Action for Better Public Health

This analysis explores opportunities for public

health improvement in the United Kingdom through effective

partnerships among public and private service

providers in the health sector and the wider

economy, with a particular focus on the role of

pharmacies.

Through an analysis of graphed data, Taylor and Newbold

select these strategic points for emphasis:

• Improving overall population health should

  not be neglected in favour of reducing health

  inequalities because substantive public health

  gains come from interventions that change the

  behaviour of the entire public, rather than just

  individuals at very high risk of harm.

• Recent research suggests that even limited

  changes in physical activity and diet can lead

  to significant health gains.

• Greater public engagement in health is

  essential, especially promoting enhanced self care on a large scale. This includes greater self management of personal
  use of pharmaceuticals. In Scotland, for example, the provision of public health

  related interventions can occur via community

  pharmacies.

They then focus their findings in age categories with respect to

the promotion of self care.

1. From infancy, healthy environments,

   providing on a daily basis good food,

   positive eating values and habits, and enjoyable

   exercise opportunities influence the formative

   years of young children.

2. For young adults, unwanted 'nannying'

   messages are unpopular. Thus, conventional

   approaches to health promotion in schools or

   other settings can be counter-productive.

3. Working adults' behaviour is often

   determined by convenience factors, and the

   practical viability of taking up health-related

   options such as programmes designed to

   facilitate weight loss or smoking

   cessation.

4. The less advantaged people are, the more

   they are likely to benefit from 'structural'

   changes that impact on everyone, such as smoking

   bans, road safety and pollution laws.

5. There is evidence for older adults that

   exercise patterns incorporated into home life

   are significantly more likely to be

   sustained.

6. The more tailored to user populations health promotion

   interventions are, the more likely they are to

   have significant effects on larger portions of

   the population.

7. Medicine use can effectively support

   behaviour change. This is well illustrated in

   the case of nicotine replacement therapy.

8. Though doctors are more likely than other

   health professionals to change smoking and, by

   implication, other behaviours, there is also good

   evidence that pharmacists and nurses can support

   smoking cessation and other health behaviour

   interventions.

The authors conclude by pointing out that health

care is changing from emphasising disease treatment

to including preventative care. Pharmacies could

take part more actively in the challenge to

provide support for health behaviour changes.

Barriers include rigidity within the profession,

low public and political expectations, limited

professional relationships between physician and

pharmacy, and lack of sharing care records.

Taylor and Newbold support the position that pharmaceutical service providers are important

stakeholders in better public health and well

positioned for patient support as public health

policy moves toward promoting self care

solutions.