Public Health

Question: Discuss about the Public Health. Answer: The increasing level of alcohol-associated costs and harm to the society as a whole in the United Kingdom has resulted in a debate on the best strategies that when implemented can be beneficial for managing the escalating issues. An interim analysis has indicated that there is a distinct connection between availability of alcohol, alcohol consumption and negative consequences in the country. The health burden as well as the social burden of alcohol consumption has drawn concentration of concerned policy makers who are continually striving to achieve better outcomes so that the society can benefit at large (1). Experts in the field of public health are repreadtedly showing concerns regarding alcohol policies in the country. A considerable requirement has cropped up for drafting global strategies applied to the country perspective after too much attention has been paid on the rising issue (2). In the present paper a discussion is put up regarding the scenario of alcohol consumption in the united kingdom, the summary of alcohol control in the country, the main challenges faced in implementation of policies, and the implementation of two global alcohol control initiatives that could lead to more effective protection from the health risks of alohol in the country. Research has indicated that alcohol consumption has increased largely in the recent years owing to a number of factors. The price of alcohol has become half since 1960s. In addition, successive governments have been very much reluctant to apply taxation policies that can act as a way to control alcohol consumption in the country since it has been perceived as an unpopular strategy on the political ground. With the development of mass communication media, the society has witnessed a steep increase in the advertisements of alcohol and promotion of alcohol at different levels (3). The statistics of alcohol consumption in the united kingdom has drawn attention of the policy makers in the light of increasing health concerns as well as increasing crime rate as a result of unhealthy consumption of alcohol. In the united kingdom, a totl of 8,697 deaths were reported that were due to alcohol consumption. Around 9 million people in England drink alcohol at a livel more than the permitted one. Alcohol has been reported to be 10% of the UK burden of death and diseases thereby indicating that alcohol in one of the three most significant lifestyle risk factors for death in the country, next to obesity and smoking. It has been estimated that around 7.5 million people in the country are not aware of the damage that is being done to the heir health due to drinking. Alohol leads to around 60 medical complications in individuals including stomach, liver, mouth, throat and breast cancers; liver cirrhosis; high blood pressure, and depression. In the year 2013, around 100800 hos pital admissions were reported due to alcohol consumption as a result of alcohol related diseases or injuries. Alcohol-related crime in the country has been estimated to be contributing to a cost of approximately 13bn on an annual basis. In Wales and England, about 63% of all deaths due to alcohol in the year 2012 was due to alcoholic liver disease. Costs of harms related alcohol has been reported to be 3.5bn to the NHS per year. It must be noted in this context that alcohol has become 61% more reasonably priced as in the year 2013 when compared to the year 1980 (4). The UK government have implemented a number of strategies in the recent past that aims to address the issue of alcohol consumption in the country. The strategies have the vision of bringing radical changes in the attitudes and approaches of the common population and want to turn the tide in opposition to irresponsible drinking. The strategies focus on a number of aspects like reduction of availability of alcohol at cheap prices, advertising for alcohol, changing behaviours on the local basis, challenging the enforcement and adequate response to emerging issues (5). The polices implemented in UK have recognised that local businesses, services and communities are the best places for tackling alcohol-related issues and enforcing the desirable behaviour and developing a suitable culture. Reduction of the availability of alcohol at cheap prices have been the main concern for government policies to curb alcohol consumption. The government has taken an initiative by raising alcohol duty by 2% above the retail inflation (RPI) each year to 2014-2015. A minimum juice rule has been implemented for cider in order to enable high strength white cider to be disqualified for lower rates of duty applicable for cider. A minimum unit price (MUP) for alcohol has been introduced in Wales and England (6). Alcohol advertising has also gained attention of the policy makers who seek to prevent advertising targeted at young people. A number of controls have been put up over online, print and broadcast advertising. These have been initiated by the Portman Group and the A dvertising Standards Authority (ASA). The Portman Code is responsible for covering marketing domain such as product packaging, promotion and sponsorship. The controls exercised may be having the ability to adequately address the issues related to advertising alcohol. The ASA has ensured a vigorous and full application of powers to put social media and online media under distinct schemes for verifying the applicability of the alcohol advertisement (7). Over the last three years, the government has taken significant steps for enabling local agencies to take the appropriate decisions. A new approach has been set out to policing, crime and health care. From April 2013, unitary and upper tier local authorities are receiving public health fund for alcohol services. The support of Public Health Australia is significant in this regard. From November 2012 Police and Crime Commissioners (PCCs) are ensuring that priorities of the public are driving local police force activities. PCCs are remitting to cut crime rates along with anti-social behaviours due to undesirable levels of alcohol consumption. They are working with the local leaders, such as Clinical Commissioning Groups and Health and Wellbeing Boards for developing a collaborative initiative against alcohol-related issues in order to achieve an effective safety and criminal justice in the country. It is the local communities who are known to set the standards in the surrounding enviro nment (8). The polices undertaken in the UK in the recent years for reducing the impact of alcohol consumption have been based on a sound framework that is supported by four fundamental objectives. These are education and information; proper identification of treatment and issues; reduction of alcohol related crime and alcohol industry to be made as a voluntary partner. The government has been spending a considerable amount of fund for providing education to the public on the harmful impact of alcohol consumption in order to prevent higher degree consumption. This is more prominent for the young generation for chaging their drinking patterns, promoting safe drinking and providing information for seeking required help at the time of need. A number of campaigns have been conducted to giving a better education for changing attitudes and beliefs (9). There are some issues that are being faced in the present era that are hindering the success of the already existing alcohol reduction strategies. A combination of poor habits, ignorance and irresponsibility have been the underlying causes of such unfavourable situations. The issues arsing are multi-faceted. Alcohol is available at a cheap price in the country, and the needs of the industry along with the commercial advantages have been gaining more priority over concerns of the community. The impact has been a change in the behaviour of the of the individuals drinking at a socially unacceptable level. Previous governments have shown a failure to handle the issue to a considerbale extent. Enough challenges have not come up for the individuals who drink and consequently cause harm and injury to others. Such challenges are also not adequate for businesses that even encourage such form of intolerable behaviour (10). The measures adopted by the implemented policies have been extensively criticised due to the multiple challenges faced by the public health community. Though there is an acknowledgement of the close relationship between rising consumption and affordability, there are no strict policies that limit the consumption for limiting alcohol-related injuries and harm. Adjustment of taxes is a key challenge in this regard. Another serious challenge is that there are no set of targets against which one can review the effectiveness of the policies in the future. Work is effective when it is done in a target driven basis, and this lay the chances the alcohol policies would fail to bring the desirable changes. Another major challenge is related to focus on binge drinkers and the relation with antisocial behaviour. The polices have given a major emphasis on measures for criminal justice for targeting the group of binge drinkers. Binge drinking has been a part of the British culture since many centu ries. The set policies have been no attempts to understand the social and cultural perspective of binge drinking. The polices, therefore, run the risk of stigmatisation of those who misuse alcohol. This plays a role in shifting the policy debate from the significant matters like industry accountability and availability towards a focus on the responsibility of individuals to consider drinking at an acceptable level (11). A further challenge is an allocation of adequate resources and funding by the government. Sufficient funds are not being allocated for implementation and reviewing of new policies and attention is not been given on a strict basis to ensure that the policies are abided by. It is therefore not possible to get complete evidence of the extent to which the policies have been successful and brought about the desired outcomes. The lack and delay in investments have constantly been criticised. There lie some outstanding questions that are to be clarified in due course. On the challenge regarding the voluntary partnership, it can be stated that a number of voluntary agreements have resulted in minimal adherence to the policies. Another issue is the method by which the policies have embraced the changes and have disregarded the available evidence in this context (12). Against the backdrop of the present status of alcohol control in UK and the corresponding challenges faced, it would be a proper approach to discuss how implementation of different global alcohol control initiatives might lead to more robust protection of the public from health risks of alcohol in UK. The first key alcohol control initiative that can be applied in the UK context is community action. The negative impact of alcohol use that is found to be occurring in the communities have the potential to trigger as well as foster local solutions and initiatives to local issues. Communities are to be supported and widely empowered by the important stakeholders, including the government so that the local expertise and knowledge are used maximally for adopting effective measures in order to prevent the harmful consumption of alcohol. This change can be brought by considering collective instead of individual behaviour. It is however crucial to remain sensitive to cultural beliefs, values and beliefs. This cn be achieved through a number of interventions and policy options. Rapid assessment are to be supported for identifying gaps along with priority areas that need immediate attention. Facilitating recognition of harm due to alcohol and promoting cost-effective responses to the determinants of the local community of harmful use of alcohol related issues would be beneficial. The capacity of the local authorities are to be strengthened for encouraging and coordinating strenuous community actions through promotion and support of development of municipal policies in order to reduce use of alcohol. The capacity of the local authorities for enhancing partnerships are also to be promoted. Providing information regarding effective means of monitoring success of strategies would also aid in this regard. Communities are to be mobilised for preventing the sale of alcohol and consumption by underage drinkers. Supporting alcohol-free envrionemnt by the community would mainly tar get the at-risk group. Providing community support and care to the individuals who are effected by alcohol would be another major initiative in the present context. The second global alcohol control initiative that can be applied to the context of UK is drink-driving policies together with counter measures. Driving under the influence of alcohol is a key issue has it affects the individuals coordination, judgment and other forms of motor function. Driving under the impact of alcohol is a major heath issue affecting the drinker as well as other parties. This implies that evidence-based initiatives are needed for reducing the prevalence of drink-driving. These can include deterrent measures aimed at reducing chances that a person would drinkg and drive. A safer environment would be build up along with the creation of a reduced consumption of alcohol. An upper limit for alcohol concentration in blood would need to be enforced and the limit for professional drivers need to be reduced. Promotion of sobriety check points along wth random breath-testing would be beneficial. Suspending driving license when found guilty would be a strong administrative m easure. Graduated license for those who are new drivers with zero-tolerance for driving under alcohol impact would complement the above mentioned strategy. Ignition interlock can be helpful in reducing the incident of drink-driving in certain contexts. Driver-education is mandatory and counselling the drivers would increase their levels of knowledge and awareness. The government needs to allocate funds for setting up counselling programs. Funding must be in alignment with the resources available in order to promote best allocation of resources. Conducting public information campaigns that support the policies of drink-driving would increase the common anticipation effect. Running high-intensity, properly planned, well-implemented mass media campaigns which are targeted at particular aspects, like as holiday seasons, would be significant. Stipulation for alternative transportation after drinking places have closed down would lead to a reduction in cases of drink-driving. This is a ve ry suitable approach that would be helpful in reducing a number of accidents due to drink driving (13). From the above discussion it can be stated that despite the opportunities to address the issues fully due to alcohol consumption in UK, the government has been found to produce a set of robust policies after many years of forethought and deliberation. However, these policies are lacking in terms of effective measures and have contributed less to alcohol prevention. A widespread acceptance is present for the harm caused due to alcohol, and the government has taken up many strategies for quantifying them. Alcohol is known to bring considerable financial benefits for the Treasury and alcohol industry. Reduction of consumption may be going against the interests of those who are responsible for the commerce of the country. Policies in the UK have therefore not received much support from the concerned authorities. By taking lessons from the evidence-based strategies applied worldwide for curbing alcohol consumption UK might be successful in setting up better strategies as alcohol control i nitiatives. These new policies are to be based on the already existing policies that have been advantageous in reducing the alcohol consumption in other parts of the world, making them evidence-based strategies. References Britton A, Ben-Shlomo Y, Benzeval M, Kuh D, Bell S. 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