Changing social and medical attitudes affect ill health

Changing neighborly and medical checkup attitudes affect ill wellnessHealth was defined by The World Health Organisation in 1948 as, a state of masterful somatogenetic, mental and accessible well-being and non merely the absence of sickness or infirmity.Varying definitions of health keep be found depending on an individuals perspective. Medics will focus on biological stimulate spot sociologists turn incessantlyywhere that health is a product of social and environmental factors. (Naidoo Wills, 2009a chapters 12)In the primordial nineteenth Century at that place was focus on the elimi earth of diseases much(prenominal) as plague, depletedpox and epidemic cholera. With industrialization and rapid ur prohibition eraization, as the nineteenth atomic procedure 6 progressed, health issues became focused on environmental issues such as rinse piddle supplies, disposal of waste and better housing. (Naidoo Wills, 2009bp3)Health inequalities guide been recognized in the UK since William Farr front published statistics in 1837. It re importants the case at present that health is directly influenced by social class and the effectuate of imp everywhereishment and associated behaviour factors. (Ewles, 2005 pp243-245)urbanisation is the process of population concentration. The 19th century saying the massive growth of cities and the migration of the population from the country and into cities on a ordered series never seen before. Houses became over crowded with entire families living in unity room. The process caused huge problems for semi worldly concern health.(Pathfinder pack on Urbanisation the trend to the city in the 19th century, n.d.)(Urbanisation in the nineteenth and twentieth centuries, n.d.)Urbanisation was the approximately profound effect of the Industrial Revolution which developed at a pace in Britain between 1800 and 1850. Cities grew rapidly and lacked sanitation, accumulated sewage, had steep place of crime and pove rty and consequently high rates of disease. lumbering use of coal led to an accumulation of dirt and grime.(Urbanisation, n.d.)Larger cities were a necessity of industrial growth yet the conditions they brought were in many ways regressive. (Lee, 1995p48)The Growth of Cities 1801-1901 in thousands.City180118511901Birmingham71233523Bradford13105280Leeds53172429Liverpool82376704Manchester70303645Newcastle3388247Nottingham2957240Sheffield46135407(Reynoldson 1996p10)A break dance of capital of the United Kingdom was described by doubting doubting Thomas Southwood-Smith in 1838 as follows, Beckwith Row has an open drain. The houses have common, open privies (toilets) which atomic bout 18 in the most offensive condition. In one house I found six persons living in a very small room, dickens in bed, ill with fever. (Reynoldson, 1996 p110)http//t2.gstatic.com/images?q=tbnHcwSJOrT5lACaMhttp//www.makingthe lateworld.org.uk/stories/the_industrial_town/06.ST.02/img/IM.1064_zp.jpg Slums in 1872 London Making the redbrick world, n.d.)thither were no controls on the standard of housing and the Government maintained a individualistic attitude. That is they believed in that location should be no central disposal intervention. contental anaesthetic efforts were haphazard and insufficient. (Todd, 2002p31)Smallpox was the sterling(prenominal) chargeer at the beginning of the 19th century. Jenner observed that milkmaids who caught a mild form of the disease or vaccina didnt develop variola. From this study, Jenner discovered a method of vaccination against smallpox. He face up much opposition to his uncovering as several(prenominal) batch only didnt like anything red-hot while others described his theory as bizarre. Jenner wasnt a fashion suit equal London Doctor and he couldnt explain how or wherefore vaccination worked so he wasnt taken seriously. whatever hoi polloi called it an rub with nature. (Lee 1995p44) (Todd, 2002p32)Success of the vaccine was entrap down to coincidence by some Doctors who get money through an older practice of inoculation. (Lee, 1995p44)A smallpox epidemic, during which 40,000 people died, settlemented in the giving medication making the smallpox vaccination coercive in 1840 even though some continued to argue that this magazine was against human rights. Smallpox declined, until by 1900 it had almost disappeared. This was the first example of the brass accepting duty for an area of public health. (Lee, 1995p44)Cartwright in A social History of Medicine (1977) describes Jenners discovery as one of the most respect fit changes in the history of social medicine.his work is recognised as the starting line point of attempts to encounter infection by immunization. (adapted from Lee, 1995p45)Jenners work and the train of events that followed unnatural a social revolution. Individual choice was sacrificed for the interests of the community. (Cartwright, 1977p92)At the same time, two other diseases als o presented a challenge. TB cholera were more voiceless to tackle as both diseases spread as a result of poor living conditions. TB or consumption took hold as towns grew and took over from smallpox as the greatest killer disease. Cholera epidemics infatuated several times during the first half of the 19th century. In 1854 john Snow proved that cholera was connected with polluted water. He was able to show that a water pump in the Broadgate area of London was the origin of 500 cases. People using other pump near did not catch the disease. Once the Broadgate pump was attri only whene out of action, no further cases were reported in the area. (Lee, 1995p51)http//t3.gstatic.com/images?q=tbndkmPPVrjlaE3NMhttp//historyday. staleray.com/wp-content/uploads/2008/12/john-snow.jpg John Snow (1813-1858) http//t2.gstatic.com/images?q=tbnfd12xpKjN8GveMhttp//thedoublethink.com/wp-content/uploads/2009/04/450px-john_snow_memorial_and_pub.jpg likeness Broadgate pump(www.health.eku.edu/ehs/fa culty/darryl_barnett.htm)A fierce debate raged about responsibility for public health with strong views about the role of the government. Several arguments for non-intervention were put for struggled including that government intervention would interfere with peoples basic rights or the emancipation to be pestering. most people believed that if the state acted to break housing the righteous courage of the poor would be reduced. (Lee 1953 p53)A letter to The Times in 1854 read, We prefer to take our chance with cholera than be bullied into health. Many people have died from a good washing. (Quoted in Lee, 1995p53)But several chief(prenominal) people put the case for action by the state including William Farr and Thomas Southwood-Smith who both recommended government intervention. Tonge in Challenging History 1700-1914 says, Of all the passers for modify public health, Edwin Chadwick stands monumentally above the rest. Chadwick stressed the connection between public health an d disease and how such factors needed to be addressed by government intervention. Chadwicks report The sanitary conditions of the Labouring Population of Great Britain was published in 1842 and recommended that the government take steps to improve drainage, remove rubbish from the streets and improve the water supply. (Wilkes 2007 p 92) (Reynoldson 1996, p 113)http//t0.gstatic.com/images?q=tbniK4kyWJkVFmbWMhttp//wpcontent.answers.com/wikipedia/commons/thumb/9/9e/SirEdwinChadwick.jpg/200px-SirEdwinChadwick.jpg Edwin Chadwick (www.answers.com/topic/edwin-chadwick)The government distanced itself from Chadwicks report largely because of the influential figures he has discredited and the laissez-faire debate lasted for much of the 19th century. Loosely translated this means do not interfere. Some members of parliament were making money from rent on the slums and refused to commove them down. Eventually, however, the social effects of economic growth were so severe that stepwise the st ate became more involved in issues of public health. The great fume in 1858 (when a heat wave caused the Thames to smell worse than ever) providential the government into action. (Wilkes 2007).In 1861, Prince Alberts finish from typhoid was attri notwithstandinged to contaminated water from the Thames and put further pressure on the government to do something. (Cartwright, 1977, p95)In 1867, working(a) class men were given the right to vote. Political parties realised that by promising to improve living conditions, they could secure the working class vote. When the Conservatives won the 1874 election, they introduced many public health reforms. Aaron Wilkes (Medicine through Time) sees this as the most burning(prenominal) reason out why politicians began to make improvements.Some cities including Birmingham and Liverpool started some headway of slums, built sewers, improved refuse collection services and opened public baths. Some private companies such as Lever, Cadbury and R owntree precept the benefits of providing good housing for their workers. It was, however, not until after the First World War that extensive slum clearance was commenced. (Lee 1995p57)Miasma or the infectious mist given off by rotting animals, rubbish and human waste was thought to be the cause of many of the epidemics in the 19th Century. Scientists place germs using a microscope unless believed that the disease caused germs rather than the other way round. This was known as unwritten generation. Louis Pasteur questioned this theory and was able to prove that germs caused disease but many Doctors wouldnt deem his ideas. It took the German Doctor, Koch, to apply Pasteurs theory to human disease. Koch was able to prove that germs caused TB, cholera and anthrax. (Mantin Pulley, 1988p49)http//t2.gstatic.com/images?q=tbnOdyqTCWJiq49tMhttp//web.ukonline.co.uk/b.gardner/pasteur.jpg Louis Pasteur (web.ukonline.co.uk/b.gardner/pasteur.htm)Pasteur built on Kochs work and developed a v accine for rabies. curtly the germs responsible for typhus, tetanus, typhoid, pneumonia, meningitis, plague, septicaemia and dysentery were identified. Once germs were discovered vaccines could be made. Scientists now had a powerful new weapon to passage of arms disease. (Wilkes, 2007p88)Vaccination is one of the greatest success stories of modern medicine. Smallpox has been wiped out and tuberculosis and polio have been significantly reduced. Children are now regularly vaccinated against a number if diseases. (Lee, 199582) The smallpox vaccine was given apologise in 1840 but it was some other 100 social classs before vaccination against TB was provided. This was followed by vaccines for diphtheria, whooping cough out and tetanus (1954), polio (1955), measles (1964) and rubella (1969). (Lee, 1995p82)Progress continues today as a new vaccine has been introduced this year which protects girls against the virus that causes cervical cancer.The 19th Century also saw increments in surgery. The problems were pain and infection. The breakthrough came with the development of anaesthetics and antiseptics. (Lee, 1995 pp5961)William Moston experimented with ether and James Simpson tried chloroform. As with most medical discoveries, the first reaction of surgeons was criticism. Some argued that the long term effects were unknown and others objected on religious grounds. In some cases patients cool it died if the anaesthetic wasnt correctly administered. Some people thought that surgeons would cut off whatever they liked while the patient was unconscious and army Doctors thought the use of anaesthetic was soft. (Reynoldson, 199697). Others verbalise that it was unnatural to ease a womans pain during childbirth. The breakthrough came when Queen capital of Seychelles used chloroform during the birth of her eighth baby and use of anaesthetics thus became common practice. (Wikes, 1988 p101)The use of anaesthetics was a great step forward but it didnt stop deaths from infection after the doing. In the 19th Century hospitals were dirty places. Patients with disease were herded together, the same instruments were used on many patients and Doctors didnt change their argumentation stained coats between operations. Doctor Joseph middle buster was influenced by Pasteur and believed it important to kill the bacteria in the operating theatre. He did this by spraying carbolic superman (although his theory wasnt quite accurate as the bacteria was really on the instruments not in the air, but the incidence of infection was reduced by some of the antiseptic also landing on the instruments in use). Lister encountered much opposition as nurses and doctors complained about the smell and the amount of time taken to faint the theatre. Lister didnt communicate well and surgeons who didnt work with him were not convinced. (Lee.1995 p64)Eventually antiseptics and cleanliness came together to form the modern approach to surgery or asepsis. By the beginning of th e 20th century Doctors were operating in a germ free environment, using sterilised equipment and wearing gowns masks. Death rates reduced massively at Newcastle Infirmary before 1873, 59.2% of patients died after an operation (pre antisepsis), after 1873 only 4% died (post antisepsis). (Figures from The Lancet in 1878 in Lee, 1995p65). usage of a carbolic spray during an operation circa. 1880 and the sterile environment of a modern operating department.http//t0.gstatic.com/images?q=tbn476AON2yuy0EGMhttp//www.answersingenesis.org/assets/images/articles/aid/v4/antiseptic-surgery.jpg http//t0.gstatic.com/images?q=tbnsgiACWjAMvVpNMhttp//www.workingmats.com/images/Operating_Theatre_115313_08.jpg(www.history.langtreeshout.org/tag/lister/)(www.workingmats.com/images/Operating_Theatre)During the Crimean war (1854/56) Florence Nightingales influence saw death rates reduce as she was responsible for organising better water supplies and food and keeping the wards clean. Fiona Reynoldson in Me dicine Through Time says the death rate of hurt soldiers in hospital reduced by 40% under Nightingales influence.In 1899 a recruitment disturb for men to fight in the Boar War highlighted the fact that around 40% of those volunteering were disincline for military duty. In 1904 a government report concluded that there needed to be more government intervention to improve the health of children. When the Liberal government was elected in 1905, a large number of reforms were introduced including free school meals for poor children, a free school medical service and women were taught about hygiene and childcare. Pensions for over 70s and basic sick and unemployment relent were also introduced. Over the next 30 years successive governments took measures to improve the health of children and mortality rates dropped. (Wilkes, 2007p114)During the 1st World War, Prime subgenus Pastor Lloyd George promised soldiers returning homes fit for heroes. The government set itself a target of edif ice half a million decent homes by 1933. The war revolutionized gild and made us move in a new and dissimilar direction. (Fenwick-Baines, 2009)When Britain was plunged into the First World War the need for a way to combat staphylococcus, a highly resistant bacteria, was urgently needed. Many soldiers died, not from the bullets, but from the infection caused by the bullets deep in the body. Conditions in the trenches were appalling and wounds quick turned septic. Alexander Fleming worked on wounds and infections during the war and made an important discovery that the penicillin mould would attack and kill certain bacteria. Fleming is credited with its discovery but other scientists went on to develop the drug for human use. Initially, money wasnt ready(prenominal) for its manufacture but The Second World War was vital in progressing its mass production. The American government recognised its value and agreed to succumb drug companies to manufacture vast quantities to treat injur ed soldiers. Penicillin is still the most widely used antibiotic and is used to treat many bacterial infections, many other antibiotics followed . By the end of the war, drug companies made it on tap(predicate) for general use. (Wilkes, 2007 p118) (Board works, 2003)The problem of blood diddleage baffled Doctors for centuries but hundreds of wounded soldiers provided the strongest possible reason for expediting the establishment of the new blood transfusion service. This is another typical example of war acting as a accelerator for change.The 2nd World War very saw the health of the nation improve as rationing meant that fatty sugary foods were in short supply. The government urged people to dig for victory and grow their own vegetables. The government promoted healthy living including basic hygiene and immunisation against diphtheria all part of a campaign to have a healthy nation able to stand up to Hitler.(Board works, 2003)Dig For Victory http//www.5aday.nhs.uk/images/top_ tips_2/pic_carrot_eyes.jpgThe Dig for Victory campaign during the 2nd World War is remarkably similar to todays Try 5 message.(www.bbc.co.uk/dna/h2g 2009) (www.5aday.nhs.uk )Birth rates reduced with the availability of contraception and with few mouths to feed, better food was provided for children.Between the wars little changed as the economy go through difficulties (the 1930s depression) but during and after the Second World War there was a further huge development. In 1942 The Beveridge Report recommended a offbeat state and that the government should help people from the cradle to the grave. After the war people wanted change and a social revolution. The war was over and it was time to look to the future. Some people did not like the new ideas and said everyone should be independent, the rich objected to paying heavier taxes to fund the welfare state. (Cartwright 1977 p173)The suggestions made by Beveridge were not immediately put into force as the appeal was questioned bu t when Labour took power in 1945, the NHS was born. From the introduction of the NHS in 1948, everyone was entitle to free medical treatment. The welfare state and the NHS in occurrence met with opposition. Churchill and the hidebound party felt the cost was too much for the economy to bear. Critics suggested the health service was wasteful and that people were getting things they didnt need. The service was also free to overseas visitors and some argued that this was over-generous. The BMA objected, initially fearing Doctors would lose their independence and that their income would reduce as an employee of the NHS. Compromise was only reached when agreement was given that Doctors would still be able to take on private, fee-paying patients. (Lee 199595) (Reynoldson, 1996118) (Lloyd T. 1986289) (Wilkes, 2007123)The dawn of the NHS was a huge change in the way people accessed healthcare.After the war New Towns were built to switch over the inner city slums. The 1947 Town and Countr y Planning Act identified green belts where houses would not be allowed to swallow up the countryside. In 1954 the clean air act reduced smoke and smog in cities.In 1980, The Black Report stated that although health had improved since the introduction of the welfare state, huge inequalities in still existed between the rich and the poor. It concluded the reason for the disparity to be poverty. (BBC History, 2009)1992 saw the publication of The Health of the Nation. This was the first ever strategy for healthcare improvement setting out objectives and measurable targets in four key areas tit disease stroke, cancers, mental health, HIV/ aid and accidents. The areas were selected because they were either a major cause of premature death or avoidable, interventions were possible and achievements could be monitored. (Childs, 1996)In 2000 health authorities became more autonomous and the establishment of a healthy competition between them. However, postcode can now determine the qualit y of healthcare provided and whether the hospital can hold or is willing to pay for the specific drugs and treatments, Press reports in new months have highlighted how some patients been declined expensive cancer drugs by a particular hospital while it is provided to patients of a neighbouring authority. This contradicts the ethos of the NHS its position of equality of provision for all. abundant changes took place throughout the 19th and 20th centuries in terms of public health provision and scientific and medical discoveries. The NHS didnt stay completely free. It is seldom out of the news as waiting lists get longer because people are living longer. The main problem is funding as modern drugs and treatments are expensive.Most Infections and diseases can be prevented or cured but Doctors still struggle with heart disease and cancer. Viral infections like the common cold and AIDS cannot be cured and emphasis is now placed on educating people about how to avoid diseases like AIDS and lung cancer through lifestyle changes. (Wilkes A. 2007p124)Two aspects of modern living which can have a detrimental effect on the health of the population are take in and diet.Although initially promoted as cleansing the lungs by tobacco manufacturers, the detrimental effects of locoweed have been know for half a century. Naidoo Willis in national Health and Health Promotion developing practice highlight smoking as the single most preventable cause of ill health and premature death. A third of cancer deaths are united to smoking and it is also linked to heart and lung disease. Smoking is estimated to cost the NHS 1.7billion each year (Dept of Health 1998 Royal College of Physicians 1992 in Naidoo Willis 2009)Marlboros for Mummy Examples of early cigarette advertising.http//news.bbc.co.uk/nol/ overlap/spl/hi/pop_ups/03/uk_goodbye_tobacco_ads/img/2.jpg(news.bbc.co.uk//html/2.stm) (news.bbc.co.uk//html/2.stm, 2009)Early Cigarette advertising actually promoted the health be nefits claiming relief from asthma, wheezing and hay fever. Craven called itself the Doctors Choice. Marlbroro promoted the benefits of smoking to Mothers.In 1998 the government banned tobacco advertising and targeted an anti-smoking campaign at children, big(predicate) women and disadvantaged adults. Demand is controlled by taxation and a ban on smoking in a public places including pubs.Obesity is a maturement problem and has trebled since 1980. It is linked to social disadvantage and the way childrens lifestyles have changed over the last 50 years (more TV/computer time, less physical activity, convenience foods, working Mothers with less time). There is mounting pressure to ban the advertising of junk food. A high fat diet has been linked to heart disease and some cancers. NHS spending on sickness attributed to corpulency has been estimated to exceed 3.6billion. (Joint Health Surveys Unit, 2002 Mulvihill Quigley, 2003 Naidoo Willis 2009p239).Last year the government launche d the change4life education campaign to promote the message eat well, move more, live longer which encourages parents to make sure their children have a minimum of one hour cause each day and reduce the amount of fat in their diet.http//t2.gstatic.com/images?q=tbnlg0Gy-_B7JmSnMhttp//www.sunseaandcycling.com/Files/Images/C4L_master-logo-rgb.jpg http//t1.gstatic.com/images?q=tbnn39JMfcD3UH9DMhttp//images.teamsugar.com/files/upl2/1/15111/11_2009/cb3240a4f35793dc_uk-change-4-life-ad.jpg(www.nhs.uk/Change4life, 2009)Public Health interventions have evolved as the government have taken responsibility for living conditions and health service provision, mass vaccination and immunization programmes.The epidemiological transition in the 20th Century saw the main causes of death and illness shift from infections to illness such as heart disease and cancer where lifestyle is a huge factor. (Naidoo Wills 20054)Current public health measures include mass screening programmes for example for bre ast and cervical cancers, extensive vaccination programmes as well as education and advice delivered by practitioners and the media campaigns.Examples of recent/current health media campaigns.http//t1.gstatic.com/images?q=tbnvS8pq7HettyShMhttp//www2.glos.ac.uk/offload/staff/news/swineflu.jpg http//t3.gstatic.com/images?q=tbnqNfrnzs-ahQTYMhttp//draust.files.wordpress.com/2009/01/nhs-measles-poster.jpg http//t0.gstatic.com/images?q=tbngslEVyv3VyG7SMhttp//www.elements4health.com/images/stories/conditions/breast-cancer-ribbon-2.jpg(www.chesterfield.gov.uk/lowgraphic)..(draust.wordpress.com)(www.elements4health.com/report-highlights-ser)The policy-making agenda is dominated by social responsibility and recognition of the associate between poverty and ill health. Acheson defines health promotion as the skill and art of preventing disease, prolonging life and promoting health through the organised efforts of society. (Acheson 1988 in Naidoo Wills, 20054)