Community Health in Tower Hamlets

Introduction

Community health is focused on enhancing the health and wellbeing of people in the community. This initiative is aimed at providing clean environments, prevention of the spread of diseases, and improving access to healthcare for all people. This submission summarises the community health profile of Tower Hamlets using various secondary sources.

This submission develops a community health profile for Tower Hamlets in England using secondary data sources. The profile identifies that Tower Hamlets' population is income deprived and that there is a high prevalence of substance and drug use. Besides, people are exposed to infectious diseases such as tuberculosis and HIV. Therefore, this submission recommends that the council should create a healthier place by initiating community driving change. The conclusion sums it all.

Background

A community health needs assessment (CHNA) involves a methodical procedure engaged with a community in identifying and assessing critical health needs (CDC, 2020). This process uses comprehensive data collection and analysis tools to identify these objectives.

CHNA applies various principles, they include

Multi-sectorial collaborations that reinforce shared ownership of all levels of community health advancement such as evaluation, planning, and investment, among others

Active, vast and varied community engagement to enhance outcomes

Supreme transparency to enhance community involvement and accountability

Employment of evidence-based strategies and support of innovative undertakings upon rigorous assessment

Assessment to update continuous advancement procedures

The ultimate goal of a CHNA is to create approaches to solve the community's critical health needs and ascertained concerns. In this process, community engagement and collaborative participation are the most vital aspects to attain these goals (Gupta, 2011). Upon which, the CHNA acts as a way to prioritize health needs and to plan and act upon unmet community health needs.

Community health profile

A community health profile is a thorough compilation of data relating to a particular community. The information could include data already published about a community or info collected by individuals or organizations to create a profile (Stanhope et al., 2019). The profile comprises of various indicators involving socio-demographic characteristics such as health status, the quality of life, the health risk factors, and health resources available and pertinent to the community (Adams, 2010). These statistics offer basic descriptive info that could inform priority setting and analysis of data on specific health concerns.

A community health profile relates to a CHNA since it assists a community in maintaining a broad strategic perspective of its population's health status and attributes that affect health in the community (CDC, 2020). Therefore, a community health profile supplements a CHNA in efforts to assist a community in realizing its health needs.

Monitoring and surveillance

Monitoring and surveillance involve the ongoing systematic collection, analysis, and interpretation of information closely connected with the timely implementation of responses for improving health needs in a community (Jamison et al., 2006).

Monitoring and surveillance can also be described as a tool for estimating the health status, and critical health needs of a population. Since surveillance measures what is going on directly, it is vital to measure the effects of interventions directly. The objective of monitoring and surveillance is to endow decision-makers to lead and manage policy interventions more effectively by offering evidence in a timely fashion (Nsubuga et al., 2006).

Monitoring and surveillance relate to CHNA since it provides up-to-date, reliable, and clear status of key health needs based on the current interventions in a community.

Community health profile of Tower Hamlets

Public health has been drawn increasingly to the population health indicators, which are made up of four categories. They include; demographic, deprivation (inequalities) determinants of health such as education and family, and health status of the community. These indicators provide the primary descriptive data that can be used in implementing priority setting and interpretation of information on particular health issues.

This health profile information assists in motivating communities to solve health concerns. For instance, evidence of under-immunization among children or older people could encourage several stakeholders in the community to respond via official undertakings such as evaluation of patients' immunization status and initiate community activities such as transportation to immunization centers.

Key demographic characteristics

Population size

The Office for National Statistics (ONS) projected the resident population of Tower Hamlets to be 308,000 as of June 2017 (ONS, 2018). At the end of 2017, the Borough gained the addition of 7,000 residents; this addition is equivalent to 20 households each day in a year. In terms of population size, Tower Hamlets is ranked number eleven out of 32 boroughs in terms of population size (see figure 1).

Proportion of population-age

According to the ONS, Tower Hamlets has a relatively young population as compared with other boroughs in the U.K.

The median age as determined in 2017 was 31 years; this represents the fourth-youngest median age in all the local authorities in the U.K. In comparison with the London, England and the U.K., Tower Hamlet's median age is 4.1 years older, 8.8 years older and 9.1 years older respectively (ONS, 2018).

The working population has grown quite significantly see figure 2, whereas the Borough's population is projected to age marginally; it is expected to preserve its distinctive younger population.

Proportion by sex

Tower Hamlets' male to female ration is 109:100, or 52.1 percent of the Borough's population represents males while 47.9 percent are female. The male proportion is the fifth-largest amount in the country. This proportion is higher than London - 99:100 male to female ratio; England -98:100 male to female ratio. Overall, Tower Hamlet's sex ration shows that there are approximately 13,000 more male residents than their female counterparts (ONS, 2018). There is little evidence on how genetic and physiological composition affects the health of individuals; however, most works of literature associate social inequalities and behavior among genders as the primary determinant of health and wellbeing in gender. Central to this argument is that women are marginalized and are mostly excluded from the mainstream of economic and social life, which exposes them to severe health risks significantly (Hayes et al., 2017).

Ethnicity and language

ONS ranks Tower Hamlet as the 16th most ethnically diverse Borough in England, given the mix of various ethnic group populations (ONS, 2018). Over two-thirds of the Borough's population are minority ethnic tribes (not white British), while only a third are white British. The largest ethnic group in Tower Hamlets is Bangladeshi who accounts for approximately 32 percent (one in three residents) in the 2011 national census.

Key measures of deprivation (inequalities)

Income deprivation

The latest information from Tower Hamlets Council indicates that deprivation is widespread in the Borough with 58% of the locality's lower layer Super Output Areas (LSOAs) are listed in England's 20 percent LSOAs (Tower Hamlets Borough, 2018). Averagely, the Index of Multiple Deprivation (IMD) scores that reflects the score of deprivation across all LSOAs ranks Tower Hamlets number 10 of the most deprived area out of 326 boroughs in England.

Child poverty

The Borough has the highest child poverty rates in the U.K. According to the Borough's council statistics, approximately 18,875 children live in low-income families representing 31% of the total population of children in Tower Hamlets as of august 2015 (Tower Hamlets Borough, 2018). As compared to the national levels, Tower Hamlet represents the highest rate in the U.K. with a comparison of the national average of 17% and 19% in London.

Older people in deprivation

Tower Hamlets has the majority of pensioner poverty in the U.K. The Borough's council estimates that almost 50% of the older residents (go years and above) live in an income deprived state. This represents three times higher than the national average rate (50% versus 16%). This percentage represents around 12,500 older residents in terms of numbers who are living below the poverty line (Tower Hamlets Borough, 2018)

Key measures of the determinants of health

Child development and education

The percentage of children attaining good development in 2017 was 68% as compared with 46% in 2013. Tower Hamlet has increased by 22 percent as compared with London's 20% and England's 19% during this period (Tower Hamlets Borough, 2018).

Employment

Tower Hamlet's employment rate has increased significantly over the last ten years. In 2008, 56% of the working population were employed; in 2017, the percentage increased by 12%. Tower Hamlets' 2017 employment percentage nears England's rate of 74% (Tower Hamlets Borough, 2018).

Housing and living environment

The Borough's housing stock has increased significantly by 27% since 2003; the latest statistics, in 2017, show that there are approximately 126,000 units in the Borough. Besides, in 2017, 18,726 households were in the waiting lists, placing the Borough the second-highest among London and eighth nationally. These statistics show that housing in the Borough is on the right path to attain affordable and better housing facilities (Tower Hamlets Borough, 2018).

The health status of the community

Life expectancy at birth- in 2016, healthy life expectancy for men was lower than females standing at 78.7 and 82.4, respectively. As compared to London averages, Tower Hamlets' statistics are the third lowest.

Healthy life expectancy at birth

Tower Hamlets has had higher death rates considered preventable or premature death rates as compared with London or England averages. In 2016, for instance, infants under the age of 1 year old, the Borough recorded five deaths per 1,000 live births. These statistics are the highest in London boroughs.

Disability free life expectancy at birth

Tower Hamlet records a significantly lower disability-free life for men and women as compared with London and England averages. However, the prevalence of long-term mental health illnesses in the Borough stands at 6.4% as compared with the national average of 5.7% (ONS, 2018).

Summarise and discuss:

Tower Hamlets’ profile and what it tells about the community health needs

The rate of population growth affects the long-term planning of community health; for instance, a growing population with disparities in distribution adds pressure to the environment to feed the population to cause malnutrition (Pimentel et al., 2007). While Tower Hamlets' population continues to grow, the risk factors to the population’s health are related to undernutrition. The aging factor greatly influences the health needs of a community; for instance, older people are more vulnerable to the chronic and long duration of illnesses as compared to young and middle ages (Pimentel et al., 2007). Besides, age is a vital attribute in determining terminal illnesses such as heart problems, with the prevalence increasing after the age of 40. A majority of Tower Hamlets are a working population aged between 20 to 59 years; therefore, the chance of illnesses or death incidences are quite less as compared to people with advanced ages (Perrott & Holland, 2005). The connection between deprivation and poor health has been established (Hayes et al., 2017); Even though Tower Hamlets' IDM status has improved, its residents still experience the highest rates of child and pensioner poverty as compared to the national rate. Besides, poverty and deprivation also create challenges among residents relating to health issues and inequalities in access to healthcare opportunities. Concerning male and female life expectancy rates, Women live longer than men; therefore, this is inequality but can be planned for in perspectives of sex-related illnesses and services for older people.

Tower Hamlets' health needs and its key social determinants are specific to every stage of life. From prenatal health through to the end of life, specific attention should be given to every stage to ensure an improved healthy life.

Healthy homes offer good physical and mental health; in this regard, better health is contingent on living in better homes free from physical danger. Substandard housing, including poor ventilation, water leaks, or pest infestation, is associated with poor health.

Ethnicity and language- The department of health records that there is a consistent pattern of higher levels of dissatisfaction with the National Health Service’s offerings among the minority groups (non-British whites) as compared with the white majority (Memon et al., 2016). While a majority of the Borough's population are minority ethnic class, the healthcare services are most likely to be insufficient and dissatisfactory. Besides, the minority groups are mostly associated with having fewer opportunities to attain better healthcare services due to inequalities, such as lower income levels and disposable income levels, among other factors.

Briefly discuss how theories of health need (describe need and Bradshaw’s taxonomy of need)

Bradshaw (1972) delivered a plan of making an 'actual' need possible. To him there are four types of social needs; Normative needs tend to be professionally defined and contains a knowledge base. In this regard, the needs below the standards are termed to be in need; for instance, support and social service can be an example of a normative need. Felt need includes what people want- a reference to their own high expectations. A felt needs could be better and affordable housing. Expressed needs are equated with being demands, as an unmet need. The logic that one does not make a demand unless one feels the need. An expressed need is justified; Tower Hamlet needs an example include education or industrial safety. Comparative needs are measured by reference to a user already receiving the service. Therefore, the user is already receiving the same or worse features of the service. In this regard, Tower Hamlets' comparative need is increased opportunities for better access to quality healthcare among the minority groups. On the other hand, the theory of demographic transition argues that a population cycle starts a decline in death rate progresses towards a rapid population growth rate, and eventually, a decline in the birth rate. However, it notes that economic development reduces the death rate of a population. The demographic data show that majority of Tower Hamlets are a working population that is actively engaged in economic development. Therefore based on this theory, the Borough's death rate is likely to decrease in the future because of the shifts in economic trends.

Indicators of health status show that the residents of Tower Hamlets are particularly vulnerable to respiratory infections such as tuberculosis. However, the key indicators to Tower Hamlets’ profile are HIV, alcohol and substance use, and mental health problems. These key indicators are connected to the epidemiological model, which entails a process by which the pattern of mortality and disease transforms from high mortality in children and an epidemic affecting all age groups.

Tower Hamlets has a strong sense of community unity and civic responsibility; this is demonstrated by the level of participation and community engagement in annual activities such as the young mayor election, which attracts over 55% of the members. While 65% claim the religious belief, the networks and affiliations created by the faith communities provide opportunities to enhance health and wellbeing. Besides, 3.7% of the community's population can offer over 20 hours of unpaid care per week, while 50% of them provide over 50 hours of unpaid care.

Conclusion

Tower Hamlets residents experience some of the bleakest health inequalities in the U.K., including fewer years spent in good health, higher prevalence of drug and substance use, increased inequalities to better access to healthcare, among other attributes. This community health profile proposes various solutions to improve the community health members' wellbeing. Some of the proposed improvements include improved services for both children and young people, better services for adults, especially those with long-term health conditions and most vulnerable to illnesses. Increased focus on prevention and support for people to lead a healthy life.

References

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