The purpose of this paper is to discuss the policy that should guide the public health sector about how social determinants of health are addressed. The paper highlights the construction of policy problems and shows the social perspectives that have influenced this policy. Alternatives on how the problems should be solved and alternative views in regards to the policy will be discussed. Strategies that should be employed to influence decision makers in regards to this policy will be addressed.
Public health is a concern for everybody. Therefore, proper policy formulation in place needs to be put to improve public health. Such a system should take into account the social determinants of public health. These determinants could be political, economic or even religious in nature (White 2009). Consideration of these determinants could be effective in enabling the formulation of an effective public health policy.
What is public health?
Public health is concerned with the promotion of health in families and communities (CDC Foundation). Those involved in the public health sector aim at promoting “healthy lifestyles, research for disease and injury prevention and detection and control of infectious diseases” (CDC Foundation). Public health is therefore necessarily concerned with promoting healthy communities by encouraging safe lifestyles. That is done through policy formulation, creating educational programs and conducting research in the area. The policy formulation must take into account several factors for it to be effective.
The concern for public health should take into consideration the cost implication of containing diseases. Substances and factors that lead to diseases and ailments that can be prevented should be looked into with the intent of coming up with policies that will help control such factors. The health of the public has a greater impact on the economy. Therefore, working towards reducing the use of substances that are detrimental to health should be a primary concern for policymakers in the world.
Concerns of a public health policy
According to World Health Organization, a public health policy refers to those decisions, plans, and actions that are undertaken to achieve specific health care goals within a society (WHO). The public health policy is affected by several factors that must be addressed to make it achieve the desired objectives for the promotion of good health in the society. These factors are social in nature. They include ideological, economic and moral factors (Baggott 2011). Health care practitioners are expected to involve themselves in practices that ensure that people do not contract diseases and those that promote the healthy wellbeing of every person in the society (Baggott 2011). The formulation of an effective public health policy should take into account that health is not just a state affair but also the responsibility of every individual in the society (Baggott 2011). White (2009) in the book, An Introduction to the Sociology of Health and Illness, argues that health and illness are not just products of human biology; it is rather products of the society people are born. In this regard, policymakers must take into account historical, socio-economic and political factors that affect health (Baggott 2011).
An evaluation of the public health policy should be concerned with evaluating health strategies that have been put in place taking into consideration its limitations as well as the campaigns brought to promote this policy. Ways of addressing these limitations must be found to ensure the goals of public health are met. This evaluation should be done in the realization of the lifestyle of the people concerned. The impact of the environment and the inequality found among the public regarding socio-economic status should be a matter of concern for every active health policy.
Taking into consideration that the world has become a global village, a health policy should have in mind the international scopes and general questions in the public health sector. Such issues as the environment, climate change and poverty levels across the world should be a matter of concern for policymakers. In essence, the policy should have a global outlook and be concerned with the perspectives of various world players in the public health sector. Political goodwill by all those involved in promoting the health of the public should be worked. Proper legislation should be put in place to control the health of the public.
The Center for Disease Control and Prevention definition of the public health policy is a “law, regulation, procedure, administrative action, incentive or voluntary practice of governments and other institutions” (CDC). An example of such a public health policy could be the tobacco control policy that regulates the marketing and the consumption of tobacco. The policy is concerned with the promotion of public health in various ways and has a direct relationship with the social determinants of health. These determinants are of political, economic and even religious nature. These factors should be taken into consideration while formulating a policy for public health.
The social health factors affecting the tobacco control policy are both local and global. The politics of the day and international trade policies, as well as country trade policies (Collins 2012), pose a challenge to the implementation of this policy. It should also be noted that the socio-economic status of concerned countries plays a significant role in the efficient application of this policy. The policy is aimed at combating tobacco (Collins 2012) given its damaging health effects not only to the consumers of tobacco but also to the public. This policy takes into consideration the cost impact of managing the health complications that arise from smoking. For this strategy to be effective, there is a need for international political goodwill. The challenges posed by conflicts with foreign and trade policy priorities (Collins 2012) are bound to hamper full Implementation of this policy thereby preventing it from achieving the intended goals.
The factors that promote trade, especially international trade are a major hindrance to full implementation of the global tobacco control policy. Proper policy framework needs to be put to enable countries to prioritize on people’s health when it comes to public health. The fact that tobacco-related illnesses are not just a concern of smokers themselves but also the general wider audience should be a thing of concern to policy makers in the public health sector. The lifestyle and preferences of an individual should not be allowed to be detrimental to the health of others. Political and economic factors should not take precedence over people’s health. It is people’s health that should come first before any other discussion can be considered, especially when it comes to dealing with public health. It should not be forgotten the cost implication of handling such diseases and illnesses resulting from tobacco consumption. Policymakers should care to remember that these complications are preventable, and, therefore, funds should not be spent to cater for something that could have been avoided in the first place. There is a need for all the stakeholders to come together and look for a way of dealing with tobacco consumption. Third party exposure should be a factor in making framework policy considerations when it comes to tobacco control.
Players in international politics and socio-economic programs should find a way of addressing the role of the multinationals and even local companies dealing with the manufacture and distribution of tobacco products. Moral and ethical considerations should be a point of concern for policy makers in the public health sector in the issue of tobacco control (Wilkinson & Picket 2009). It should be remembered that there is also a spiritual concern regarding policy formulation in the public health sector.
In analyzing the tobacco control policy, the policy analysis framework developed by Chambers (2000) which relies on Burns (1949) the American Social Security System, there need be an understanding of its goals and objectives. The benefits and the services the policy will deliver, eligibility, administration or organizational structure and financing should also be understood (Chambers 2000).
In this regard, the tobacco control global health policy aims at reducing exposure to smoke as well as mitigating the deaths and complications arising from consumption of tobacco products. It means to protect the public and the user by warning them of the dangers of smoking and safeguard the nonsmokers from exposure. The financing of the tobacco control global health policy is through the world health organization and the countries that have adopted the policy (Lloyd et al. 2007).
The implementation of the tobacco control global health policy largely depends on individual states passing legislation that is aimed at ensuring the goals of the policy are met. The legislation is what gives legitimacy to the system. It should be therefore noted that political goodwill is necessary, and the desire for more taxes and profits on the part of tobacco manufacturing factories should not be made the basis for determining the success of the tobacco control policy.
The profit factor for industry players should be thought afresh to reduce the consumption of tobacco. There should be a general campaign aimed at reducing the effects of tobacco not only for tobacco smokers but also for the public. Research should be done to offer industry players with an alternative business that has little or no impact on the health of the public. Other uses of tobacco should be found to direct the industry players towards other ventures. Campaigns should be adopted to reduce consumption of alcohol and those who are already addicted assisted through setting up of programs that will help them reduce smoking or completely stopping it.
Improving the tobacco control policy
There has been an increase in global awareness of the dangers posed by smoking. The world health organization (WHO) Framework Convention on Tobacco control for all sectors aims to respond to this issue that is of grave concern for public health (Mackay et al. 2012). The success of tobacco control policy has been strengthened through empowering of nongovernmental organizations that work against tobacco as well as conducting conferences on tobacco and health (Mackay et al. 2012). Through this support, the public awareness of the dangers of smoking is stepped up with a greater impact. That is instrumental in reducing smoking as well as preventing the exposure of public to tobacco smoke.
Coercion, however, should not be used as a strategy towards efforts designed to reduce consumption of tobacco. Legislative framework should be such that those already involved are helped to overcome this habit while preventing new entrants from getting into the habit. That does not mean that stiffer penalties should not be put in place for those who violate legislative rules on tobacco control. There is a need for the goodwill of all players in working on strategies that are meant to reduce or even bring to an end the consumption of tobacco.
Those in the industry should be made to give a blueprint for the efforts they intend to employ to warn the public of the dangers of smoking. They should be in the forefront in the campaigns that urge the people on the dangers of smoking. That might seem illogical since all industries are established with an aim towards profit making, but it must be remembered this is a matter of public health, which should be given priority over profits.
Tobacco control is an ethical question issue. It should be noted that there are religious beliefs regarding tobacco consumptions. Besides this, the moral issue that needs to be addressed is whether any venture aimed towards profit-making should be detrimental to the health of the public. The tobacco industry players should be able to answer this moral question to deal with the concerns to public health. In doing so, it should be remembered that tobacco is the leading cause of killer diseases that can be prevented (Barry &Yuill 2008).
There is also the question of individual rights. Ethically, one should argue that smokers are doing what they desire to do. In short, it is their right to choose to smoke or not to smoke. In this regard, the concern for public health should be able to address the question of choice. In doing so, however, there is a concern that the smokers should not directly endanger the lives of others by exposing them to tobacco smoke (Rogers & Pilgrim 2010). It should be remembered that third party exposure to tobacco smoke has been cited to be more dangerous to health. Secondary smoking as it is referred to contribute to major illnesses for nonsmokers. The question that needs to be addressed therefore is how do we protect those who have chosen not to smoke?
Another concern is the cost implication of dealing with tobacco-related ailments. It should be remembered that health is a concern for the state in as much as it is an individual responsibility. In this regard, the amount of money injected towards treating those who have developed tobacco-related diseases should be taken into consideration while developing a public health policy. The lost workforce from those who die from tobacco-related complications and the impact on the economy regarding the money spent on the health care (Crinson 2009) of those who have developed complications arising from tobacco smoking should be measured concerning the profits made from the industry. The question here should therefore be, should the profits made by few individuals be detrimental to the wellbeing of the larger population?
Despite the achievements raised in the implementation of this policy, there have been numerous challenges faced that the policy makers have tried to address in various ways. Countries and the international community have worked to reduce the prevalence of tobacco (Laverack 2013). There has been an increased effort to lessen the demand for tobacco. That has been done by monitoring the use of tobacco and prevention policies, protecting people from tobacco smoke, offering help to quit tobacco use, warning about the dangers of smoking, enforcing bans on tobacco advertising, promotion and sponsorship as well as raising taxes on tobacco (Mackay et al. 2012).
The greatest challenge towards full implementation of the tobacco control policy has come from the industry players. They have attempted to prevent regulation of tobacco. They have engaged in campaigns aimed at undermining tobacco control and public health (Mackay et al. 2012). There is needed to come up with legislation that exerts stiffer penalties on those who undermine the efforts geared towards tobacco control to overcome these challenges. If this is done, the benefits that will arise from controlling tobacco will be more than the profits the industry players in the tobacco industry will make. Public health concerns should take center stage in addressing this issue.
For full implementation of the tobacco control policy globally, certain improvements have to be made. There should be concerted efforts to reduce exposure to tobacco of the members of the public. Smokers should be designated places far from other people. These designated smoking areas should be stationed in such a way that people are protected from the harmful exposure to tobacco. In fact, the primary concern of the policy makers should be how to help those addicted to stop this habit.
The packaging of tobacco, though following strict guidelines on warning smokers, especially of cigarettes of the dangers caused by smoking, should be restricted to non-attractive packages that have the sign in bold letters so that smokers themselves can clearly see the danger they are exposing themselves. Attractive packages may only work to distract the target population of the tobacco control campaign from the warning message on the packaging.
Advertisement of tobacco products should be highly restricted. The young and the old alike should not be made to view cigarettes as an acceptable social standard that is worth emulating. They should, in fact, be done to see the dangers they are exposing themselves to so that they are well informed that health is their responsibility (Scrambler 2008), and, therefore, the smokers and consumer of other related tobacco products should not be made to see smoking as a very useful pastime activity. The advertisement should, therefore, be restricted and instead, a proper health campaign be conducted to reduce significantly the number of addicts to tobacco.
Taxation regime for tobacco related products should be so prohibiting enabling the vice to be stopped. These taxes can be used in organizing sensitization campaigns. Public health education should be planned so that they may see the need for stopping the consumption of tobacco and other related products. To attain global goals concerning public health, richer nations and individuals should influence others.
Strategies for policy makers
For effective policy formulation, different strategies have to be adopted to achieve the desired results for policymaking. There is a dire need to come up with clear goals and objectives by those involved in policymaking. Policy makers should work towards achieving the eligibility of the policies they have come up with so that they are implemented. Close working with governments of the day is vital for policy makers to ensure that the policies are implemented through legislation. That is what will make the policies effective and attain the desired goals.
Policy making also needs to take into consideration the benefits to the public. There should be a campaign aimed at sensitizing the people of the benefits accruing from the implementation of such a policy. Therefore, policy makers should have budgetary allocations towards public campaigns addressing the benefits of adopting the said policy. Everyone should be made aware of what the policy is intended to achieve and how it is going to benefit them. That will make the system efficient and eligible.
The Proper organizational structure should be established to ensure that implementation of the policy is closely monitored and that improvements are made where need be. Policy makers should, therefore, begin by creating proper organizational structures that will govern the making and implementation of the policy they come up. Proper evaluation tools and mechanisms should be implemented to ensure that the said system achieves the desired goals.
The improvement of public health is a concern for all. Proper health formulation aimed at safeguarding the health of the society needs to be put in place to ensure that the public is protected against diseases and other health related complications. There is a need to come up with policies that will prevent the spread of communicable diseases as well as those diseases that can be avoided. For instance, tobacco-related diseases and ailment can be prevented through a proper policy framework. The many deaths arising from tobacco smoking can be avoided if all joined hands and implemented existing policies towards tobacco control. Appropriate strategies should be put in place to enhance public awareness of the dangers posed by tobacco smoking to their health. There should also be an understanding of the social dimension in regards to public health. The social determinants of public health, which include politics, socio-economic status (Dorling 2010), and morals of the society need to be taken seriously while coming up with a policy for public health.