Posted: March 14th, 2024

Heal3600 Mini research paper product 1 – write 600 words

Heal3600 Mini research product 1
This is the first of two mini research papers that you will need to write this semester, and is worth 50 points, incluidng 10 points for the peer reviews. Your mini paper must be at least 600 words (excluding citations) and written in APA format with appropriate citations.

Please pick a disease of your choice among what you have learned in this course so far, and provide a review, answering the following questions:

What is the name of the disease or condition you selected?
Why is this condition or disease meaningful to you personally? This question is optional. You don’t need to include it in your work if you are not comfortable answering it.
Cite some statistics / epidemologic facts of this disease.
What groups of people are particularly susceptible to this disease, why?
How does the disease develop and progress?
What are the risk factors, symptoms and three consequences of this disease or condition?
What are common treatments recommended to care for a person with this disease or condition?
What are two recent (within the last 2 years) research findings or advancements in treatment of this disease or condition?
Note that you should write a coherent paper, instead of just answering a list of questions. Citations must be provided to verify the accuracy of the information you provide. It is highly recommended that you first write your draft in a word file with spelling and grammar checks and copy and paste to the blackboard. Please put a word count at the end of the post.

To respect the efforts and time of your readers (your instructor and peers), please do not copy and paste from an artificial inteligence generated product.

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Assignment 2
SWIFT HEAL 3600 Course-Syllabus-ROASS
Faculty of Health Sciences Department of Community Health Sciences
HEAL 3600 A01: Integration of Health Determinants for Communities (CRN 53156) Course Description Students study, integrate and use community level determinants of population health in selected case or learning scenarios. These cases present a variety of issues in the design of health-related services that are intended to benefit population health. Prerequisites: HEAL 2600 with a grade of “C” or higher and 39 credit hours in the Curriculum for Interdisciplinary Health or consent of the instructor. General Course Information Students who enrol in HEAL 3600 are typically interested in earning a Bachelor of Health Studies or a Bachelor of Health Sciences degree from the University of Manitoba. Many employers are interested in the skills that Bachelor of Health Studies/Sciences graduates tend to possess. These include: •An understanding of health and illness in a cultural context; •A willingness to learn new information and to adapt to an ever-changing field; •The ability to gather, analyze, and interpret information in a clear and concise manner; and •Excellent written and oral communication skills.

Integration of Health Determinants for Communities
1. Introduction
The socio-ecological model is used by the World Health Organization (WHO) and Canada Public Health, as shown in Figure A, to deliver a detailed understanding of how the relationship between health determinants and health. This model illustrates “how various properties of the individual and the environment interact in a bi-directional causal chain. Integrated health determinants refer to the cooperation of all the health determinants to improve community health and well-being. It is also seen how the options of health determinants, which have been shown at different layers of health determinants, impact our lifestyle or behavior and thus, impact health. The physical environment in the middle, at the third layer, is where people live and environmental conditions as well as access to health services and technology will then be affected by more proximal factors, including health lifestyle and social, community, and culture. Also, those “more distal conditions,” for example, income level and social policies, will have an enduring impact on the physical environment. This essay will define what the health determinants are and discuss the importance of integrated health determinants and the objectives of the essay. Moreover, there will be production of evidence and examples from academic research and the real world.
1.1. Background of health determinants
Despite this, it is clear that primary health care in Asia is paved with good intentions and is often driven by a sense of community and collective, yet culturally, it has been rooted in an traditional “biomedical” approach, which respects biologically oriented clinical progress and pharmacological innovation rather than considering environmental, community, or social factors that may impact patient care. However, research essay and argument within this field have unearthed a strong correlation between regional health and the social and environmental determinants that impact the local population – a correlation that many in the western world have come to take for granted in the search for an alternative to secondary care systems and the backlash against hospital-oriented priorities. Moreover, as time goes on, the aging population in areas such as Hong Kong and Taiwan show that there is a complex emission and changes in diseases from one world to the next or, in the case of a more globalized community, from one continent to the next. This has provided more visible evidence for the need for societal change. There are frequent articles from both social scientists and medical experts regarding various chronic, non-communicable diseases that are rising in effect and prevalence within these nations, and it often links these phenomena to the altering and stratification of modern life, increased industrialization, and a push for further global connections.
The rise of the social determination of health within many Asian countries, including China, Hong Kong, and Taiwan, has largely been informed by the recent re-emergence of the primary health care approach as the most effective form of tackling health problems. Namely, both Taiwan and China have already taken on primary health care, or PHC, as the foundation for their health system. Such a strong commitment to primary health care from government and policymakers has been linked to the fact that they both started to understand the political, social, and medical reasons for pushing ahead with the type of societal approach being developed in primary health care, and how results generated from nations such as America or the UK cannot be directly applied to the Eastern hemisphere. Owing to this unique disparity, research essay into the integration of health determinants has proved to be exceptionally difficult.
1.2. Importance of integrating health determinants for communities
Integrating the health determinants means taking into account the social, economic, and environmental factors that affect health. This is very crucial for the welfare of the people living in the communities as it helps in ensuring that every person gets an opportunity to live a healthy life. The integration is not just important but also necessary. It can provide opportunities to develop and implement the strategies that take into account the wider spectrum of the health determinants. As a result, the communities can become more equitable and fair. Besides, integration of the health determinants can be beneficial to the communities in various ways. First, it can lead to real improvements in the health and well-being of the public. Evidence suggests that wider approaches to health determinants often help in delivering improved health outcomes. By integrating the health determinants, the communities can ensure that the resources are used in the most efficient way, which can further enhance the positive impacts of the strategies. Secondly, integration can help in changing and improving the provision of the services. Most of the health and social care services are provided to individuals. However, it is seen that the majority of the health issues arise from the broader social, economic, and environmental factors. By using the integrated approach, it gradually leads to the mechanisms where the services are provided keeping in view the root cause of the most health issues. This approach to providing the services will definitely help in preventing diseases and ill health. It is particularly important when the resources are limited and it is essential to make the best use of them. Lastly, an integrated approach helps in developing mutuality, collaboration, and partnership between the agencies and organizations that are working to improve the health and well-being of the public. Most of the health issues need cooperation and support from the wider society and the different sectors of the economy. But the benefits of such partnership working are often seen as limited. However, if the organizations and the groups work together in integrating the health determinants, it will foster collaboration. This can bring the professionals and the communities together, giving them the opportunities to work in partnership for improving the health and well-being of the local population. Also, involvement doesn’t just mean being involved in the treatment of the illness; it is about seeking the views and the contribution in planning the services and providing the activities that lead to better health. So, this integration not only serves to improve health but also helps in improving the health care services and ensuring that every individual is provided with the opportunity to live a healthy life.
1.3. Objectives of the research essay
– To identify the strategies for integrating health determinants for community health. The author will scrutinize different methods for promoting a successful partnership between the health and non-health sectors, including policy, data, machinery, community engagement, and funding approaches. From the essay, readers will gain a better insight into how different health determinants can be bridged successfully and measures be materialized in reality.
– To provide an in-depth understanding of health determinants and their impact on community health. The author will try to illustrate the constituent components of health determinants and how they can affect the health of the community. This will no doubt facilitate the readers to acquire an overall perspective of what health determinants are before moving on to the main discussion.
Through this essay, the author hopes to explore the discussion of integrating health determinants for community health in detail. He will attempt to provide an insight into the background of health determinants and their importance. But he will especially focus on outlining the objectives of integrating health determinants for communities and the various ways to promote it. Thus, as an elucidatory research, the main objectives of the essay can be summarised as follows:
2. Understanding Health Determinants
Health determinants are the range of factors that can affect health, either in a positive way or a negative way. There are the health determinants that we can have control over, such as knowing how to live a healthy way of life, and those that we have no control over, such as our genetic make-up. Health determinants also vary for different population groups – for example, for people with a mental health disorder, the support they get from their social network would be an important health determinant. On the other hand, for people with no mental health problems, the support they receive would not be relevant. These different types of health determinants can interact and create an intricate network of causes and effects that therefore means that different strategies and interventions are needed. This is why “integrated” support services agencies and organizations need to work well together to provide the right support for people as and when they need it. For some of the most common exertions like smoking, alcohol misuse, poor diet and nutrition, and overeating, our friends, our families, and our colleagues can all have an unfavorable effect on our health and well-being. By contrast, health-enhancing behaviors and attitudes like regular physical actions, a balanced diet, a positive approach to life, and supportive networks of family and friends can have a positive effect on our general health and well-being. There is a want for greater political, social, public health, and medical acknowledgement of and action on health inequalities, appreciating that health is not just the result of behaviors and choices made by individuals.
2.1. Definition and types of health determinants
By considering these types of health determinants, we can begin to understand what changes need to be made in terms of policy and practice. For example, the provision of healthcare services with restructuring and friendlier environment could be made more accessible to people of all genders, ages, and socioeconomic status. Also, research and continuous development in areas such as health education and social care policy, where there may need to be a focus on efforts to look at the overall improvement of population health in terms of prevention of illness.
Health care providers can take advantage of the growing body of evidence that shows that social factors are a large determinant in physical health. This can then be used to work out a health care plan that will not only treat an illness but also improve the overall population health. This is known as a ‘prevention is better than cure’ approach and it is becoming increasingly popular when discussing health policy and management.
For years, even without the welfare state, but particularly in modern times, as much should be made of the potential for helping social determinants of health as possible. The work of charities such as the National Heart Forum is increasingly beneficial to the health of the population as a whole. Such bodies use research and policy proposals to push healthcare policy in the direction in which it is most needed in terms of social determinants of health, often picking up from what the government has left and developing it further.
The healthcare system is very important because it helps the social determinants of health to be accessed by the public. The matter of inequalities in the healthcare system is particularly important but is often overlooked. We have the National Health Service with the intention of providing a service for ‘all’. However, everyone has experienced times when they have not been able to access a healthcare professional when they need it most. This is because, far from being equal, the healthcare system is extremely hierarchical and is under constant pressure to meet the needs of the population in different ways. This is referred to as ‘healthcare reform’ – something that requires the system to change and become more accessible for all.
Environmental factors are also very important. They include things such as safe drinking water, clean air, and adequate housing. I paid particular attention to the Environmental health section of the Centers for Disease Control and Prevention (CDC) website in exploring these factors. This is because this website is connected to public health agencies and research institutions. It provides extensive coverage of the study of environmental health and its many jigsaw pieces.
Biological and genetic factors determine who we are in a very basic way. Our genetic makeup will determine our eye color, blood type and other traits. However, the biological factors that we will be most interested in on this level are those that influence the overall population, such as what particular things in the environment are affecting people’s health.
A vast array of factors play a role in shaping the health of individuals and populations. Every type of health determinant can have both a positive and negative influence on the health of an individual or a population. Among the various types of health determinants we can examine, there are social, biological, environmental, and healthcare system factors. These are known as social determinants of health. They include income and social status, social support networks, education, employment and working conditions, physical environments, biology and genetic endowment, personal health practices and coping skills.
2.2. Factors influencing health determinants
Factor is a broad term which has a range of meanings. It is based on evidence, and it is on the basis of risk explanation and not causation. Factor is an abstract term which can be linked with anything. It is an effect which affects health. So, it is important to find out what different influences, whether positive or negative, affect health. There are different factors that can influence health and they can be discussed from social, psychological, and biological perspectives. On health determinants, there are many factors that are involved in the health status of a person or a community. According to research, there is no single set of determining factors that can predict whether people stay healthy or become sick. It has been identified that there are social, economic, physical, personal or emotional, and other lifestyle factors that adversely affect health if they are not controlled and properly managed. However, scientists believe that lifestyle factors are the only factors that people can control to maintain good health. Social and psychological factors related to health determinants can be presented by promoting good health (for example, encouraging exercise), explaining ill health (poverty causes healthcare and personal management issues, and lack of knowledge about health issues), and investigating patterns of health (who suffers from which health problem). Social help does not guarantee that a person remains healthy. The most important health factor is food. We can’t overlook it because eating good quality food in a proper manner has a lot of impact on people’s health. If people don’t get good, proper food, that leads to malnutrition. Most of the social help done by professionals is focused on long-term diseases. That is why patients benefit from free medications from the National Health Service. Alcohol-related deaths and diseases are enormous and easily preventable. There is still a big effect of alcohol on death rates; however, men are three times more likely to die from alcohol than accidents on roads, whereas women’s chances are five times. Most results of drugs and medicine cause some behavioral change. The term “health factor” means the number that controls. Social factors mean the fact that people are active and interact with others. Economic factors could include being confident about making good decisions, taking self-responsibility for good or bad choices and decision making. Social and community help promote or produce good health. One explanation is that it increases the sense of self-importance. We can see that a person is active in the community. It means everything to him. Having a role to play in society and being useful to others are both important in many respects.
2.3. Impact of health determinants on community health
It is important to note that the concept of health determinants is very broad and it not only includes the medical and biological factors in a person’s individual health, but also the non-medical factors. Nowadays, the impacts of health determinants on community health are getting more and more attention. In the research essay titled “Integration of Health Determinants for Communities”, the main idea is to explore the importance of integrating health determinants, understand the definition and types of health determinants, examine the factors influencing health determinants, and analyze the impact of health determinants on community health. To elaborate the idea of how health determinants can affect the community health, the essay has provided some good examples. It is found that health determinants have significant impacts on community health. The health determinants that can affect the community health are including social and economic factors, the built environment, physical environment, health services, biology and genetics, healthy behaviors and coping skills. For example, income and social status can be the one of the social and economic factors. People with higher incomes and more education and political power will have better health than people with lower incomes. They have more access to good and services such as the medical care, better food and a healthier physical environment. Also they have the ability to avoid risks and choices that have positive impact on health. On the other hand, in the medical approach, the doctors and other health professionals are more likely to addressing the physical and biological aspects of disease. However, it is often the socio-economic conditions that will have the greatest impact on human health. In reality, health determinants interact with each other and can be affecting the community health in different ways. For instance, lack of education or job opportunities for people in a community may lead to the communities with unhealthy behaviors, and poor coping skills. Also, the lack of family services and healthy supports will be the result of unhealthy physical environment. Think about the poverty and social isolation and how they affect the access to the health services and nutritional food and some of the healthy practices for the healthy behaviors. By analyzing the impacts of health determinants on community health, the learned that it is essential to adopting the comprehensive approaches that consider the advances and specific needs of the community. So, the researchers and government are increasingly promoting the idea of the integration of health determinants. So that the health determinants can be effectively identified in the medical practices and the wellness activities can be promoted in the public policies.
2.4. Case studies on successful integration of health determinants
An exemplary case of fruitful incorporation of wellbeing determinants is the Healthy Neighborhoods, Sound Families activity of the Baltimore City Health Department. This multilevel activity conducts research, creates approaches, constructs vital organizations, and actualizes activities helping networks in Baltimore City to improve the conditions that influence making a network sound. The joint effort with Jenkins and different authors directed a contextual analysis to assess the degree to which the Healthy Neighborhoods, Healthy Families activity accomplished what Jenkins calls continuous joint effort, one of the pined for results of incorporating wellbeing determinants. The examination was a joint effort between scholastics, network accomplices, and the Baltimore City Health Department. The writers found that the program achieved a great deal in its 13 years of activity and used an orderly way to deal with better understand the procedure of how social and physical condition mediations are employed to incorporate wellbeing determinants. Dr. Wen has filled in as the Commissioner of Health for the City of Baltimore and as of now is the President and CEO of the Notorieties Institute. In her practice, Dr. Wen is centered around understanding open arrangement and social determinants of wellbeing in guaranteeing network-based programs that truly help the networks that they are planned to help. She has watched firsthand that incorporating wellbeing determinants is hard to realize except if the strategies for executing it are well-looked into and all around characterized and ‘ongoing joint effort’ is a key procedure in getting to that reconciliation. The utilization of strategies delineated in the essay to satisfy such effective long-haul incorporation in the Healthy Neighborhoods, Healthy Families activity guarantees the security and the supportability of the advantages originating from the program after some time.
3. Strategies for Integrating Health Determinants
Some countries apply a national public health approach in which the national government sets the legislative and policy frameworks for addressing health determinants, established national goals and priorities, defines roles and responsibilities of government and other sectors, and determines the division of power among government health departments at different levels. According to McDonald and colleagues, a national public health approach is essential for meeting the diverse health needs of specific populations or jurisdictions. It adopts a scientific and evidence-based approach to guide the practice of public health and support the ongoing evaluation and improvement of the effectiveness of public health programs and interventions. McDonald and colleagues further identified that dual jurisdictions or divided sovereignty offer the significant advantage of combining different types of expertise from multiple levels of government; drawing ideas from experts in different geographical areas; coordinating with different parts of the health system to help specific target populations; and lending itself to the introduction of small scale healthy public policy measures, which can be rigorously evaluated before wider implementation.
3.1. Policy and governance approaches
These approaches are useful and have been utilized in many countries. By applying an interdisciplinary and multilevel approach, successful integration of health determinants by various sectors can be facilitated and promoted. It is important for policy makers and communities to be informed about the pros and cons of different approaches, and it is also essential to consider the fit between different approaches and the specific context of target community. By continuing to develop the evidence base on these approaches and evaluate their impacts, and by fostering active citizenship and knowledge on health, it is hoped that the unfulfilled potential for collaboration among different sectors and for greater community empowerment in the context of health promotion can be realized.
Last but not least, evidence-informed policy making is considered to be an effective approach. It aims to provide policy makers and stakeholders with the best available evidence necessary for making informed decisions; to use the most rigorous and up-to-date scientific research to shape and improve policy; and to evaluate existing and new policies objectively. To facilitate evidence-based policy making, it is essential to improve capacity within governments to support and expand on the use of evidence in policy. This can be done by enhancing individual skills and improving organizational capacity; making processes more transparent and receptive to new knowledge; and fostering a culture where policy learning and innovation are valued.
Another approach is a population health approach which focuses on the social determinants of health and aims to improve the health of an entire human population. Its main strategy is to intervene across all levels of social ecological model. For example, identifying and measuring problems, identifying and developing interventions, and monitoring and studying interventions and their effectiveness. This holistic approach goes beyond the policy debates to integrate scientific findings, health policy decisions, and societal consensus. Strong governance structures can facilitate the integration of scientific findings and societal consensus into policy decisions. Public participation also plays a key role in a population health approach. By involving community members in decision-making, identifying problems, and generating options, it is more likely to encourage a responsive and preventive public health orientation and to address social determinants of health.
There are multiple policy and governance approaches that can be utilized to integrate health determinants for communities. One important approach is to develop and implement health in all policies (HiAP). In such an approach, decision-makers in all sectors – public, private, and civil society – are encouraged to incorporate health and well-being outcomes and considerations into their decision-making. By doing so, the converging goals of optimal health policy and good governance are pursued. In some countries, HiAP has been established to facilitate intersectoral collaborations between health and other sectors such as housing, education, environment, and labor. The purpose is to ensure joint action for addressing broader determinants of health while establishing mechanisms for policy coherence processes.
3.2. Collaborative partnerships and community engagement
Community engagement is the process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting the well-being of those people. It is a powerful vehicle for bringing about environmental and behavioral changes that will improve the health of the community. Efforts to improve community health are increasingly recognizing that involving the people who will be served by health programs and initiatives (like local health departments, hospitals, etc.) in the process of identifying needs and implementing solutions is the most effective way to assure that the programs are addressing the right issues, and that they will be successful. Over the past two decades, research has demonstrated the value of community collaboration for addressing many public health issues. This has led to a recognition of the importance of not just community involvement (i.e., a one-way information flow from the community up to the health programs and initiatives), but full-fledged engagement — which is a willingness on the part of all parties to work together in a collaborative and empowering manner. Well-implemented community engagement extends the influence of public health beyond the traditional ‘four walls’ of healthcare and into the many parts of the community that are necessary for people to live healthy lives. Quality improvement through engagement is a powerful tool for those looking to implement large-scale change. By giving community members an active voice in the process and plans for improvement, it is more likely that the changes will meet with success and be sustainable for the long term. Also, studies have shown that successful community engagement attracts and retains talent to support the health programs. This can take the form of volunteers who give their time and expertise to public health initiatives, or in the location preferences of professionals in the field.
3.3. Data collection and analysis methods
Data collection and analysis are critically important to the research and planning process for health and social change programs. Every stage of the research process, from planning and design to analysis and reporting, requires careful consideration of data in both its raw and analyzed forms. As well, it is important to think about what data can be gathered, from whom, and how it can be of most value in answering unanswered questions. There are many different methods for collecting data, and the two main methods of data collection are ‘quantitative’ and ‘qualitative’ research. Quantitative data is data that can be measured or compared on a numerical basis, while qualitative data is gathered from interviews, direct observation, public meetings, and reviewing literature. For example, surveys and census can be used to collect numerical data, such as numbers and statistics that can be compared. On the other hand, direct interviews with individuals or group interviews that ask people’s opinions and feelings about a certain topic give qualitative data. One specific example our research team will be using is the ‘Community Health Status Survey’ from the Centers for Disease Control and Prevention. This survey collects data from adults on core measures of health, health care access, and use of preventive health services and was specifically designed to develop a health profile for the community. In terms of quantitative research, the survey uses a questionnaire that allows residents within the community to give their opinions and feedback on their own or their family’s health. This represents a useful data collection method because not only would data be generalized, but the researchers can easily make comparisons in health compared to other areas. As well, qualitative data will be collected using a secondary source – that is, other forms of data that would have been collected in the past. The ‘Morbidity Reports’ are one example, and this data source is a local authority report that gives detailed descriptions of specific diseases and conditions in the community. This information is collected by local medical practitioners and sent to the local authority and gives an indication of the impact of that disease on the individual and the community at large. This is particularly useful for our research when looking at the frequency of certain conditions within the community. One major issue in relation to data collection is that many data sets are very vast and it’s often difficult to know where to start with the analysis. On the other hand, sometimes the amount of data can be very small and no meaningful statistical analysis can be done. However, a well-planned and designed data strategy can alleviate this type of issue. For instance, it’s a good idea to plan an analysis strategy for each data before any has been actually collected. This ensures every single piece of data gets considered and used in some way – so no data is wasted. On the other hand, actually considering the format and type of the data before designing its collection is equally as important. For example, in our research, it is essential to use data that has some sort of reliability and that can be generalized. Therefore, the amount of qualitative data will be kept to a minimum and the vast majority of data collected will be quantitative so that meaningful comparisons can be made.
3.4. Resource allocation and funding strategies
Resource allocation refers to the distribution of resources, usually financial, between the various organizations, programs, and services competing for those resources. On the other hand, funding is the provision of financial resources, which is usually for a particular project, product, or initiative. There are three main strategies when it comes to resource allocation. First, there is the historical or baseline funding where resources are allocated based on the past use. Secondly, there is the incremental funding where resources are given to expand existing programs or services, usually done by providing small additions to the base fund. Incremental funding is the most common approach found in local governments. The last strategy is the priority-based or needs-driven funding. Resources are allocated based on the relative need or importance of the program or service. This is the most strategic and can assist in achieving the socio-economic objective. However, the transition from funding strategies to action can be challenging. In recent years, the economic recession and subsequent slow recovery have left many funders in a difficult position, since there has been decreasing resources but the demand for services has been increasing. Therefore, strategic thinking is necessary across the organizational structure, and a methodical and evidence-based approach is needed. This can improve the decision-making process and help maximize the impact of the resource allocations. Such practice will assist the organizations and individual programs to grow and evolve in response to the diverse needs of the community. It can also help the local and regional development activities to achieve their strategic goals. By engaging stakeholders in a dialogue about funding priorities and sharing information and perspectives, it is possible to build consensus and coordinate resource allocation. This collaboration can take a variety of forms from the very informal to the very structured, such as collaboration through projects and programs or collaboration through overseeing a community plan. Each provides a different level of influence for the participants. This is because a good collaboration effort can generate more ideas and derive the best possible solutions to prioritize the resources. This will eventually assist in breaking down or minimizing the institutional and jurisdictional barriers. By creating that collaborative environment, it will help to provide effective coordination of resources and ensure efficient use of funding.
4. Benefits and Challenges of Integrating Health Determinants
The benefits of integrating different aspects of health determinants are remarkable, as this approach can bring about improvements in the overall health of the population. One of the main advantages of an integrated approach to health determinants is that it focuses on the underlying causes of ill-health and diseases in addition to curing disease. In other words, it emphasizes the preventive methods of health care. It also helps to address the broader health issues in addition to individual diseases. Another benefit is that, by developing the collaborative approach involving different sectors, professionals, and the community, it may lead to the ownership of the wider health agenda outside the health care sector. As a result of the integration of health determinants such as housing, education, and employment, a society with greater equity in health can be created. This is mainly because the integrated approach can seek to reduce the variations in health status between the different socio-economic groups. On the other hand, challenges exist and may affect the process of integration of health determinants. One of the main challenges is the difficulty in finding a consensus on the definition of health across different sectors. In other words, some people may define health as a state of physical well-being while others may define health as a sense of social and emotional well-being. When health determinants from different sectors are being integrated, the professionals from each sector may struggle to agree on the main focus and objectives of integration. This challenge may be intensified by the fact that each sector ultimately aims to get a bigger share of resources and funding. Another challenge is that there are many different ways of integrating health determinants and each way would require different types of investment. For example, the successful integration of health determinants through the creation of a health and community hub in a deprived area would require new investment in terms of building and training for staff, whereas the integration through the creation of informational websites would require new investment in the provision of digital devices such as computers and the internet for all the residents. As a result, it is quite difficult to convince the policymakers and the investors that integration of health determinants is a good investment and this may slow down the whole process of integration. On the other hand, challenges exist and may affect the process of integration of health determinants. One of the main challenges is the difficulty in finding a consensus on the definition of health across different sectors. In other words, some people may define health as a state of physical well-being while others may define health as a sense of social and emotional well-being. When health determinants from different sectors are being integrated, the professionals from each sector may struggle to agree on the main focus and objectives of integration. This challenge may be intensified by the fact that each sector ultimately aims to get a bigger share of resources and funding. Another challenge is that there are many different ways of integrating health determinants and each way would require different types of investment. For example, the successful integration of health determinants through the creation of a health and community hub in a deprived area would require new investment in terms of building and training for staff, whereas the integration through the creation of informational websites would require new investment in the provision of digital devices such as computers and the internet for all the residents. As a result, it is quite difficult to convince the policymakers and the investors that integration of health determinants is a good investment and this may slow down the whole process of integration.
4.1. Improved health outcomes and equity
In order to help improve the consistency across varying levels of healthcare throughout the UK, technology is being looked into as a recommended tool for delivering the 2020 health and social care vision. It is interesting to note that there has been a steady improvement in the healthcare system over the last five years, with health trends seeing a continuous upward trend and a good healthy increase in funding year on year. The UK healthcare is mainly tied to age due to the number of health conditions people are expected to suffer from. It’s therefore positive news that the number of over 60-year-olds in England who smoke has dropped by a quarter. Mental health has been addressed politically in the form of more funding and dedicated projects aimed at improving mental health therapy services; this important step reflects the plan to deal with future health determinants. The government has been working on promoting more individual choice and placing the patient at the very center of the healthcare system, a crucial factor in the drive to shift more services from hospitals to regional communities. Also, the vast majority of households have a computer or access to smart technology – making it easier for the health and social care system to embrace the exciting technical opportunities ahead. As discussed in The Guardian, the grand prize for accelerators of health innovation – the Garwood Award – was won in 2019 by ‘MediShout’, an application designed to help busy nurses capture, share, and act on data using a smartphone. With over 100 hospitals already relying on paper-based, inefficient systems that can delay getting the right care to patients. By the NHS embracing the new technologies and ‘push to create a virtually integrated system that’s paperless from GP to pharmacy to nurse, to hospital etc’ as Matt Hancock (the health secretary) ‘demands’. He is quoted here, and in my opinion, this is an incredibly positive sign for the future of the healthcare system. We can see that there is momentum and real drive for standardization and modernization of health technology used by all of the respective services; all moving towards embracing the idea of integrated healthcare provision. Also, as covered in eHealth News, major healthcare providers in the UK such as DrDoctor Health, a communications software provider for helping to find patients the right care, are contributing to the transition to digital healthcare. Adapting their ways for casting two-way communication for health services in modern-day society will continue to entice major figures such as DrDoctor and Babylon Health, the digital-first healthcare provider, to seek new means of reaching out to patients. These major health providers have the same goal – helping to modernize health provisions through utilizing the latest technologies available and focusing on allowing patients to be more involved in their healthcare through the power of information aides and user-friendly applications, that may lead to a digital health revolution in the UK. Also, things such as ‘wearables’, e.g. smartwatches, exercise monitors, and other personal health monitors that are all currently available on the market with many mobile application companion apps. These have not only shown to be reliable for quantifying and measuring an individual’s health but can also now potentially send data through the internet to a person’s healthcare professional. This is a clear example of how personalizing a person’s health and fusing it with the ability to give information instantly to provided services is becoming the next leap forward in modern healthcare provision and health technology as a whole.
4.2. Enhanced community resilience and empowerment
Furthermore, integrating health determinants can increase community resilience and empower. Community resilience refers to the capability of a community to recover from adversities or disasters. By working in partnership and increasing the capacities and strengths of different community sectors, integrating health determinants can help to cultivate a resilient community. Prof Siah pushes this argument further, referring that to achieve a resilient community, top-down reaction alone is not enough. Instead, community-focused intervention is needed. Integrated projects that combine residents’ programs with community initiatives could help to enhance the social cohesion between different communities. It is also important to incorporate diverse voices of the community into the decision-making process. Only by understanding the needs and expectations of the communities, the intervention could have a sustainable impact on increasing their resilience. As what has been reflected in the case study of Chula Vista, the incorporation of community voices into the process of building healthier neighborhoods has borne positive results. In particular, the increase in participation and decision-making power that comes with the collaboration with the local residents has provided a good foundation for the community to demonstrate a high level of ownership and commitment to the projects. The concept of empowerment, on the other hand, is vital to progress that leads to sustainable improvement of community health. When individuals and communities are supported by social and physical environments, they are more able to exercise autonomy and control over their own lives and health. Dr. Michael P. O’Connell, a state health officer in Michigan, commented that “empowerment comes from within the individuals and the communities”. It is not a sole output of governmental policy or intervention – instead, it is an ongoing effective approach to help communities and people to take control over their own lives. By improving self-image, confidence, and capability of self-control, integrating health determinants can be a powerful mechanism to support community empowerment. In Chula Vista, researchers observed that larger proportions of chronic disease cases were found in communities that lack access to healthy environments compared to the more wealthy neighborhoods. However, after years of development and collaborative effort initiated by the Chula Vista Community Action Plan, the evidence already showed a significant step towards the reduction of health inequities. A greater sense of awareness and community ownership of their own health has been established, and the successful blueprints of combining health-promoting environment with neighborhood vintage and community well-being studies are indeed inspiring. These concrete examples illustrate the significance of community empowerment in instigating positive changes in community health and the potential efficacy of integrated community projects.
4.3. Barriers and obstacles to integration
Evidently, building and sustaining integrated models of health determinants and service practices pose considerable and ongoing challenges. But it also presents a great opportunity to put in place innovative and personalized health and wellbeing service systems. Aligned with the call to turn the focus of strategic and service planners towards patient-led care and supported self-managed lifestyles, my views are that the serious departure and transformation from institutional and disease-focused models can be achieved through the amendment of underlying risk management and legal compliance arrangements. This shift the orientations and accountabilities from provider-centric procedures and protocols to citizen empowerment and holistic output and user-satisfied outcomes.
These entrenched and deep-seated barriers, such as the lack of shared vision and empirical evidence-based approaches which put greater emphasis on the role of different health determinants in influencing and promoting the wellbeing of populations, unnecessary specialized and competing resolution-focused acute care, and the overemphasis on curative biomedicine, underinvestment in health resilience and prevention, and target-driven performance management systems that disempower communities and service users, need to be understood to adopt a cultural transformative strategy and improve the quality, innovation, and sustainability of integrated service developments.
The requirement to transition and develop different skill sets among the wider health and administrative personnel workforce may act as a barrier due to the perceived unacceptability of change and costs of staff realignment and retraining. But it also poses a separate challenge with contractual, professional, and patient consent and the complex interchange and crossover between different patient/client identity and service delivery systems.
Integration and pathway working is extremely difficult to achieve in fragmented health and social care systems that are designed to be responsive to the different needs of populations, age groups, and special interests rather than on the development of one size fits all singular and coordinated service continuum focused on the promotion of population health and wellbeing. The human rights dimension that incorporates respect for privacy, dignity, and choice are often compromised as a consequence of a lack of or poor security and confidentiality of data and information sharing.
The varying administrative, procedural, and financing models and barriers are major obstacles to integration that exist at different levels of governance and operations. According to Manuella et al. (2013), professionals, financial and organizational systems, data and information technology systems, performance measurement and quality and safety monitoring infrastructure, governance and effective leadership coupled with a culture of collaboration and integrated ways of working together with patient engagement and community assets and support systems are key integration enablers. But many reforms and proposed policies are often obstructed by conventional practices, uneven diffusion of innovation in healthcare, lack of autonomy and dependence of providers on public funding, and politics driving the centralization of resources.
4.4. Overcoming challenges and promoting sustainability
Finally, it is important to outline how the previous approaches have shaped the field of integrative medicine and identify where the field may be heading in the future. As the movement toward evidence-based medicine continues to gain steam, the call for more high-quality comparative effectiveness research studies is likely to intensify. These types of research will be necessary to show not only whether integrative treatments are effective, but also how they compare to conventional treatments. Additionally, some posit that even the term “integrative medicine” may eventually fall out of use. As more conventional medical practices begin to integrate alternative therapies and create a more comprehensive, patient-centered philosophy, simply referring to what’s being practiced as “good medicine” may become more common. As such, it’s likely that the practice of integrative medicine may become more widely known simply as “medicine”. However, in order to get to this level, more research and more publication of that research must occur, and new practitioners must be rigorously trained in the evidence-based methods of the future. Without solid evidence supporting the field, it is likely to remain on the fringes. Yet, the promise that integrative medicine holds, especially in comparison to the rigidity and sovereignty of current medical practices, makes it a field worth watching in the coming years.

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