Community case study. The authors chosen township has a higher than national average of smoking and obesity rates which is reflected by the DH (2011b) which has identified health generally of individuals in this area is poorer than the average in England.

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The aim of this community case study is to focus upon important health issues around the challenges to adult health and well being of a selected township.  It will look at a particular health issue and consider the influencing factors such as perceptions of health, behaviours, and socio-economic status.  The author will also look at health education, health promotion, plans and services that are in place in relation to the identified health issue within that community, and provide epidemiological statistics.  

Throughout this piece of work the author will be maintaining confidentiality at all times by not identifying the Health Trust as under the Nursing and Midwifery Council (NMC) code of conduct on how to maintain confidentiality within a healthcare setting and state that we must treat information about patients and clients as confidential and use it only for the purpose in which it was given (NMC Code of Conduct, 2008).

A community is commonly known as a place where individuals and families live, for example a neighbourhood.  The term community has many definitions, one of which can be described as a group of individuals whom share same government and have share some common characteristics and interests (Oxford, 2011).

The community in which this case study is based on is a township located in the Northwest of England, a working class community well known for its coal mines and cotton mills in the 18th and 19th century.  In 2001, the Census recorded 301,415 people living in the community and mid-year estimates for 2009 suggest that this has now increased to 306,500 (Office of National Statistics (ONS), 2010a).  Deprivation in the township as of 2007 is £31.5% with the national average standing at 19.9% which shows that this is a concern for the community as a whole (Department of Health (DH), 2011a)

In the local area that the case study will be focused upon, they have a number of local shops and large supermarket chains which sell a range of foods which can be easy accessed by people with cars or on public transport.  There are noticeably a large number of fast food takeaways, which are all widely accessible within walking distance of the majority of people’s homes. Within the community there are three hospitals, many General Practitioners surgeries, Health Centres and Fitness Centres.

The authors chosen township has a higher than national average of smoking and obesity rates which is reflected by the DH (2011b) which has identified health generally of individuals in this area is poorer than the average in England. Life expectancy in the area is steadily increasing in line with the trends nationally and in the North West region. The latest figures for 2007-2009 ONS (2010b) show that men in the chosen community can expect to live 75.9 years and women can expect to live 80.3 years. However, this is currently 2.4 years less than the average for England in men and 2 years less in women; and the gap appears to be widening, especially in men.

The township remains predominantly a borough of white ethnicity, with only around 4% of residents of a Black or Minority Ethnic (BME) background (ONS, 2007).

There are three key factors that can lead to inequalities in health. The first factor is the conditions that people live in; some people have no choice in the matter it just depends upon where they are born. If they are born in a deprived, run down area they are more likely to suffer from health inequalities.  Secondly is their behaviour towards life itself. Some people smoke knowing that it is damaging their health but they carry on because they enjoy it.  Thirdly is the access and availability of services, many people live in deprived areas and are financially under strain, sometimes it is not possible for them to catch buses or get taxis to access health facilities (*****, ****** and ***** NHS Foundation Trust, 2009a).

The focus of this case study will be Coronary Heart Disease (CHD) which is a disease of the blood vessels supplying the heart muscle; the author will be looking at why this is such a big problem in the area, and ways in which health promotion and education could decrease the number of people contracting the disease in the near future.

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Smoking, a diet high in fat and salt, insufficient physical activity, high blood pressure and high cholesterol, type 2 diabetes are amongst the many factors which put a person at increased risk of coronary heart disease.

Under the National Institute of Clinical Excellence (NICE) (2007) guidelines recommendations have been put into place to help, support, recognise and prevent individuals whom are at risk of CHD and enable them to make changes to their lifestyle before it is too late.

Chemicals in cigarettes are extremely damaging to the cardiovascular system and nicotine can also act as hypertensive which may cause ...

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