This paper reports on an innovative whole-systems approach to improving uptake of breast screening in Tower Hamlets, a deprived borough in the East End of London with a large minority ethnic population. The approach, developed by the public health team at NHS Tower Hamlets, draws on analysis of needs and existing literature about effective interventions to promote breast screening. Social marketing research led to a campaign targeted at Bangladeshi women, together with a range of initiatives to promote breast screening through primary care services and community outreach through local well-known organisations. The breast screening service itself was upgraded and a new service specification is being introduced from April 2009.
PurposeThis paper aims to measure access to food in an inner London borough.Design/methodology/approachThere were six phases, which included designing food baskets, consultation with local residents and a shop survey. Recognising the cultural make‐up of the borough food baskets and menus were developed for four key communities, namely: White British, Black Caribbean, Turkish, and Black African. Three areas were identified for the study and shopping hubs identified with a 500‐metre radius from a central parade of shops.FindingsThe findings paint an intricate web of interactions ranging from availability in shops to accessibility and affordability being key issues for some groups. It was found that in the areas studied there was availability of some key healthy items, namely fresh fruit and vegetables, but other items such as: fresh meat and poultry, fish, lower fat dairy foods, high fibre pasta and brown rice were not available. Access was found to be defined, by local people, as more extensive than just physical distance to/from shops – for many shopping was made more difficult by having to use taxis and inconvenient buses. Small shops were important in delivering healthy food options to communities in areas of deprivation and were judged to offer a better range and more appropriate food than the branches of the major supermarket chains.Research limitations/implicationsThe importance of monitoring the impact of shops and shop closures on healthy food availability is emphased. From a policy perspective the findings suggest that approaches based on individual agency need to be balanced with upstream public health nutrition approaches in order to influence the options available.Originalty/valueThe paper is arguably the first to examine and dissect the issue of food availability and accessibility in the inner London borough in question, especially in the light of its proposed redevelopment for the London Olympics in 2012.
The Public Health Foundation (PHF), under contract to the U.S. Department of Health and Human Services, Public Health Service (PHS), worked with federal, state, and local public health, mental health, substance abuse, and environmental agencies in nine states to develop and successfully test a methodology for estimating investments in essential public health services. Estimates from the nine-state sample revealed the predominance of personal health expenditures in the public health system. Of total state health care dollars, only 1 percent was spent on population-based health services by participating agencies. This pilot provides a rational starting point toward a uniform methodology for highlighting public health expenditures that may be critical in revealing the effects of a changing health care environment on the nation's health. In combination with other data, results are expected to lead to a more informed policy-making process.
This is the first of two articles that will outline the role of public health and the importance of partnership working, and describe some of the opportunities available to acute care nurses for promoting health improvement. Public health is defined, along with the three domains and competencies of public health. Participation in a ′Healthier Hospital′ scheme is proposed as a way for acute care nurses to promote public health within their work settings.
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