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Social determinants of health are the conditions in which people live that determine health conditions in an area. The first part of the paper discusses the demographic details and social determinants of health at London Borough of Croydon. London Borough of Croydon, a London borough situated in South London, has the highest population of the London boroughs. 2001 census indicated that it had a population of 269,100, which rose to 342,700 in 2005 – making it the ninth most populated local authority of the 354 boroughs in England (London European Partnership for Transport n.d.). 233,748 out of 330,587 residents had good health, representing a mean of 33,75. This shows that a larger percentage of people living in the borough have health problems which are mainly brought about by poverty, lack of education, unequal distribution of resources, and unemployment (CDC 2011).

London Borough of Croydon provides health and social care for both adults and young people. Every group is vulnerable to contacting diseases and encountering dangers in the course of living in the area. The elderly in the borough develop health and social problems that make them not to interact well with others and perform their daily duties. They develop mental health problems, eye problems, leg problems and social problems such as not able to interact well with people in the society. Based on the 2011 census, the borough consisted of 101,941 young people who were below 20 years, making 28,05% of the total population (Croydon Observatory n.d.). Children and young people are vulnerable to infant mortality, teenage pregnancy, and child obesity. The adolescent are also vulnerable to mental torture due to vices such as rape and abduction.

Poverty has greatly determined the status of health in the borough. With 5000 children born every year; one out of four children lives in poverty in Croydon borough. This is mainly because of the high percentage of single parents in the borough – 3,1% of the total population of the borough. This increases chances of becoming homeless and contacting diseases. According to Watson (2010), poverty makes people to eat less nutritious meals, have little knowledge about health, illnesses or medicine, visit doctors or health care providers less frequently, and receive low quality medication and attention.

Poverty causes stress and mental health problems. Adults that live in poverty have high chances of developing psychological problems compared to that are above the poverty line (Watson 2010). Poverty also promotes obesity and infectious diseases. Once diseases attack people living in poverty, they spread very fast and affect many people. The development of children at their early stages or ages affects their later health status. Poor people do not have enough money to treat their children when they develop some illnesses and vaccinate them for some diseases which make them vulnerable to many diseases at later dates that would have been prevented (Danziger 2009). Poverty also promotes unhygienic conditions that promote health problems. For example, poverty makes people not to build toilets and pit latrines, therefore, become vulnerable to diseases caused by not depositing human waste in the right places.

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The returns of health to education are higher than the financial returns. It is estimated that one year in education increases the net returns by about 10%. Lack of education also increases chances of developing health problems. Lack of education makes individuals not to practice hygiene in their homes as they do not know the benefits of hygiene. They also not take their children to hospitals to get vaccinated as they do not know the benefits of the practice or just ignore them thereby putting them at higher health risks later in life.

High rates of employment affect health as it increases earnings. It makes facilities that improve health such as gym affordable, improves access to medical services by increasing income or utilizing health insurance from employers, and reduces stress. According to Curtler & Lleras-Muney (2006), more educated individuals live in safer environments and interact with healthy fellows thereby reducing their risks of becoming unhealthy. Unequal distribution of resources such as health facilities, roads, and water greatly determines the health status of a place. Lack of health care facilities in a place  increases the time people take to reach the nearest facility to seek for treatment and increases the chances of people becoming very ill or the disease, in case it is contagious, spreading to many people. Lack of proper roads also increases the time taken to reach a medical facility, therefore, increases the chances of spread of the diseases.

Poverty is the main determinant of health in Croydon London borough. Though it is a relatively wealthy borough, the large number of refugees and asylum seekers it has in its northern part indicates that poverty exists in some parts. It is ranked number 125 out of 354 of the most deprived boroughs in London. Health inequalities are seen within the Croydon in terms of gender, ethnicity, and location. Men living in the most deprived places of the borough are expected to live nine years less than those living in least deprived areas. Female in the same areas have a life expectancy difference of five years. However, the borough has developed ways of curbing the health inequalities in the region. The Joint health improvement plan prioritizes various issues relating to health inequalities and provides direction on the effective ways to solve them. The borough has put in place effective leadership who work close with the Public Health department to identify health inequalities and develop strategies and plans, which are reflected in the budgets and plans of the Council, to solve it. The borough has also put in place the Local Strategic Partnership and Health Croydon Partnership which include people from all over the borough to device and implement strategies that solve the inequality issue. The borough recommends engagement of all parties involved with local businesses to identify the root causes of health inequalities and device ways of reducing them.

Health and Social Care Policies and How They are Implemented in London Borough of Croydon

London Borough of Croydon has put different policies to safeguard their people. The second part discusses the Charging for Residential Accommodation Guide (CRAG) 2011 policy and how it is implemented. The Charging for Residential Accommodation Guide (CRAG) 2011 policy is a policy that guides the way residents should pay for the accommodations they receive for residential or nursing care. It provides that the local authority should access a person’s ability to pay for the treatment and services he gets using The National Assistance Regulations 1992 designed for the purpose in case he is unable to pay (Departmen of Health 2011). It provides the charging of full costs of accommodation by local authority in local authority managed homes. When a person is unable to pay for the standard rate, the local authority should assess his ability to pay and provide him with a lower amount that he can manage to pay. In case the local authority makes a contract with independent homes, there should be a contract between local authority and independent home to pay the home for the accommodation, including the amount to be paid. The person is thereafter required to refund the money to the local authority. In case the resident is not able to fully refund the money to the local authority, the local authority assesses his inability to pay just like that in homes managed by local authority and decide a lower amount that the resident should refund.

No assessment is done by the local authority regarding the ability to pay for the services offered to a resident for a period of up to eight weeks. In this case, local authority performs a financial assessment and decides on an amount that is reasonable for the resident to pay. The local authority charges standard amount to residents who stay for more than eight weeks and assesses their ability to pay.

During treatment of couples, local authority does not assess them in relation to their joint resources but allows each individual to enter a residential care individually. All local authorities are moving to implementing a self-directed support in Croydon that provides more choices for people to choose the way they lead their lives. After local authority assesses financial status of people, they come up with the amount of funding that is suitable for their support. It enables people to seek for the support they are able to pay for with ease. Social care manager talks with people about their needs, allows them to fill a supported self-assessment questionnaire, and the works out suitable personal budget amount.

Health and social care policies are implemented at London Borough of Croydon with the help of various agencies and professionals. Health and social care professionals go through such policies and use them as a guide while undertaking their daily duties. Different agencies also assist in the implementation of the policy. The local authorities, for example, ensures that it uses the policy to disseminate its duties and guides residents on what the policy says and updates them on any changes that are made. Some agencies oversee the implementation of the policy by ensuring that the policy directions are followed to the latter and giving guidance on any issues that might bring confusion. They get to the people and identify flaws that exist in the policy and provide recommendations to relevant bodies to make changes to ensure it serves people well. Citizens also help in the implementation of the policy; those who understand the policy guide others and educate them on what the policy stipulates. 

Health and Social Care Provisions at London Borough of Croydon

The last part discusses various health and social care provisions at London Borough of Croydon. The borough provides support and medication to its elders who have dementia. Dementia is a condition where the ability of the brain to process information deteriorates. Various social care provisions have been put in place to control the disease and take care of affected patients; Alzheimer’s Society assists dementia victims by providing outreach support to them and those who take care of them through telephone calls and visits; Forget-me-not Café creates an environment for social interaction with those affected and provide support such as guidance and medication; Information and Advise provides advice to people with dementia, their families, and friends through telephone; Singing for the Brain helps the brain through singing; and Safeguarding Adults Board and Sub-Groups ensures that elderly people are not physically, emotionally, financially, and sexually abused.

Alzheimer’s Society

Alzheimer’s Society respects people with dementia and ensures that they are respected as they are still valued members of the society. It ensures that people with dementia are reassured and supported by carers, health care professionals, and friends and families so that they feel they are worthy in the society. It provides support to people assisting dementia patients by making them to be tolerant and flexible to them, listening, talking, loving, and socializing with patients.

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Alzheimer’s Society supports those who care for dementia patients by ensuring that they have enough background information of the patients’ and information about what they undergo. This makes sure that they see the patients as whole persons instead of that with dementia. They also teach them to have more topics to converse with the patients and suggest more activities that patients may enjoy. Alzheimer’s Society spearheads research that is aimed at developing various treatments to dementia. In response to the results of a systematic review published in The Cochrane Library about a possible treatment for vascular dementia using Cerebrolysin drug, Alzheimer’s Society commented that there was lack of research concerning vascular dementia and recommended that more research to be done (Smith 2013).

The society provides telephone and online services to people with dementia and those assisting them. It campaigns for equal rights to people with dementia through analyzing various policies in place and raising awareness concerning the disease. It also ensures that people with the disease are treated well by providing training to health care professionals.

 Forget-me-not Café

Forget-me-not Café creates an environment for social interaction with those affected and provide support such as guidance and medication. It understands that taking care of dementia patients can be very tiresome and organizes periodic social events for interaction of both patients and carers which promotes reduction of stress and anxiety.

Information and Advice

Information and Advice provides advice and counseling to people with various diseases such as dementia and their carers. It also offers support and advice to people who have developed mental illness as a result of an accident, housing problems, job loss or stress, and the environment and provides treatment plans and therapies to people with mental illnesses.

Singing for the Brain

Singing for the Brain, a service offered by Alzhemer’s Society, brings people together using songs. The programme involves specialists in music who sing songs to help people with memory problems especially thoose with dementia. In addition to fun associated to music, singing builds on the preserved memory for song and music in the brain. Unlike other things which are difficult to remember, music is easy to remember and people with dementia can refresh their brains by recalling songs they once heard. According to Mashhood Ahmed, Support Services Manager of Alzheimer’s Society in Croydon, the programme encourages friendship, support, and sharing of experiences among many people who are interested in assisting people and patients with memory problem. He contends that he has seen many people with dementia being transformed by music.

Safeguarding Adults Board and Sub-Groups

Safeguarding Adults Board, set up according to the Department of Health 2000, ensures that all agencies that work with communities that are with adults that are vulnerable must collaborate to ensure that the adults are protected from abuse. It makes decisions regarding both national and local policies developed to ensure that vulnerable adults are safeguarded. It develops work plans for its subgroups, approves their work, and monitors the implementation of various projects carried out with the subgroups. The Best Practice & Procedures Sub Group receives suggestions and recommendations from different subgroups regarding policies that need to be improved or considered further and pass them to the Safeguarding Adults Board for verification.

The borough also acknowledges that children and young people are the leaders of tomorrow and has put in place various services such as the Advocacy Services for Children and Young People, Child Protection and Safeguarding, Child and Adolescent Mental Health Services, Children and Young People with Disabilities, Volunteer Peer Supporters, and Hospital Social Work Services for Children to safeguard them. 

The Advocacy Services for Children and Young People

The Advocacy Services for Children and Young People supports children and young people to ensure that their rights are not breached and their concerns are addressed in a respectable manner. The services helps children say what they want and get listened to, ensure their feelings and wishes are heard and attended to, helps children complain, ensures children obtain their rights, and support them in their meetings.

Child Protection and Safeguarding

Child Protection and Safeguarding acknowledges that family members, family friends, and strangers pose risk to children. Every year, many children lose their lives because of abuse or neglect by their family members. As a result, various safeguards have been put in place to ensure that children are safe. For example, Local Authority Designated Officer (LADO) receives all allegations regarding agencies or people that work with children and provide advice and guidance on cases regarding child abuse and ensure they are resolved amicably. It collates and presents information regarding allegations and presents them to the Croydon Safeguarding Children Board in order for them to train, research, and raise awareness (Local Authority Designated Officer 2013). Children Social Service Complaints receives, investigates, and reviews complaints regarding child abuse.

Child and Adolescent Mental Health Service

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Child and Adolescent Mental Health Service deliver mental health and social care services to adolescent and children. It assesses treats, advices, and trains adolescents and children with constant and severe mental health problems, their families, and health care professionals that deal with them. 

Children and Young People with Disabilities

Children and Young People with Disabilities offer both health and social services to children and young people with disabilities. Aiming High for Disabled Children is a government established body that provides various services to disabled children to improve their health and social wee-being. In collaboration with other organizations, Aiming High for Disabled Children provides short break services such as home based care where a child visits home of those who care for them for some hours or overnight, individual support where those who take care of the children visits and provides care in their homes, activity schemes when children are out of school, and direct payments.

Volunteer Peer Supporters

Volunteer Peer Supporters consider those mothers who, therefore, have breastfed their children for a period of four weeks and have concern to continue to breastfeed. Moreover, they offer guidance to mothers who are involved in breastfeeding in a conducive atmosphere.

Hospital Social Work Services for Children

Hospital Social Work Services for Children offers services to children in need especially those who are at a risk of harm and are receiving medication at Mayday Hospital. They offer services that would reduce the risks of self-harm, teenage pregnancy, and risks associated with social, financial, emotional, and mental problems in pregnant women. The kinds of children that they consider to be in need are those with poor health and disability caused by illness of their parents or just passing through the need themselves. Hospital Social Work Services identifies the needs and supports such children by advising them and their families, counseling them, and offering them with material goods. 

Conclusion

With a population of 342,700 in 2005 and a fraction of 233,748 out of 330,587 residents having good health, London Borough of Croydon has implemented various health and social care policies that safeguard its residents from abuse, harm, and health problems. It has put in place services such as the Advocacy Services for Children and Young People, Child Protection and Safeguarding, Child and Adolescent Mental Health Services, Children and Young People with Disabilities, Volunteer Peer Supporters, and Hospital Social Work Services for Children to safeguard its children and young people, and implemented Alzheimer’s Society which assists dementia victims by providing outreach support to elderly and those who take care of them through telephone calls and visits, Forget-me-not Café which creates an environment for social interaction with those affected by dementia and provide support such as guidance and medication, Information and Advise which provides advice to people with dementia, their families, and friends through telephone, Singing for the Brain which helps the brain through singing, and Safeguarding Adults Board and Sub-Groups which ensures that elderly people are not physically, emotionally, financially, and sexually abused.

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