“International Healthcare Policy”
- Determinants of Health
- Demographic distributions of populations
Demographics of a certain population can be the greatest factor that can affect the health status of the said groups of people. Demographic factors include employment status, income, education, housing, age and gender. Of all of these factors, income has the most significant impact on health indirectly (National Advisory Committee on Health and Disability, 1998). It is an established fact that income and the quality of health are correlated. Low income usually leads to poor health, and sufficient to high income leads to good health. Not only health, but income also has an effect on mortality and morbidity rates, affordability to access health care services and hospital admissions. The reason for this significant impact is that income determines the quality of other factors, such as education levels, adequate housing, and access to consistent nutritious food.
Educational attainment is also an important determinant of health, as with employment status. This is mainly because educational attainment determines the employment status, and consequently income levels. In most cases, high income means affordability of goods and services that give benefit physically, mentally and socially. Employers only hire qualified people, and the more skilled a person is the higher the pay for that person. Educated people are usually at the top of the skilled workforce, and they have a high employment rate and wage rate.
Adequate housing also has an impact on health. Overcrowding, cold and damp conditions are detrimental to health of the occupants; adequate housing eliminates these factors. As mentioned earlier, adequate housing can only be afforded if income is sufficient. Adequate income can provide for a sufficiently spacious house far from pollution and risk factors that may lead to the detriment of health.
Gender and age have their special impacts on health. Each group have their own particular sets of diseases and vulnerabilities, and therefore health care services that are provided to them must also be given accordingly.
These demographic factors also affect the planning, implementation and evaluation of health care interventions. Because of the peculiarities of each demographic group, the health care intervention must be planned in such a way that it will cater to the vast majority of its subjects. This may be difficult in the implementation phase, as some demographic groups may resist the changes brought about by the said interventions. It is usually preplanned that each demographic group has its own particular policies that help the intervention fit in that demographic group, minimising conflicts and ensuring the success of the intervention. For example, a nationwide intervention is planned by the government. It is known by the government that the intervention covers all citizens, and that its citizens are divided into groups according to their income, education levels, and other factors. The government then plans to put more of its resources into the implementation of the intervention on the underprivileged population, and lowering the resources spent on the rich citizens.
- Political Values
It was found out that political values have an influence on how people react to new information that they are exposed to (Diorio, 2014). This also includes new health policies implemented by the authorities. People may agree with or resist this information according to their values and beliefs. Depending on how health interventions are implemented, it may be easy or difficult for people to accept these interventions. If the interventions are in such a way that it gives a feeling of threat to freedom, people naturally resist this policy and implementation of these interventions is thus delayed. In the policy making level, differing political views may also interfere with the planning of the health care interventions. Nowadays, policy makers are usually divided by differing views and interests, especially if they belong to different parties.
- Religious beliefs
In order to maximise healing and recovery, religious alignment must be taken into account. Different religious organisations have different sets of beliefs that may contradict the norms of health, and usually adherents of the said religions follow these beliefs strictly. Because of this, religious beliefs have significant impact on the implementation of health care policies and interventions. For example, Catholic groups may oppose the implementation of health policies regarding artificial contraception. If these religious groups hold a powerful sway on the policy makers, in these situations policies that may benefit the majority may be held in an uncertain status. In some countries, where the interests of the state and the religious groups are different, these problems may lead to the decline of the health of the majority of the population.
- Human Values
Another intrinsic factor that may affect the implementation of health care interventions is human values. Each of us has our own set of values and principles that may affect our perception of changes in our surroundings. In a population-wide context, this can be a significant factor, especially in population groups that belong to particular ethnicities, each group with its own particular set of values and beliefs. In an event of an intervention, specifically in health care, human values may determine the success or failure of the said intervention. This is mostly due to the fact that for an intervention to be successful, the full cooperation of the beneficiaries of the intervention is required. If they resist the implementation because of conflicting values, the intervention may fail.
Ethnicity and culture can have an impact on the implementation of health interventions, particularly in areas with diverse ethnic and cultural makeup. Each ethnic group have their own set of values and beliefs, which may have the potential of aiding or delaying health interventions. An ethnic group may quickly accept health care interventions, or resist the changes brought about by the change in policies. In some countries, ethnic groups that are in the minority are underrepresented in the government, particularly in policy making bodies. Policies may be made without considering the welfare of these groups. In such cases, implementation of a health care intervention may be hampered by the very people it benefits, just because of conflict of interests. Evaluation may also be difficult, because of the mentioned reasons; if a particular group doesn’t like the intervention, they may refuse to talk about it.
Traditions are a significant part of the lives of most people. This is important since it identifies them as a member of a culture or ethnicity. Such, they adhere to these traditions religiously. Sometimes, traditions have an impact on the planning, implementation and evaluation of health care interventions. As with culture, these may be due to conflicts in the traditions and interventions. For example, an implementation that may reduce the mortality rate may be negated by traditions that encourages risk taking. Since the population group following the said traditions adhere to these traditions religiously, an intervention contradicting these traditions may be hard to develop, leading to possible failure of implementation.
- Public Attitudes
- Public concepts of what health is
One important factor in the success if an intervention is the cooperation of the public in accepting and adhering to the changes brought about by the said intervention. However, their perception of the intervention is influenced by their views on what health really is. If the intervention leads to a significant change that is the same with what the public views as healthy, it may become successful. For example, a health care intervention on reducing the incidence of diabetes may be successful if the public is aware that diabetes is a serious disease, and that preventing such illness is important. However, if the intervention is expected to create a change that does not conform to what the people sees as healthy, problems in the implementation may happen. For example, in some cultures, obese people are viewed as healthy and give a status of opulence. These obese people plan to stay that way, as they are not concerned being viewed as unhealthy. A planned intervention that aims to reduce the incidence of obesity and hypertension in these cultures may lead to failure.
- Public concepts of what illness is
Another important factor is the public’s view of what illness is. Illness is described as a state of being that is below what is considered normal or healthy. Across cultures and races, there is a wide variety of interpretation on how ill is considered ill. As with public perception on health, the public only does things that will put them into a more healthy state, away from illnesses. If an intervention leads to reduction of an illness that the public perceives as significant enough, the public will cooperate with the intervention, greatly increasing the chance of complete success of the intervention. On the other hand, if the said intervention doesn’t lead to a change that the public considers significant enough, it may fail. For example, if the public doesn’t consider strep throat as significant enough, a campaign to reduce the incidence of rheumatic heart disease may not reach its full potential.
- The importance the public put on health
As with public concepts of health, the success of health care interventions also depend on the importance the public puts on health. People have their own sets of priorities, which they consider important. If a health care intervention is implemented, and these people do not consider it as a significant benefit, they will give the least priority to the intervention. Overall, the intervention will be a failure. In some cases, information dissemination and encouragement is included in the intervention, in order to increase awareness of the importance of the intervention. This will ensure the prioritisation of the intervention, increasing its chances of success.
- Public attitudes towards health and medical professionals
In most nations, the public has great respect towards health and medical professionals. In these situations, a planned intervention may increase in effectiveness if these medical professionals endorse or complements what is advocated by these interventions. The public will usually listen to and follow the advice of these medical professionals, due to the fact that they recognise the expertise of these professionals in the field of health care. The public usually follows what they perceive to be beneficial to them, and it can be concluded that they will follow and cooperate with the planned interventions, if these professionals say to the public the benefits of the said interventions.
- Influences of Policies on Health Intervention
Effective health policies are essential in the planning, implementation and evaluation of health care interventions. Essentially, effective policies greatly improve public health through this fact. Policies such as smoke ban and seat belt regulation improved the quality of health of the public. These policies are usually effectively implemented by the government. The national policies, particularly those health care policies, greatly complement the health care interventions. As the government has the manpower and resources to effectively implement policies and interventions, health care interventions planned by the government are usually successful.
In the case of international policies, health care interventions depend on whether they conform to the international policies or whether they are in conflict with these policies. As international policies are universally recognised, it will be success for the intervention if the international policies agree with it.
The same can be said with cultural and social factors and policies. The success or failure of an intervention depends on whether the intervention agrees or disagrees with the policies followed by the people. In this case, it is not the law mandating the disposition of the intervention; it is the public that will determine its success of failure.
It can be concluded that policies are essential in determining the success of any health intervention. Implementing any intervention in a country with well-established health care policies, such as New Zealand, will almost always result in a successful intervention, completely attaining its goal of benefiting the public as a whole.
In conclusion, various factors greatly affect the success or failure of an intervention. It is not only the ones who plan that can affect the disposition of the intervention; it also greatly depends on the beneficiaries of the intervention, which is the public. The authorities plan, implement and evaluate the interventions they make to ensure its success. No matter how well it is made, full cooperation in the part of the public is still essential in determining its success.
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