of cultural influences simultaneously. For many groups, especially the ethnic groups, culture is central to their well-being and health. Our analysis and understanding of health must place culture as a vital determinant and methods to improve health in different groups must be aware of the influence of culture.
In New Zealand’s case, it is important that we understand the culture, behaviour and beliefs of the people especially the Maoris. Maoris culture is known to be dynamic and like any other ethnic groups; they consider their culture as the central to their life. Their practices and beliefs play a great role in their everyday lives that is why health care practitioners should place utmost importance to their culture, remembering that providing care means being able to give them what they need and being able to respect their dignity as human being. This should be true to every country with diverse culture.
Politics can be loosely defined as the governance of people. It is the idea of influencing them on an individual level. In terms of public health, it is important that the health professionals know how politics works in order for them to raise awareness about specific health issues for instance about tobacco or alcohol use. They should be able to use the political arena effectively for them to be successful with their agenda. Health care professionals may be able to use political arena to improve access to health care or to tackle health care inequalities amongst group of people. It is important that these health care professionals not only know basic knowledge about politics but importantly on how politics impact the people they are giving service to. It is better to have realistic expectations as to what politics can achieve; otherwise it will result to dreamy illusions.
- Statistics New Zealand. New Zealand in Profile: 2014. Retrieved from http://www.stats.govt.nz
- Statistics New Zealand. Estimated subnational population (RC, AU), by age and sex, at 30 June 2006-13 (2013 boundaries). Retrieved from http://www.stats.govt.nz
- Wilkinson, R., Marmot, M.G. (2003). Social Determinants of Health: The Solid Facts. Copenhagen, Denmark. WHO Regional Office for Europe
- Mackenbach, J. P. (2014). Political determinants of health. The European Journal of Public Health, 24(1), 2-2.
- Ministry of Health. Rest Homes. Retrieved from http://www.health.govt.nz
- Cornwall J and Davey J. (2004). Impact of Population Ageing in New Zealand on the Demand for Health and Disability Support services, and Workforce Implications. A background paper completed for the Ministry of Health in June 2003 by the New Zealand Institute for Research on Ageing (NZiRA) and the Health Services Research Centre (HSRC), Victoria University of Wellington. Wellington: Ministry of Health.
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