Practicing Public Health

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Public health as agreed by the faculty for public health (2010) is “ The science and art of promoting and protecting health and well-being, preventing ill-health and prolonging life through the organised efforts of society.”

A health needs assessment HNA, is a public health tool which underpins a large proportion of government policy. It offers ideal opportunities to engage with an identified population, and accumulate evidence from them and about them. This provides an evidence base from which resources can be prioritised and delivered. Through partnership working with key stakeholders, increasing the capacity to promote and protect the health needs of a population, and reducing the level of unmet need and health inequalities. (Cavanagh and Chadwick 2005)

An HNA is designed to lead to the implementation of a public health strategy. (Cavanagh and Chadwick, 2005) The assessment is supported by local and national government priorities which encourage local authorities, groups and individuals to establish which services are required to meet these needs, therefore implementing strategies that are needed by communities to prevent ill-health. Through Healthy Lives Healthy People (2010) the government promotes the move of power to local government and communities, enabling them to tackle local problems and increase their health and well-being.

Epidemiology is the study of health and disease in populations (Saracci 2010). It enables a strategic insight into the prevalence and indecencies of particular conditions or needs, and promotes the understanding of why they concentrate in particular populations. (PCT Network 2008).

'Need' implies the capacity to benefit from an intervention. Asadi-Lari et al. (2003) acknowledged that this capacity to benefit can be influenced by several factors including epidemiological aspects such as incidence and prevalence of disease and the effectiveness of interventions.

An HNA is an initial step in planning a health promotion intervention. Historically, the promotion of population health has been dominated by focusing on why individuals and communities become ill. This is known as a pathogenic approach. However, this approach has been shown to be inadequate in promoting health and well-being amongst individuals and communities, as they have a tendency to ignore psychosocial factors as well as abilities and resources for health and well-being. More often than not, pathogenic approaches are usually professionally-led, and encourage dependency on health services; they are inclined to dis-empower individuals and communities. (Naidoo and Wills 2010)

Antonovsky (1996) promotes the Salutogenic approach to health, which offers the opportunity to discover why individuals and communities remain healthy despite being faced with challenging circumstances. Antonovsky identifies this as a sense of coherence which is the capacity to understand, manage and make sense of change.

The concept of need has many dimensions, as individuals and populations have varying perceptions of what need is. There are four main types of health and social need, as identified by Bradshaw’s Concept of Social Need (1972) cited by Naidoo and Wills. (2010) An HNA must involve a balance of Bradshaw’s identifies health and social needs when selecting priorities. (Canvanagh and Chadwick 2005) Normative needs, which are professionally identified with professionally defined intervention. Felt needs are identified by individuals as a variation from what is normal health. Expressed needs are felt needs which the individual has requested support for. Comparative needs are compared to similar population groups or individuals.

Public Health Observatories provide information on a population's health. Their purpose is to produce a format from which practitioners, commissioners, policy makers and the wider community can gain insight into the health needs, and access meaningful health intelligence (2012). Indicators are...
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