CAM529 Introduction to Public Health Assignment Sample
Cardiovascular disease is considered by the World Health Organisation to be the “world’s number one killer.” This group of diseases causes considerable morbidity and mortality worldwide, and greater than 75% of cardiovascular disease deaths occur in low and middle-income countries
You are to write an essay describing the global health problem of cardiovascular disease. You should consider how the epidemiology of heart disease differs in low, middle and high- income countries, and the reasons for this. Imagine that you are working for a regional office of the World Health Organisation
You can choose which WHO regional area you wish to focus on. You should then search for and interrogate the literature on current public health challenges and responses to cardiovascular disease for your chosen region and use this information to make recommendations for future action.
Your essay paper should be structured as follows:
• Introduction: Introduce the topic and define the scope of your paper.
• Background: Include the most recent data to illustrate the public health problem in your region, and describe how the problem differs within and between countries in your region. Discuss the determinants of health that are relevant to this issue and explain how they contribute to disease burden.
• Public Health Response: Based on your reading of the literature, describe the current public health policy and strategy responses to this issue in your defined geographical region. Critique this response – identify strengths, weaknesses and gaps, as well as opportunities in relation to the current response. Consider public health approaches that you believe will reap the greatest population health gains. Support your arguments with reference to relevant scholarly literature.
• Recommendations: Based on your critique of the current public health response, provide three policy recommendations for improving the disease burden of cardiovascular disease in your region of choice, and identify the governing bodies that would be responsible for enacting these recommendations.
The essay should be approximately 3000 words (including references, tables and figures). A word count within 10% of this is considered acceptable.
It is to be noted that “Cardiovascular Diseases” are the number one killer disease in the world. Globally, an estimated 18 million people had died suffering from cardiovascular disease and amongst all these deaths, more than 85.2% deaths had been due to “stroke” and “heart attack” (Bansal, 2020). Over three-quarters of cardiovascular deaths occur within low and middle-income countries. Amongst 17 million premature deaths in 2019, more than 37% of the deaths had been caused by CVDs (Mehra et al., 2020). The essay discusses the various aspects of cardiovascular diseases and a discussion entailing how heart disease differs in low, middle, and high-income countries (Fuchs and Whelton, 2020). The WHO region that has been taken under consideration in this paper is “South-East Asia” (Peltzer and Pengpid, 2018). The various public health challenges and responses towards “Cardiovascular diseases” for the chosen region would be carried out and some relevant and suitable recommendations would be made for future actions (Dehghan et al., 2018). It is needless to mention that it is of utmost importance to detect cardiovascular diseases at the earliest so as to manage, counsel, and discover effective cures and medicines for the disease (Thomas et al., 2018). The scope of the paper is that it would help future epidemiologists to find the spread, and measures of Cardiovascular diseases within the various high, medium, and low-income countries in South-Eastern Asia for assignment help.
Heart diseases account for more than 33% of all deaths take place in the South East Asian region and as per reports, cardiovascular diseases are responsible for more than 4 million people every year (Oliva, 2019). Within the region some of the majorly identified causes of cardiovascular diseases (Shafiq et al., 2018). In addition to this, the high blood pressure, as well as unhealthy diets, air pollutions, and so on, are some of the most important risk factors for cardiovascular diseases in the South East Asian regions and they account for more than 18 percent of the total number of deaths and 28 percent of the cardiovascular-related deaths (Jankowski et al., 2021). According to the study by Zhao (2021), amongst all deaths from CVDs, 39% percent of deaths in Southeast Asia are caused by Ischemic heart attacks, 49% percent of deaths are caused by Stroke, and 12 percent of deaths are caused by other cardiovascular diseases (Zhao, 2021).
Low income countries: Bangladesh:
Bangladesh is one of the low income countries of South-east Asia and a recent study from the rural Bangladesh has demonstrated that a there had been drastic increment in the cases of cardiovascular diseases between 2010 to 2019. The age-oriented cardiovascular diseases had increased by 30 times (Islam et al., 2016). Also, it can be said that Bangladesh has exhibited some prominent increment in the prevalence of some non-communicable chronic diseases and the related ates of mortality and morbidity in the previous few years (Islam et al., 2016). Some of the major health determinants pertaining to the prevalence of cardiovascular diseases in Bangladesh include hypertension, diabetes, body-mas index, raised blood pressure, education and so on. As Bangladesh has experienced some rapid urbanization within the last few decades and also exhibited fast economic growth and thus has recently emerged as “a developing nation” (Sharif et al., 2021). As a result of this increased urbanization and growth, there is an increasing concern about further risks of chronic diseases due to the habits of people to adopt sedentary lifestyles (Barua et al., 2018). Bangladesh has also undergone changed food habits and increased inclination of young and middle aged people towards processed foods and inconsistent means and reduced physical activities (Islam et al., 2016). It is to be noted that poor lifestyles are being increasingly adopted by the people of Bangladesh, and as a result, more and more people have been suffering from Coronary Heart Diseases and renal failure than ever before (Hahn et al., 2021). Also, within Bangladesh, the males, unmarried people, the non-slum urban people and the non-Muslims tend to greater possibilities towards the risks of cardiovascular diseases (Barua et al., 2018). In addition to this, according to many studies, the Cardiovascular disease risks had been seen to be conversely proportional to the level of education amongst the males and females and Bangladeshis. For the people having more than 1 years of education, the chances for them to suffer from elevated cardiovascular disease risks is less than 10% (Sharif et al., 2021). Thus, education can be an effective way to prevent and control the risks of CVD within the country.
Middle-income countries: India
In the of the Southeast Asian regions, India is a developing nation with middle-income, and in this country, hypertension, stress-related brain activities, and so on have been reported as some of the most potential factors attributing to cardiovascular deaths (Peltzer and Pengpid, 2018). In the 21st century, Cardiovascular diseases had been one of the most significant causes of mortality in India (Geldsetzer et al., 2018). As compared to the people of Europe, the Indians are affected by cardiovascular diseases 10 years earlier and mostly during the most productive period of their lives. In India, amongst all deaths caused by cardiovascular diseases, 52% are middle-aged. It is to be noted that the most prominent health determinants pertaining to cardiovascular diseases in India is include age, gender, unhealthy food habits, sedentary lifestyles, consumption of tobacco and alcohol abuse.
Moreover, the case of fatality that is attributable to cardiovascular diseases within the middle-income countries like India is significantly higher than high income countries (Kundu and Kundu, 2022). As estimated by the World Health Organization, with the present burden of cardiovascular diseases in India, the nation might loose more than $230 billion from productivity losses and expenditure within the healthcare in the coming decade. In India, the high propensity to develop Cardiovascular diseases can be attributed to various biological mechanisms, various social determinants and other interactions (Nambiar et al., 2020). Migrant Asian Indians have three-times greater prevalence of coronary artery diseases within the rural parts of the country (Kundu and Kundu, 2022). Moreover, the prevalence of Coronary artery diseases within Indians is more than 22 percent for the diabetic patients and 11 percent for the non-diabetic ones. The coronary artery disease prevalence within the rural parts of the nation is more or less 50 percent than within the urban population (Nambiar et al., 2020). Therefore, in order to address the significant burden requires a thorough understanding of all sociological and biological determinants and the complex dynamics underlying the various interactions as well.
High-income countries: Thailand
As per the latest World Health Organization data for 2018, cardiovascular diseases including coronary heart diseases in Thailand has reached more than 60,372 which is equivalent to 12.35% of the total deaths in the country (Juntarawijit and Juntarawijit, 2020). The “age adjusted Death Rate” of the country as per WHO report is approximately 63.10 per 100,000 of population ranks the country #157 in the world. In this country, the main health determinants relevant to cardiovascular diseases include “high blood pressure levels”, “high cholesterol levels”, “diabetes”, smoking, and so on (Juntarawijit and Juntarawijit, 2020). In the last decade, there had been a drastic increase in various chronic diseases within Thailand and Cardiovascular diseases and coronary artery diseases had a significant rise. In the year 2019, in Thailand there had been more than 350 thousand patients undergoing “ischemic heart disease” (Jensen et al., 2019). In that same year, the highest number of patients suffering from Cardiovascular diseases was from Bangkok and there were nearly 48 thousand patients. In the last decade, the number of Thai people suffering and dying from CVD including coronary heart diseases had been increasing in a drastic manner and had been considered to be one of the major causes of deaths in Thailand (Gheewala et al., 2019). The most potential factors that can be attributed to these diseases are unhealthy food habits, and the drastically changing eating behaviours of the people. The Thai people often eat high fat content and high carbohydrate content foods and also they barely exercise but exhibit high levels of stress. In the increasing rates of cardiovascular diseases in Thailand, genetics also play a significant role (Hahn et al., 2021). Apart from that, hypertension, high cholesterol, increasing rates of obesity, smoking and adoption of sedentary life styles are also some of the major factors contributing to the increasing cardiovascular disease rates in Thailand (Krittayaphong et al., 2019).
Public Health Responses within the region
At present, the South Asian tends to account for one-fourth of the total world population, and yet it already claims nearly 60 percent of the worldwide burden of heart diseases (Hahn et al., 2021). It is to be noted that the burden of cardiovascular diseases ion would continue to increase in a drastic manner within the region of Southeast Asia in the future few decades. Substantial public health achievements had been made in the prevention of cardiovascular diseases and strokes; however, they are not sufficient to prevent or reverse the epidemic (Zhao, 2021). Public health services societies by guaranteeing conditions of life where the people can be healthy by addressing 3 major functions, namely, assessments, policy development, and assurance (Thomas et al., 2018). Fruitful achievements within these areas include effective assessment, policy development, and assurance (Peltzer and Pengpid, 2018). For many decades, Southeast Asian public health agencies and epidemiology researcher’s has gathered data on cardiovascular diseases and had carried out research on the ways to measure and prevent them. Despite the persistence of some crucial gaps, the collected information tends to provide a great evidence-base for effective decision-making by public health (Oliva, 2019). Moreover, a wealth of various policies had been developed based on the gathered knowledge and some policies had been implemented in an effective manner but await broader and more intensive applications in order to gain the optimum impact (Dehghan et al., 2018). The others had yet to be acted on. The evaluation of all these policies needs the implementation on an optimum scale and enough resources for evaluation. It is important to note that assurance is evaluated by the level at which the society is protected from the cardiovascular diseases and strokes that can be attained in spite of the latest progress (Dehghan et al., 2018). Therefore, it can be said that the public health agencies can out the recent knowledge for working through a targeted plan of action. However, it is unfortunate to note that most public health agencies are not yet “well-equipped” for these tasks. Within the region of Southeast Asia, this is considered to be further complicated by the provisions of “care split” amongst public and private systems (Shafiq et al., 2018). Primary care services can one of the main contributors to heart and cardiovascular diseases and should be strengthened for realising the actual integration of care for “secondary prevention of cardiovascular diseases”.
However, in the public health response in Southeast Asia, there is a lack of patient participation in the various rehabilitation programs and there is poor adherence to the medication (Fuchs and Whelton, 2020). These are the two main issues associated with the public health responses within south-east Asia and these must be addressed to strengthen the secondary prevention responses for heart diseases. It is to be noted that the evidence-based patient education and empowerment initiatives tend to be lacking all over the region and thus must be prioritized. The uses of technologies might provide scopes within the area. Improving and expanding the registry data coverage is important for understanding the actual views of the disease and informing policies (Fuchs and Whelton, 2020). The data integration via “electronic health records” is lacking at present, however, might contribute to that goal. Strengthening the monitoring of the “secondary prevention goals” within the non-communicable diseases or cardiovascular plans and auditing services, delivery based on the establishment of quality standards, and the patient outcomes must be regarded as high priorities for studying economies for refining the healthcare offerings and assure that the requirements of patients are met (Jankowski et al., 2021).
The gains against cardiovascular diseases, in particular, and the impact of the better interventions are, without a doubt a great news. At the same time, they tend to introduce a new problem. Within high-income countries like Singapore, there are an increasing number of people who are now the supervisors of heart attacks and strokes (Mehra et al., 2020). The more the supervisors the more likely it is that there would be more survivors of heart attacks and the more there will be a recurrence of the diseases. The data sets that describe the prevalence of ischaemic heart diseases and strike certainly tend to tell a story of “long-term growth” (Hahn et al., 2021). Thus, it can be said that an ever-increasing part of the population is considered to have cardiovascular disease and might survive a heart attack or a stroke (Peltzer and Pengpid, 2018). This tends to demand some urgent attention but also tends to represent a realizable opportunity for assuring those individuals get appropriate care. For instance, the fight against tobacco can be considered the most important public health success (Thomas et al., 2018). The prevalence of smoking between 1990 and 2015 has declined in all study economies, minimizing the risks of cardiovascular diseases. During the same period, a considerable increment in the population percentage of those who are obese in the economies (Peltzer and Pengpid, 2018).
It is to be noted that the “WHO south-east Asia regional office” had coordinated the development of “national cardiovascular control programs that focus on secondary prevention of community and primary care settings within the countries like Thailand, Indonesia, and so on. Moreover, the “Global cardiovascular atlas report” of 2011 depicts a list of some “best buys” of some immensely cost-efficient interventions, strategies, and policies for preventing and controlling cardiovascular diseases which can be feasible for the implementation within the middle and low-income nations of the region (Dehghan et al., 2018). These include various effective public health strategies that address various behaviural risk factors like tobacco and the use of alcohol or unhealthy diet practices. Combined with some interventions for secondary preventions like the use of “aspirin, beta-blockers, angiotensin” turning enzyme inhibitors and the lipid lowering therapies, the risks of “recurrent vascular events can be reduced by approximately 75%. It is to be noted that within Southeast Asia, the cardiologist density is decreasing while the need for cardiology is increasing at an incredible rate, especially within the low and middle-income nations (Babatola, 2018). Therefore, cardiologists tend to feel overloaded and frustrated with the trends. In spite of that, the health administrators and the policy makers would need some comprehensive data for considering the aspects for some future planning of the health workforce, provided the rising prevalence of the heart diseases and the requirement for “coordinated care”. This would continue to exert pressure on the health systems (Thomas et al., 2018). The need for balancing the other public health policies must be recognized, but the most significant challenge here is that it is not just about increasing the number of the cardiologists, and even if there are an adequate number of doctors to take care of the elderly population in a more generic manner, many cardiologists would just move out of the “public services” to the private service due to the financial incentive and the flexible workloads (Cheong et al., 2019).
It is important to note that the World Health Organization demonstrates the public health surveillance as a continuous, and systematic collection as well as analysis of interpretation of various health-associated information required for the planning, implementation, and evaluation of the “public health practices” (Cheong et al., 2019). The most important aspect of policy development for Cardiovascular diseases is that effective data should be collected, analyzed, and should be well-communicated to the stakeholders. The main bodies who would play the prior roles in the policy development include the policy makers, the scientific communities, and the planners of the program along with the medical institutes, the Public health authorities, and the funding agents (Roth et al., 2020).
The most significant feature of an effective action framework for preventuig and reducing Cardiovascular diseases is that the framework should entail the present reality which should briefly summarize the current knowledge of the progressive development of cardiovascular diseases and stroke. A vision of the future that summarises the most favorable situations that should be achieved if the cardiovascular disease hazards are to reverse or arrested. Also, the framework must also consist of a set of strong “intervention approaches” that should include a number of wide approaches that when completely and effectively implemented can help to bring out the transitions to the future healthy people and partnership goals for minimizing the heart diseases and the stroke and the way the 6 intervention approaches could fulfill the various stages of the disease and can facilitate the achievement of these goals. In addition to that, the policy framework must also consist of the target population that indicates the way people can reach the successive intervention approaches (Baddour et al., 2020).
In The Southeast Asian region, the framework for combating the rising urgency of cardiovascular diseases, especially in the low and middle-income countries includes taking action by translating the current knowledge into effective public health actions (Cheong et al., 2019). The policy must have strengthening capacities for transforming the public health agencies with the new and advanced resources and competencies and by expanding strategic partnerships with the high-income countries within the region such as Singapore, and Malaysia in order to sustain and mount those actions (Baddour et al., 2020). Moreover, the policy framework must be efficient enough to evaluate the impact of the actions by monitoring and evaluating the health impact of the interventions (Thomas et al., 2018). The Policy makers and the government bodies within the regions must generate advancing policies that demonstrate the most crucial policy issues and pursue the required preventive actions and research practices to solve those issues and expedite the development of policies (Cheong et al., 2019). The scientific communities and the program planners must also engage in various regional as well as global partnerships by multiplying the resources and by capitalizing on the shared experiences with the others throughout the global communities who have been addressing similar types of challenges.
The paper has entailed a detailed discussion of the epidemiology of cardiovascular diseases within a chosen WHO region, that is South East Asia and it entails a brief evaluation of the spread of the disease within low, high and middle-income countries and the various measures and preventive actions taken by the region against the epidemic followed some recommendations entailing how the preventive measures, and the controlling policy framework within the region can be strengthened and made more effective. From the study, it can be concluded that in order to develop an effective public health policy within the Southeast Asian region, it is important for the policy makers to communicate the plan to the public at large and to establish some significant awareness and concern about the disease. It can thus be said that a comprehensive and a highly effective public health strategy for the prevention of heart diseases and strokes tend to depend on a broad understanding of the fact that the cardiovascular diseases in the Southeast Asian region tend to threaten the health of mainly the middle aged and the older adults and this can be prevented and controlled by the reversal fo the various acquired behavioral practices such as sedentary lifestyles, unhealthy diets, smoking and so on.