Health and Cardiovascular Disease Impact

Introduction

Health is defined as the complete sense of physical, social and emotional wellbeing and not merely the absence of disease and infirmity (WHO, 2002). As stated by the World Health Organisation, health is a juncture of all aspects of life, and for living a healthy and flourishing life; all aspects of the life and experiences have to be sound and positive. It is stated that, several diseases are life-threatening and fatal and cause high mortality and morbidity rates all over the world. This disease cannot be cured completely, but it can be managed through self-care, medication and lifestyle modifications. One such health condition is cardiovascular disease. Cardiovascular diseases are referred to as the health conditions that concern with dysfunction and the disorders of the cardiac system, heart and the vasculature associated with it. Cardiovascular diseases such as coronary artery diseases, arrhythmias, cardiomyopathy and heart failure are highly fatal and cause severe reduction in the life expectancy of the individual, who are suffering from it. These diseases are seen to have a specific impact on the overall quality of life of the individual (Dietrich et al., 2017). This assignment focuses on identifying the health implications and influences of cardiovascular diseases in the population of Lambeth Borough of London. The assignment will aim to identify and define the policy documents that are introduced by international, national and local sources, which are aimed towards tackling these issues and reduce its rising prevalence. The policy initiative geared towards handling this issue is keenly explored and discussed in this essay, and lastly, the health promotion approaches used for tackling this issue in society and interpretation of the strategies within the policy initiative will be discussed. The overall evaluation of the findings in the essay will be well concluded, and recommendation for future practice and policy framework will be demonstrated further.

Question 1 Public health issue of cardio vascular diseases in the defined population

Cardiovascular diseases are defined as the chronic long-term conditions that impact the function of the cardiac system of the human body (Ortega, Lavie & Blair., 2016). These diseases are mainly the result of the lifestyle habits, genetic inheritance and the risk associated with other debilitating diseases (Dietrich et al., 2017). Cardiovascular disease is the term used to define a group of diseases, which includes coronary heart disease, cerebrovascular diseases, deep vein disease and congenital heart anomalies. The path physiology of cardiovascular disease can be well explained through the type of disease and its root cause. Coronary artery disease is the highest cause of death all over the globe and the factor that cause sit, the major factor that influences the type, severity and intensity of cardiovascular disease for any individual is the process of atherosclerosis. Atherosclerosis is the process, where due to hypercholesterolemia the plaque forms in the vessels leading to their blockage. This plaque formation is expanded by the consumption of tobacco, smoking, alcohol and unhealthy diets (Faithfull et al., 2017). Hypertension and diabetes also act as risk factors for cardiovascular diseases and enhances the risk of the individual to develop long term conditions. The development of plaque into the vessels cause the restricted blood supply to the heart; this leads to hypoxia and ischemia of heart muscles causing coronary artery disease and dysfunction of heart to pump blood to the body parts (Ortega, Lavie & Blair., 2016). This whole process is modifiable and can be prevented by adjusting the lifestyle habits and adapting towards healthy choices.

According to the Heart Disease and Stroke Statistics globally, the estimates rate of cardiovascular prevalence is up to 219.4 per 100,000 individuals (Connolly et al., 2017). These statistics show an increased burden of cardiovascular disease globally. There are certain modifiable and certain non-modifiable factors that risk the development of cardiovascular disease for the individual. The non-modifiable factors include age, gender, family history and ethnic background whereas, modifiable factors include, social determinants of health such as poverty, education, housing, physical and metabolic factors including hypertension and diabetes, behavioural factors including smoking, alcohol and lack of physical activity and poor access to quality health care services (Faithfull et al., 2017). It is seen that, cardiovascular disease are the second largest cause of death in England that estimates about 130,190 deaths per year (Connolly et al., 2017). Lambeth is the district in South London. The Borough is a mixture of different ethnic groups residing together where 40% of the population is White Irish and British whereas around 52% are from black African and Caribbean background and a small 8% of the population belongs to Asian background (Townsend et al., 2016). In the year 2011, the statistics show that around 29% of the total deaths that occurred in England were caused due to cardiovascular diseases (Townsend et al., 2016). Coronary artery disease is the most prevalent cardiovascular disease, and the majority of around 46% of deaths occurring due to CVD is due to coronary artery diseases (Connolly et al., 2017). The increasing prevalence of this disease in the boundaries of the UK region brings a great concern for health and social care services and government policymakers (Bhatnagar et al., 2016). This calls for providing Strategic Clinical Networks for the region to address the issues and tackle them appropriately (Binno., 2016). On evaluating the estimated amount of spread of cardiovascular disease in the region of Lambeth that lies under the London Strategic Clinical Networks. It is seen that the early mortality rates under 75 years due to cardiovascular disease in this region is similar to that of the national rate, the emergency admission rate is higher than the national rates, the percentage of people with long term condition and the habit of smoking is considerably higher to that of entire England (Townsend et al., 2016).

Lambeth consist of around 335,000 population, the risk for cardiovascular disease among this population is high after the age of 40 years (Connolly et al., 2017). The population above the age of 40 years in this region is about 18% males and 17.3% for females (Bhatnagar et al., 2016). The population of this region is estimated to be 36.9% most deprived national quintile and less than 1% of the entire population is under least deprived quintile (Townsend et al., 2016). There is a significant association of increased cardiovascular episodes and cases in this region due to its minority ethnic population, the black, Asian and minority groups comprise of around 42.9% (Connolly et al., 2017). It is seen that South Asian men are most likely to develop cardiovascular diseases at an early age and black community people have the highest stroke rate in the world. More evaluation into the current scenario of the region explains that the 21.4% of the population in Lambethisa chronic smoker that increases that risk towards developing cardiovascular diseases, and 20.5% are obese that is also seen as a debilitating risk factor for cardiovascular disease (Connolly et al., 2017). The quality of outcome framework surveyed the quality of life of the people residing in Lambeth, and it was found that average quality of life of the individual is 5.4% (Townsend et al., 2016).The framework also estimated that the observed prevalence of CVD in Lambeth is 40.4% (Bhatnagar et al., 2016). Lambeth estimates around 205 per 100,000 mortality rates every year from a disease that is modifiable such as cardiovascular disease (Townsend et al., 2016). The close association of social determinants of health is identified in the prevalence of the cardiovascular disease, as this disease seems to disproportionately affect the population from disadvantaged backgrounds more and contribute to the health inequalities persisting. These rising rates and increasing inequalities suggested that until 2022 the rates of cardiovascular diseases will rise to 4.2 million (Connolly et al., 2017). As the 50 to 60% of the population of Lambeth belong to the minority and black African ethnic groups, the ethnic factors play a crucial role in the development of cardiovascular disease prevalence in this region. Moreover, the increased smoking habit and unhealthy dietary habits of the population adds up to the risk (Asthana et al., 2018). Moreover, the overall life expectancy of the majority areas in Lambeth is lower as compared to rest of England due to poverty, low socio-economic groups, lack of education and ethnic background playing as essential social determinants of health (Townsend et al., 2016).

Question 2 Policy initiatives

Cardiovascular diseases have been identified to be the significant player in mortality and morbidity all across the globe, the international and national agencies and organisations have worked since years to provide strategic plans and interventions in order to tackle this disease and reduce its prevalence across the globe (WHO, 2020). The World Health Organisation- Organisational Strategic Priorities is one such international strategy working for providing adequate prevention, management and treatment for cardiovascular diseases (Faithfull et al., 2017). The aim of this strategy is to provide cost-effective services in an equitable manner. WHO aimed at reducing the risk for development of CVD, provide cost-effective health care and aim at monitoring the trends of CVD risk factors around the globe. WHO stated that due to economic transition, urbanisation and industrialisation, the prevalence of CVD is increasing in the developing countries (Asthana et al., 2018). The critical areas of work suggested by the strategy include- reducing major CVD risk factors and associated social and economic determinants by working with the use of community-based programs and providing integrated care and prevention. The program aims at the development of care and case management of CVD; the overall global action is aimed to enhance countries capability to meet the needs of the health care users, developing the surveillance methods to assess the trends, methods and prevalence of the disease in different region across the world and developing effective inter-country, interregional and global networks and partnerships (Binno., 2016). The above mentioned is the example of the international initiative and policy framework developed for tackling the issue such as cardiovascular disease around the globe (WHO., 2020). The World Health organisation guidelines are mandated to be used by all the health care systems and departments all over the world, and these policies are framed to develop standard care and health promotion strategies to reduce the prevalence of cardiovascular disease around the globe (WHO. 2020).

The national policy framed by the government of the UK for tackling the disease and cardiovascular burden on the health system in the UK, Cardiovascular Disease Outcome Strategy is introduced by the Department of Health (2013). This policy is the national initiative for reducing the prevalence of diseases such as cardiovascular disease and other long-term morbidities. The framework identified that the disease is the second-largest cause of death in the country and it affects many lives, both physically and mentally (WHO, 2020). The strategy identified that the improvement in trends within last two decades had been diagnosed that has reduced the rate of morbidity under 75 years due to this disease in the UK up to 40% (Public Health England, 2017). The strategy was proposed by indicating that despite such huge improvements, still the ratio of prevalence in England is on the rise and the strategies need to be well framed to achieve a positive outcome. Some major actions are enumerated under this strategy to be taken to reduce the over ranging prevalence of CVD in the nation (Binno, 2016). Action one includes the introduction of the NHS quality board, which is the new development that works in order to manage the CVD model as one family disease. This action aims at enhancing the risk management and prevention of the disease at local community and hospital setting (Public Health England, 2017). Action two involves working in integration with Public Health England and surveillance data to gather the trends and develop adequate progress for management and treatment outcomes. Action three includes NHS development of NHS health check programs that will help to screen the population at risk. Action four includes integrated work of NHS with other organisations to provide case tools for supporting and empowering the health service providers, and Action five comprises of developing the better early management skills and secondary prevention for CVD. Action six, aims at improving acute care and primary care in all the sectors (Public Health England, 2017).

Additionally, action seven and eight comprise of building the end of life care for the patient with CVD, which requires palliative assistance; and action nine includes developing intelligence, evaluation, monitoring and research. The outcome framework described here is well formulated with advanced and far-sighted action plans developed to tackle CVD. This policy is being into action in the UK since 2013, under which the CVD programs are been organized and run effectively for prevention, development of good health, lifestyle choices and management of the cardiovascular risk factors and diseases (Public Health England, 2017). CVD: Primary Care Intelligence Packs were created for NHS Lambeth CCG in 2017 (Department of Health, 2013).These policies are the local initiative to tackle the CVD in the region of Lambeth. The joint policy framework by GP, Nurses and professionals developed here stated that the high-risk factors for CVD such as hypertension, diabetes, kidney disorders, are the most suboptimal reason for prevention and management, late diagnosis leads to inadequate management and development of CVD (Department of Health, 2013). The policy framework stated that primary care is the first point for the diagnosis of these diseases, and early detection is the key to early prevention. In this regard, proper care plan needs to be developed through managing integrated care, so that the CVD patient will get proper treatment and continuous assistance. The CVD intelligence pack helps to initiate local conversations about quality improvement in primary care. The pack is developed to identify the variation in trends for the disease listed in it and use of these trends to explore data and evaluate the interventions to be implemented to address the needs (Timmis et al, 2018).

Further, the local action plan for quality improvement by the local authorities and local organisations is developed to ensure quality improvement (Department of Health, 2013). Managing this view, the NHS Five Year Forward view gets into the action that helps to target the risk factors and identify the target population with high risk for CVD. Hence, prevention and management of all the cardiovascular diseases lies under following the guidelines, for diagnosis, prevention, management and treatment of the disease and develop high-quality care (Department of Health, 2013).

Question 3 analysing the policy initiatives to tackle the issue

The abovementioned strategies are well formulated and framed in order to tackle the cardiovascular disease on international, national and local platforms. The World Health Organisation Strategic priorities are set in with the aim to demonstrate prevention, diagnosis and treatment or management of the cardiovascular issues on the global scale (Asthana et al., 2018). As 1.7 million people have been diagnosed with CVD yearly around the globe, it is crucial for these strategies to be implemented (WHO, 2002). The achievement of global health is a complex view and a critical challenge, where every health care staff need to be collaborated and communicative to provide better health and social care service to the patients with CVD.. The focus of these priorities was to promote diagnosis and management within the risk population around the globe. The strategy is well framed on generalizing basis; further additions on the basis of the individual set up a plan for the region can be added to enhance its utility and specificity (Faithfull et al., 2017). This is because the priorities set are to promote equitable and collective interventions for the CVD population and prevention of the disease on mega-scale. In order to achieve this aim, it is essential that the strategies being implemented should be well communicated and set for use in all around the globe (Binno, 2016). One of the essential interventions that the WHO set was to develop the inter-country, interregional and global networks, in a contemporary world where the disease travel due to urbanisation and globalisation, networking to promote better evaluation and care planning is essential to develop high-quality services that impact the overall global health (Timmis et al., 2018).

The CVD Outcome Framework set by the government of the UK was developed to be able to further set an action plan for treatment, prevention and management of CVD in the UK, 2016-2017, Action Strategy Plan were set by the government to be used in NHS all around the UK. These action plans were aimed at targeting the behavioural and social and environmental risks factors that are associated with an increase in the prevalence of health inequalities that cause increases rates of cardiovascular diseases in one group over another. The action plan includes the focus on six key areas of the primary health sector that are leadership and governance, financing, workforce, medical technology and resources, information and resource, and service delivery (Binno, 2016). Focusing the interventions and services on these six principles ensures better quality care and a wide array of services for the prevention and management of cardiovascular risk and diseases (Asthana et al., 2018). The policy framework and the cooperative government structure are effective for creating social values where the people in the society can access quality care and effective treatment to overcome their issue related to CVD. The joint policy framework by GP, Nurses and professionals developed here stated that the high-risk factors for CVD such as hypertension, diabetes, kidney disorders. They are the most suboptimal reason for prevention and management; late diagnosis leads to inadequate management and development of CVD. The policy framework stated that primary care is the first point for the diagnosis of these diseases, and early dete3ction is the key to early prevention (Timmis et al., 2018). For joined policy framework, it is also necessary for the health care providers and social workers to communicate with each other and share their experience and knowledge to develop effective care plan. Providing better care and treatment to the patients with CVD is a complex one, where integrated care plan needs to be developed and fir which it is essential for the health care professionals and the service workers to collaborate and develop effective care plan for the patients efficiently by empowering all the health care staff. CVD: Primary Care Intelligence Packs were created for NHS Lambeth CCG in 2017. It is analysed that these strategies proved to be highly effective in the area of Lambeth as it proved to reduce the amount of cost drained for CVD, helped reducing the trends in the prevalence of CVD and also enabled in promoting health and welfare of the population. The rate of morbidity related to below 75 years of age due to cardiovascular risk was also modulated well through the intelligence system and interventions placed in order from its evaluation (Faithfull et al., 2017).

Question 4 Approaches of health promotion

Health promotion is defined as the process of promoting health and wellbeing of the individual by prevention of diseases, education and encouragement for adopting healthy choices and living. Health promotion has different principles of implementation; use of health promotion tool in policy framework is one of the essential utilities of these tools. As identified in the initiative adopted by the World Health Organisation, the prevention of cardiovascular disease is one of the most important factors of the strategic priorities. The strategies prepared help to prevent the health conditions by education, campaign promotion and health prevention programs. WHO also presented some additional approaches to develop health promotion for cardiovascular disease prevention around the worldglobly (Binno, 2016). The total risk approach for prevention of cardiovascular disease, this approach targets the high-risk groups in the nation, community and region, these groups are evaluated for their persisting risk and the factors or the social determinants that influence their risks (Faithfull et al., 2017). These identifications are charted and promoted for evaluation to present the health promotion programs for the targeted population. The risk identification and evaluation will further lead to the development of the interventions for prevention and better adaptation to health (Timmis et al., 2018). Some more recommendations provided are smoking cessation, dietary changes, physical activity and weight control. The government of the UK, presenting with the CVD strategies and outcome framework also provides various recommended health promotion campaign and programs to develop a strategic health prevention setup to prevent cardiovascular diseases. Public Health Matters initiative is one such campaign and program organisation bureau that helps to develop health education and literacy and enhances the cost-effective service programs for the CVD population in the UK (Levy & Tedstone, 2017). The health cost for providing services and programs to prevent and manage CVD in the UK has different influences; the cost for these programs runs high. The policies work effectively to promote better health through advertisement, awareness and enhanced literacy. The cost of non-healthcare reasons for prevention of such diseases is estimated to be more than healthcare costs of disease. It also necessary for the government to take corrective actions in the society for raising awareness among the people about CVD, where health care campaign at the society, free check up and free advisory board settlement are effective for the government fop the country to protect the human being and give them proper advise to stay healthy and improve their standard of living condition.

The Lambeth council and JSNA introduced various programs for the prevention and management of cardiovascular diseases (Levy & Tedstone, 2017).The main of which currently working program is the secondary prevention and national ambitions program that focus at providing health literacy to the minority ethnic groups, education for prevention of long term conditions and development of healthy eating habits and physically active lifestyles (Levy & Tedstone, 2017). These are done in association of NHS Long Term Plan that aims to prevent cardiovascular diseases from the region and eliminate the risks associated with the high prevalence and development of the diseases by health education and promotion. In the recent era of globalisation, the people are interested to gather latest news and information through social media and thus for successful health promotional activities, it is effective or the health care organisations to create social media adverstoemnet6 posts and arrange the social campaigning through the social media to educate at the people with CVD and raise awareness about healthy lifestyle.

CONCLUSION

Cardiovascular diseases are referred to as the health conditions, which concerns with dysfunction and the disorders of cardiac system, heart and the vasculature associated with it. Cardiovascular diseases such as coronary artery diseases, arrhythmias, cardiomyopathy and heart failure are highly fatal and cause severe reduce in the life expectancy of the individual suffering from it. Atherosclerosis is the process where due to hypercholesterolemia the plaque forms in the vessels leading to their blockage. This plaque formation is expanded by the consumption of tobacco, smoking, alcohol and unhealthy diets. Hypertension and diabetes also act as risk factors for cardiovascular diseases and enhances the risk of the individual to develop long term conditions. On evaluating the estimated amount of spread of cardiovascular disease in the region of Lambeth, that lies under the London Strategic Clinical Networks, it is seen that the early mortality rates under 75 years due to cardiovascular disease in this region is similar to that of the national rate, the emergency admission rate is higher than the national rates, the percentage of people with long term condition and the habit of smoking is considerably higher to that of entire England. Lambeth consist of around 335,000 population, the risk for cardiovascular disease among this population is high after the age of 40 years. CVD: Primary Care Intelligence Packs were created for NHS Lambeth CCG in 2017 (Wilkins et al., 2017). These policies are the local initiative to tackle the CVD in the region of Lambeth. The joint policy framework by GP, Nurses and professionals developed here stated that the high risk factors for CVD such as hypertension, diabetes, kidney disorders etc. are mostly suboptimal reason for prevention and management, late diagnosis leads to inadequate management and development of CVD. The policy framework stated that primary care is the first point for diagnosis of these diseases and early detection is the key to early prevention. To promote health and prevent diseases currently the secondary prevention and national ambitions program that focus at providing health literacy to the minority ethnic groups, education for prevention of long term conditions and development of healthy eating habits and physically active lifestyles is developed in Lambeth. This is done in association of NHS Long Term Plan, which aims to prevent cardiovascular diseases from the region and eliminate the risks associated with the high prevalence and development of the diseases by health education and promotion.

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