Policy in Relation to Health

Health policy can be defined as the aims or programs put in place to achieve societal health goals. According to the World Health Organization (WHO), a proper health policy can accomplish the following: It develops communication with the community and fosters close relationships between healthcare and society; it defines a clear future vision and describes the objectives and roles of various organizations within society (World Health Organization, 2001). Mental wellness policy, global health policy, insurance policy, public wellness policy, healthcare services policy, individual healthcare policy, and pharmaceutical policy are all types of health policies. There are also policies that are directly related to the public health policy including tobacco regulations policy, breastfeeding campaign policy and vaccination policy. Such health policies tackle topics of healthcare access, quality of healthcare, health finance and output and equality in relation to healthcare.

The health system and policies related to it is complex and one should comprehend them beyond national laws of health support systems or health interventions. Operational policies are governmental rules and regulations that are used to compare national laws and policies with a country’s programs and services (Adler and Stewart 2009, p.50). Policy constitutes decisions, which are made at a centralized and decentralized level that determines delivery of services to the society. Supportive policies will promote health interventions in the health sector.

Decisions made by government or private health sector can be influenced by various political topics or evidence. Policy based on evidence is dependent on science and research studies in order to point out programs that can assist in establishing proper health policies. Many national political debates revolve around the personal health policy with respect to those policies that can be proven to improve healthcare delivery, which can be divided into economy and philosophy (Wang et al. 2011, p. 820). Debates related to philosophy deal with topics of personal rights, government authority in healthcare and ethical rights. Economic debates deal with how to increase health care output while minimizing costs. Modern healthcare topic deals with medication, acquiring of healthcare professionals, hospital equipment and medical technology. Additionally, it tackles topics on health services and medical research. Many countries enact the policy whereby access to medical services is left in the hands of an individual and paying for healthcare is done directly from one’s personal expenses. Research development is left in the hands of the private health sector to develop medical and pharmaceutical studies. The labor market community deals with planning and delivering resources related to human health (Tesh 1988).

However, some few countries have an extraordinary health policy whereby all citizens are able to acquire health support. The health policy also ensures that health professionals achieve laid out healthcare goals, health research is properly funded, there is equal distribution of quality healthcare and proper healthcare planning is done to accommodate optimum numbers. Several governments around the globe have adopted the universal healthcare system, which ensures health expenses is no longer a responsibility of private organizations or individuals but finances are pulled together to reduce finance risk and that every citizen gets access to proper healthcare (Story, Nanney and Schwartz 2009, p.80). However, universal healthcare is constantly debated against. Because healthcare constitutes a big part of spending, every individual and government needs to make a proper budget.

According to the personal healthcare policy, certain philosophies can be derived.

Right to health

The World Health Organization stipulates that every global country is obligated to the human right treaty of which one should be health related. Therefore, one human right is the right to health among other rights that establish proper health (Szreter and Woolcock 2004, p.660). The United Nation’s Universal Declaration of Human Rights (UDHR) also stipulates that all citizens have a right to proper medical care. Religious organizations also support the health policy of offering healthcare to the needy and the sick according to religious beliefs. Non-governmental organizations (NGOs) advocate for humanism principles in order to shape health policies; stipulating that every human be entitled to healthcare. Amnesty International, which is a human rights organization that is, recognized globally advocates health as one of the main human rights (Sassi 2010). It aims to address health issues such as low accessibility to HIV drugs and women’s rights to proper sexual and reproductive health as well as maternal mortality around the world. The Lancet, (a world medical journal), displays many health issues that ought to be addressed.

Financing of healthcare

There are many types of health policies that stipulate who should finance healthcare services. Some policies advocate for healthcare that is publicly funded that is, through insurance and taxation (individual payment) while others incorporate the voluntary or mandatory private health insurance. Some private companies pay for their workers healthcare services. Current ongoing debates look into the different health financing policies, their advantages and disadvantages in order to identify the best that would improve quality of healthcare services (Russell-Mayhew 2012). Some arguments claim that privately funded healthcare produces the best results in terms of improving efficiency and quality of personal healthcare. The first reason is that publicly funded healthcare is assumed free, which promotes wastefulness of health resources thus raising healthcare costs in comparison to the private health financing (Puhl and Heuer 2010, p.1025). Privately funded healthcare system increases access to specialized medical services and new technologies and decreases waiting time. Funding of the public healthcare sector can improve emergency care services for both insured and uninsured citizens. An example is the United States Emergency Medical Treatment and Active Labor Act. Privately funded healthcare reduces the burden on the government to increase taxes in order to enhance healthcare cover.

Medical Research

Parties that advocate for government funding of medical research claim it is profitable because it will enhance the level of medical innovation. However, medical research does not necessarily promote evidence-based policies. An example is the case of South Africa where HIV infection is widespread; previous government policy tightened its funds to HIV treatment and care services, which was controversial despite the scientific evidence offered on HIV transmission. With the new government, new policies were enacted including access to proper HIV treatment services (Nestle and Jacobson, 2000, p.12). Another pending issue to medical research is intellectual rights and patenting of medical discoveries. For instance in Brazil there are debates as to whether the government should authorize local production of Antiretroviral Drugs (ARVs) as it violates drug patents.

Healthcare professionals

In some countries, it is the responsibility of the high court to enact health workforce policies such as planning for adequate health workers, equal distribution and standards of the healthcare team that achieves healthcare goals for example addressing nursing and clinician shortages (Robertson and Minkler 1994, p.300). In other countries, labor market participants handle workforce planning.

Foreign health

Many governments and health organizations have formed a foreign health policy to assist in attaining global health objectives. One of the global goals include, supporting healthcare in the Third World countries in order to achieve a common global agenda. The first is enhancing global security by cumbering fears linked to global pandemics such as global spread of viruses and worldwide increase in health conflicts, epidemics or global emergencies (MacLean et al., 2009, p.90). The second goal is enhancing economic development through addressing issues of poor health and pandemic outbreaks. Advocating for human rights is also another foreign health goal.

Political ideologies underpinning the health policy

Incorporation of politics into health complicates simple solutions that would have been addressed if health were regarded without the aspect of politics. Healthcare is an important topic for political discussion in some countries for example UK where the kingdom’s role is highly recognizable. Health is often misinterpreted as healthcare therefore; politics of health are related to politics of healthcare (Lomas 1998, p.1185). Political discussions of health issues include health force efficiency and service delivery, health sector funding and organization or socio-political pressures on the future provision of healthcare services. According to biomedicine, health is described as being without diseases while in economics health is defined as a commodity. Health is viewed as having descended from individual factors like lifestyle choices, genetic factors or access to healthcare services and commodities.

In 1948, the Nursing Health Medical Science (NHM) organization was formed to assist in dealing with the issue of health inequality however in the 1970s; it was observed that the provision of free medical services did little to assist health inequality among different groups in Britain. Thus, the 1977 Secretary of State for Health and Social Security, David Ennals formed an organization to investigate health inequalities, which led to the formation of the Black Report (Lee et al., 2007, p.450). The Black Report explained structural and material factors, which cause the division of health status according to social class. However, recommendations stipulated on the Black Report were dismissed by the newly elected conservative government and in the 1980s, a policy was enacted that focused on health care instead of health (including decreasing health inequality) by convincing people of all statuses and social class to improve their lifestyle choices. In the mid-1990s, the Black Report research team who stressed the importance of socio-economic factors for creating health equality debated against the individualistic lifestyle behavioral approach (Lang and Rayner 2007, p. 170). The lifestyle behavior policy led to blaming victims, which became a topic for academic discussion. This consensus sparked public health research thus making health and healthcare a political issue.

Some political ideologies underpinning health policies are outlined below.

Liberalism

Liberalism is regarded as an economic approach; however, it has social and political consequences. Liberalism advocates for individual rights to freedom of choice over the rights of social groups. According to traditional liberalists, free will guarantees social justice for example those who choose to utilize their talent and work will ultimately succeed (Krug et al 2002, p.1085). Poor social situations can be explained by poor individual choices, laziness or weaknesses. An example of social repercussions because of liberalism is the 1930s Great Depression that caused the opposition of liberalism. Modern liberalism later emerged, which offered intervention to decrease overflow market economics and conceal negative effects.

Keynesian Welfare Capitalism emerged in Britain after the II World War. The classical liberal ideologies emerged again in the 1970s aided by the Reagan and Thatcher governments. Resurrection of market economics led to the establishment of neo-liberalism, which led to the conversion of government organizations into private companies because of the economic regulation and reduction in public expenditures (Koivusalo and Ollila 1997). USA is associated with neo-liberalism in the political government but with financial globalization, liberalism dominates the entire world and is accepted as having no other alternatives.

Conservatism

Conservatism seeks to preserve and resists change through dismantling of existing institutions. According to traditional conservatisms, human talent varies and any attempts to change this order will ultimately fail. The social hierarchy promotes innovation and a society’s success therefore, considered desirable because conservation stipulates that leadership be in the hands of those talented individuals (Jia and Lubetkin, 2005, p.159). Because the rich are considered as leaders and creators of wealth instead of oppressors of the poor, conservatism contradicts itself from other political ideologies and it advocates for inequality.

Conservatism may produce undesirable social effects such as racism, xenophobia and nationalism because it preserves dominance of certain groups of people. However, it emphasizes on moral values such as respect for the law, self-discipline, family ties and decency. Additionally, conservatism advocates for societal organizations of people with common interests. In relation to health, conservatives do not view the importance of government in healthcare except provision of little or no welfare. Some conservatives state it is the role of the rich to provide welfare such as shelter to the deserving needy in society. It is believed that provision of too much incentives to the poor takes away their innovativeness and the will to improve their lives thus making them over-dependent. Margaret Thatcher described the poor as “moral cripples” (Green 1986 p.220). Conservatives believe that government intervention should be enforced in form of maintaining law and order to enhance the smooth running of societal organizations.

Some conservatism acts advocate for change for instance the ‘New Right’ movement of the 1980s, which was aspired by traditional conservatism and modern liberal thinking. The New Right movement caused the remodeling of governmental states into privately owned organizations in the 1980s. In the 1990s, this movement began to slowly decline; today little is known about the existence of the British Conservative Party (Goodman, Slap and Huang, 2003, p.1845).

Impact of the health policy and political ideologies on obesity

Interventions to address obesity have been revolving around individual change through lifestyle choices instead of public policy approach for change at the public level. The obesity policy support varies among different countries.

In 2015, 63% of the adult population in UK was diagnosed with obesity. Additionally a third of this population consists of children who become overweight at an early age and remain obese during adolescence. During the year 2014 and 2015, the NHS in England spent approximately 6.1 billion euros on dealing with obesity related health issues (Dussault and Dubois 2003 p.1). It was discovered in 2014 that there were more than 50,000 junk food outlets in England. A larger number of fast food outlets were seen in deprived areas than in affluent regions. Obesity health policies in UK encourage families to make healthier choices. Policies also influence the food environment by making healthy foods more affordable and accessible to all citizens (Marmot, Allen & Golblatt et al 2010).

Current obesity health policies include education campaigns and health promotion strategies. Few obesity policies address channeling of infrastructure towards obesity as a public health issue (Centers for Disease Control, 2013). So far it has been observed that education campaigns for individual and lifestyle change to reduce obesity have not produced significant results thus there is need for multi-level population approach to effect an upscale change in structural factors affecting obesity that is, economic, social and environment factors influence obesity. Through public policy, a positive change can be effected in all these factors. Though the government plays the role of enacting public obesity policies, the society is obligated to support these policies through implementation and advocating for more social and health issues to be considered by the government.

National variation

A research conducted by the European Union (EU) found that many countries support childhood obesity policies such that schools incorporated diet and exercise programs, physical activities and regulating junk food and soft drinks advertisements aimed at influencing children. Despite varying cultural beliefs among EU countries, they all have similar policies for addressing obesity (Carter-Pokras and Baquet 2002, p. 426). For example, advocating for physical education in schools ranges at 68.9% in Sweden, 11.6% in Spain and approximately 30.5% in other EU countries. In Canada, obesity intervention strategies include nutrition and physical exercise education programs in schools and flexible working hours for children to allow more time to engage in physical exercises with their children. Studies reveal that obese victims are more likely to support obesity policies and intervention programs than non-obese victims are (Department of Health 2010).

Attribution theory

Attribution theory stipulates that people try to understand the cause of a behavior in order to understand the behavior. Behavior is influenced by internal and external effects. Internal effects are those that can be individually controlled for instance a person choosing to go the gym while external factors are those that cannot be personally controlled for instance no access to gym facilities (Burgeson et al. 2001, p.280). Therefore, according to attribution theory, the more obesity is linked to internal factors, the less likely people are to support obesity policies. The belief that obesity is caused by over-accessibility to junk foods sparks higher support for obesity policies. A research study was conducted in U.S. to identify people’s perspective of obesity; whether blame is allocated to an individual for poor lifestyle choices and overindulgence or whether the environment is to blame for oversupplying cheap junk foods. Some people blame obesity on the environment because of lack of time to cook thus being forced to purchase cheap unhealthy foods. Others blame obesity on poverty such that poor people cannot afford to buy healthy foods such as vegetables. Other people blame individual choices and poor priorities (Baum 2016). Thus, mixed blame is observed in society. Those people who blamed obesity on uncontrollable or environmental factors showed increased support for obesity policies.

Collectivism and individualism

Societal support for obesity policies depends on whether the country advocates for individualism or collectivism. Countries that advocate for individualism expect every citizen to be responsible for one’s choices whereas countries that advocate for collectivism display communion and societal support where citizens help one another. Therefore, individualist countries are more likely to blame obesity on internal (controllable) factors thus offer less support for obesity policies. Alternatively, collectivism countries will be drawn to blame obesity an external (uncontrollable) factors thus offer support to obesity policies (Bambra, Fox and Scott-Samuel 2005, p.189).

National identity

U.S.A. and Canada are 90% culturally similar in that they have similar perceptions of the obesity policy. Lifestyle of both countries resemble along with abundant supply of unhealthy foods that promote obesity. However, in accordance with statistics shared by the EU, different countries show varying levels of support for obesity policies, which can be explained by historical and cultural background of each country, known as national identity (Avenell et al. 2004).

Impact of health policies on the health of obese victims

Obese victims are highly affected by societal stigmatization, which affects their well-being. Stigmatization is experienced in the healthcare sector where health professionals display attitude towards obese patients instead of offering health interventions. Obese children withdraw from society because of the experience of stereotyping, stigma and rejection, which later influences their psychological and physical health (Crawford 1977, p.670). Obese children experience anxiety, low self-esteem, depression, binge eating, and withdrawal from physical activities, self-image concerns and suicide. According to studies, people view obese victims negatively, which affects their confidence and self-esteem. Blame is allocated to obese people for their health condition thus making them feel guilty. Public Health England (PHE) is working with the UK government in devising strategies that will reduce childhood obesity for example introducing a program for sugar reduction in child consumption products such as breakfast cereals, cakes, biscuits, pastries, yoghurts and so on.

Obesity stigma occurs when obese victims are stereotyped as social rejects, unattractive, having low IQ, lazy, gluttonous and having low self-esteem. Stigmatization of obese victims is related to blaming obesity to controllable factors. Advertisements display increase in body fat content, body shape and size to more food consumption (Nestle and Jacobson, 2000, p.12). Various health professionals believe that obesity is linked to controllable issues thus attributing for obesity stigmatization. Surprisingly obesity stigmatization is quite high among health workers because of the belief that obesity is a personal responsibility. Because of stigmatization from the healthcare team, obese patients feel disrespected, criticized and dismissed by medical professionals whereas they should feel taken care of. This makes obese patients reluctant to medical services for fear of being judged. Weight-related issues are also not taken seriously by healthcare professionals that make obese patients feel neglected. Stigmatization from healthcare professionals also causes poor patient-medical practitioner relationship.

Efforts should be made to tackle obesity stigmatization in the healthcare sector to avoid patient appointment cancellation, which may cause serious health threats to obese patients. Intervention strategies should be enforced to prevent health inequality in relation to obesity. Some anti-fat intervention strategies have been reported to cause little change and indicate low success rates (Jia and Lubetkin, 2005, p.159). Healthcare professions ought to be educated on environmental causes of obesity in order to reduce cases of obese stigma within the healthcare sector. Education interventions have been shown to produce desirable results in reducing stereotypes linked to obesity.

Certain factors heighten the likelihood of obesity. They include ethnicity, level of income and social statuses (Marmot, Allen & Goldblatt et al 2010). Childhood obesity is closely linked with social deprivation such that the level of obesity in deprived children is 10% more than in less deprived children in UK. Apart from unhealthy foods and drinks, lack of physical activity or exercise is another cause of obesity (Department of Health 2010). According to statistics, UK citizens are currently 20% less physically active than they were in the 1960s because fewer people have manual jobs. Technology is to be blamed for this change in societal behavior. Strategies devised by PHE include encouraging physical activity in addition to a healthy diet lifestyle.

According to the Department of Health (2010), the local authority can support the government in enacting obesity policies by enforcing environmental health standards whereby healthy diets are included in food outlet menus. Food outlets and takeaway centers ought to incorporate diets with less salt, sugar and fat content. They should also serve variety of foods in smaller portions. Obesity policies should also advocate for decongestion of food outlets that serve cheap unhealthy foods and drinks. UK’s government enacted a childhood obesity strategy that regulates soft drinks circulation in the country. Government revenue is also being put into strategic plans that will encourage child physical activities and access to healthy diets.

Unfortunately, anti-stigma strategies produce short-term results. This can be attributed to various factors indicated above, which are individualism, negative attribution theory caused by internal (controllable) factors, national variation and national identity (Adler and Stewart 2009, p.50).

Conclusion

Health policy can be described as goals that are set up in order to attain laid out health goals in society. Various health policies include global health, mental health, insurance, public healthcare services, personal healthcare and pharmaceutical policies. Health policies tackle topics on healthcare access, health finance, and quality of healthcare, output and equality in relation to healthcare. The best health policy establishes proper communication within the society, builds close healthcare to society relationship, outlines clear future goals and vision and lastly describes the roles of different societal groups. Various philosophies related to personal healthcare policy include right to health, financing of healthcare, medical research, healthcare professionals, foreign and global health.

Political ideologies related to health policies include liberalism, conservatism, socialism, feminism, environmentalism and nationalism. Health inequality is a topic that has been debated upon over the years. Health policies affecting obesity include national variation, attribution theory, collectivism, individualism, and national identity. Support or non-support for obesity health policies depends on individual and societal perception of whether obesity is caused by controllable or uncontrollable factors.

Obese stigma is a prevalent issue in the healthcare sector. Healthcare professionals stigmatize obese patients, which causes embarrassment and makes obese patients miss hospital appointments. This puts them at serious health risks. Proper intervention strategies such as education should be put into place to reduce obese stigmatization.

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victim. The Milbank Quarterly, 87(1), pp.49-70.

Bambra, C., Fox, D. and Scott-Samuel, A., 2005. Towards a politics of health. Health

promotion international, 20(2), pp.187-193.

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education and activity: results from the School Health Policies and Programs Study 2000. Journal of School Health, 71(7), pp.279-293.

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blaming. International journal of health services, 7(4), pp.663-680.

Dussault, G. and Dubois, C.A., 2003. Human resources for health policies: a critical

component in health policies. Hu