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Dudley is a market town in the West Midlands, England. The overall population of Dudley increased by 3.4% during the most recent two censuses (conducted in 2011 and 2021), from roughly 312,900 in 2011 to 323,500 in 2021 (Office for National Statistics [ONS] 2023a).
Socioeconomic status is a significant determinant of health in Dudley. Areas of high deprivation face numerous health challenges, including higher rates of chronic diseases such as obesity, diabetes, and cardiovascular issues. According to Dudley Metropolitan Borough Council (DBMC) data, Dudley experiences a higher prevalence of obesity and smoking among individuals in lower-income brackets (DBMC 2020). The Health Profile for Dudley 2021 reported that over a quarter (25.3%) of Year 6 children in Dudley were classified as obese (Office for Health Improvement and Disparities n.d). Moreover, the link between income and health is evident. For instance, the 2018 Healthy Life Expectancy Report for Dudley pointed out that life expectancy in the most deprived areas of Dudley is notably lower compared to more affluent neighbourhoods. For instance, the life expectancy for males in the most deprived areas is nearly 8 years less than in the least deprived areas (All About Dudley Borough 2018).
Dudley's demographics play a crucial role in health outcomes. An ageing population presents unique health challenges, including a higher prevalence of chronic illnesses like arthritis and dementia (Jaul and Barron 2017). According to the ONS, the number of individuals in the age group of 50 to 64 years increased by about 6,800, or 11.9%. (ONS 2023a). Ethnic diversity within Dudley also affects health. Different ethnic groups may experience varying health outcomes due to cultural, socioeconomic, and genetic factors. The Health Profile for Dudley 2021 highlights that certain ethnic groups may have higher rates of conditions like diabetes. For instance, among the Black population in Dudley, diabetes prevalence is nearly 12%, whereas the overall prevalence in the area is approximately 7%. These disparities emphasise the importance of addressing the unique health needs of different ethnic communities.
Access to healthcare services is a critical factor impacting health in Dudley. The availability of General Practitioner (GP) practices, hospitals, and specialised clinics can influence the timely diagnosis and treatment of medical conditions. According to data from ONS, six per cent of residents in Dudley said they were in "bad or very bad" general health in the 2021 census (Haloswen News, 2023). Furthermore, the accessibility of healthcare services plays a role in health outcomes. The geographical distribution of healthcare facilities can impact residents' ability to reach necessary medical care promptly (Kruk et al. 2018). Rural or underserved areas may face particular challenges, leading to health inequities. For instance, in Dudley, 5.4 per cent of the population said they provided high levels of unpaid care (Haloswen News 2023).
Diet, physical activity, and substance use are key lifestyle factors influencing health. The prevalence of unhealthy dietary habits, sedentary lifestyles, and smoking can contribute to various health issues, from obesity to respiratory problems (United Nations 2023). Dudley has been addressing these concerns through various public health initiatives. One notable initiative is Dudley's Health & Wellbeing Strategy 2023-2028, which promotes healthier living. It outlines plans to encourage healthier eating and increased physical activity through community-based programs and partnerships with local schools and businesses. The government's "Better Health" campaign also provides resources and support for individuals looking to improve their lifestyles (Dudely Health & Wellbeing Board (DHWB) 2023).
Environmental factors are another crucial consideration when assessing health in Dudley. Air quality, pollution, and the availability of green spaces can substantially affect residents' health. Poor air quality, often due to industrial activity or high-traffic areas, can lead to respiratory conditions and allergies (Kumar et al., 2019). Statistics from the UK government reveal that Dudley experiences air pollution levels that exceed recommended limits. The Annual Status Report 2019 report highlights areas where nitrogen dioxide (NO2) levels are above the annual mean limit, posing risks to respiratory health (DBMC 2023a).
Education and employment are vital social determinants of health. In 2021, 23.1 per cent of Dudley residents reported having no qualifications, which was higher than the national average of 18.2 per cent (Halesowen News 2023b). In Dudley, as of the year ending March 2023, the employment rate for individuals aged 16 to 64 stood at 76.5%. However, there was a decrease in employment compared to the previous year. Despite this decline, Dudley's employment rate remained higher than in the West Midlands. The unemployment rate, representing those actively seeking work, increased to 4.7%, slightly lower than the regional West Midlands average. The Claimant Count, measuring those claiming unemployment-related benefits, decreased to 4.6% in July 2023. On the downside, economic inactivity saw an increase, reaching 19.3% for individuals aged 16 to 64, signifying a rise in those neither employed nor actively seeking work in Dudley (ONS 2023b).
Mental health is a significant aspect of overall well-being. Access to mental health services and social support networks is crucial for addressing mental health issues (WHO, 2022a). The Dudley Mental Health Needs Assessment report indicates variations in the accessibility of mental health services across Dudley. Some areas may have better access to mental health resources, while others may face limitations (All About Dudley Borough 2022). Furthermore, strong social networks and community support are essential for promoting mental health and overall well-being (NHS 2022).
One of the foremost reasons for targeting adults in Dudley's health interventions is the region's demographic composition, which mirrors national trends. Like many developed countries, the UK is experiencing an ageing population, with a growing proportion of older adults. According to the ONS, the UK's population aged 65 and over is projected to increase significantly by mid-2028. This demographic shift is particularly pronounced in the West Midland region, increasing by 7%, with implications for healthcare demand and services (ONS, 2020). By focusing on adults, health interventions can address the specific health needs and challenges associated with ageing, such as chronic diseases and long-term care, ensuring the healthcare system is prepared for the evolving demographics (Abdi et al. 2019).
Adults in Dudley carry a significant burden of non-communicable diseases (NCDs), such as cardiovascular diseases, diabetes, and cancer. National and local health data consistently show that a substantial portion of the disease and healthcare costs are concentrated in this age group. In the UK, an estimated 89% of deaths are due to NCDs (Robbins et al. 2021). In addition, Dudley had the highest QOF prevalence of hypertension at 17.4%, while Birmingham had the lowest at 11.9%. (OHID n.d). By targeting adults, public health interventions can effectively reduce this disease burden and associated healthcare costs, enhancing the health and well-being of the adult population and alleviating the pressure on healthcare resources (WHO, 2023).
Typically, in their prime working years, adults play a crucial role in the region's economic productivity. The health of adults significantly impacts economic productivity at both the individual and societal levels. Health-related issues among adults can reduce workforce participation, absenteeism, and lower economic output. The Public Health Annual Report by DBMC (2022) highlights the close relationship between health and economic productivity, stressing the need to address adult health challenges.
The life-course approach to public health recognises that experiences and exposures influence health and well-being at different stages of life. This approach provides strong support for targeting adults in health interventions.
Health inequities frequently begin in childhood and grow over time. Early childhood experiences, socioeconomic status, and lifestyle choices can all influence adult health outcomes (Likhar et al. 2022). The government's "Health Profile for Dudley 2021" emphasises the value of taking a life-course approach to studying health inequities.
Adults are targeted for the prevention of future health issues. Many NCDs are avoidable or controlled with lifestyle changes such as eating a balanced diet, exercising regularly, and quitting smoking. Dudley's Public Health Strategy 2023-2028 emphasises the potential for adult preventative measures (DHWB 2023).
While early intervention theory is frequently linked with childhood, it equally applies to adults. It emphasises the need to identify and manage health issues as early as possible to avoid them becoming more severe, costly to treat, and adverse to overall quality of life (Colizzi et al. 2020)
Many health disorders, particularly chronic diseases, progress over a spectrum from moderate to severe and advanced. Adults who get early intervention can avoid advancing these disorders (Mazzucca et al. 2021). For example, a study by Fu 2021 emphasises the need for early detection and treatment to improve outcomes of chronic conditions. By detecting and treating illnesses early on, the need for more expensive and invasive treatments can be avoided later on, preserving lives and healthcare resources
Adults, for example, have a high prevalence of mental health problems. Early intervention can dramatically improve adults' quality of life (WHO 2022b). According to the DBMC study, prompt treatment and support can prevent symptoms from deteriorating and enhance overall well-being. Individuals can lead more fulfilling lives, serve their communities, and lessen the personal and societal burden of untreated mental health illnesses by addressing mental health concerns in maturity (DBMC 2023).
Understanding human growth stages is critical for establishing effective public health treatments. Every development phase brings health challenges and chances for intervention (Balasundaram and Avulakunta 2021). Young individuals in Dudley frequently make substantial lifestyle decisions that significantly impact their future health. Middle adulthood is commonly connected with professional and family obligations. The prevalence of overweight year 6 children in Dudley has remained statistically considerably higher than in England. In 2018/19, 39.4% of year 6 pupils in Dudley were overweight (DMBC 2020). At this stage, initiatives that promote healthy behaviours, like regular exercise, a balanced diet, and responsible alcohol intake, are most effective (Ross et al. 2017).
Understanding and justifying Dudley's adult population's health-related needs is critical to creating effective public health initiatives. Adults in Dudley place a high value on their mental health and well-being. The incidence of mental health problems such as depression and anxiety is a significant concern (All About Dudley Borough 2022). The obstacles of modern society have worsened these issues in the aftermath of the post-pandemic era. Individuals seeking help and treatment to cope with the stresses of modern life are becoming more conscious of the significance of mental health. The social and financial implications of adult mental health problems cannot be overstated (The Organization for Economic Cooperation and Development 2021). Untreated or inadequately managed mental health issues can result in decreased efficiency at work, increased absenteeism, and strained relationships, resulting in financial losses for people, families, and the community (All About Dudley Borough 2022. Interventions addressing mental health can lessen these adverse effects, promoting the economic and social wellness of individuals and the community.
The significance of mental health in Dudley is well-documented in the DBMC 2020 report, highlighting the prevalence of mental health issues among adults in the region. Dudley's proportion of adults using secondary mental health services (4.3%) is statistically considerably higher than the England norm. It is the second-lowest in the West Midlands (DBMC 2020). It emphasises the importance of early intervention and assistance to promote mental health and avoid long-term repercussions. According to the survey, about one in ten children and young people and one in five young adults in Dudley suffers from common mental health concerns, emphasising the importance of treating this issue (All About Dudley Borough 2022). The Dudley Health and Wellbeing Strategy 2023-2028 also prioritises mental health, emphasising the importance of focused interventions to address these challenges. This strategic acknowledgement reinforces the community's dedication to tackling mental health issues and emphasises the importance of implementing holistic programs and support services for people in Dudley (DHWB 2023) .
Secondly, for Dudley's adult population, chronic disease prevention and treatment are major public health concerns. The region has a high prevalence of chronic disorders, such as diabetes, cardiovascular disease, and respiratory ailments, significantly impacting individual health and healthcare resources. Addressing these chronic diseases effectively is critical because it holds the key to improving the general well-being of Dudley's adult population (DBMC 2020). The considerable cost burden these disorders entail on the healthcare system is one of the most compelling arguments for concentrating on chronic disease management and prevention in Dudley. Chronic diseases can demand long-term and expensive care, from drugs to hospitalisations and regular monitoring. This has a significant financial impact on people and the healthcare system (Holman 2020). The 2018 report by the Strategy Unit emphasises the economic effect of chronic diseases, emphasising the critical need for efforts to alleviate this burden (The Strategy Unit 2018). Adopting effective management and preventative initiatives may relieve pressure on healthcare resources and distribute them more efficiently to serve Dudley's broader health needs.
Furthermore, the impact of chronic diseases extends beyond healthcare costs. These conditions can severely affect an individual's quality of life. Pain, discomfort, and reduced mobility are expected consequences, making it challenging for adults in Dudley to engage fully in work, leisure, and family life. For instance, Dudley's value is statistically significantly lower than England's value, even though Dudley's proportion has declined over time, from 16% in 2010/11 to 12.8% in 2018/19. In addition, In 2017/18, Dudley's percentage of overweight adults was 64.7%, statistically comparable to England (DBMC 2020). Many individuals with chronic conditions experience heightened stress, anxiety, and depression due to the challenges of managing their health. Chronic diseases and mental health challenges often co-occur, forming a vicious cycle that can profoundly affect an individual's health (National Institute of Mental Health 202). Addressing chronic diseases in Dudley directly impacts physical health and has a positive ripple effect on mental well-being, contributing to a more resilient and healthier community.
The reason for prioritising chronic illness management and prevention in Dudley is supported by a 2018 report. This comprehensive report revealed that in 2017, more than half (55%) of GP patients in Dudley reported suffering from a long-term condition. This is close to the national average (54%). This report also emphasises the urgent need to take action and minimise the incidence of chronic diseases in Dudley, not only for the betterment of the adult population's well-being but also to mitigate the significant economic impact of these conditions (Strategy Unit 2018).
Promoting health behaviour change and promoting positive lifestyle adjustments are critical health requirements for Dudley's adult population. Obesity, smoking, and physical inactivity are prominent in the region, and they all add substantially to chronic diseases and adverse health outcomes. Effective interventions to address these behaviours are crucial for the adult well-being in Dudley. The fundamental motivation for focusing on health behaviour management and promotion in Dudley is to avoid chronic diseases. Poor diet and lack of exercise are significant risk factors for diseases such as diabetes, heart disease, and certain types of cancer. Dudley may dramatically reduce the occurrence of chronic diseases by addressing these behaviours, ultimately reducing the disease burden on people and the community.
In Dudley, as in much of the UK, there is an urgent need to promote regular physical exercise, balanced diets, and smoking cessation (Dudley Formulary 2016). Dudley faces issues related to physical inactivity, which has been linked to more excellent rates of chronic disease. More physical exercise is critical in resolving this condition. According to the DBMC 2020 report, Dudley's proportion was typically greater than England's; in 2017-18, Dudley's proportion was 29.6%. Furthermore, Dudley has higher-than-average obesity rates in the West Midlands; every Family Centre Cluster had an average of 32,500 overweight adults putting dietary changes as a priority (DBMC 2020). According to research, ceasing smoking improves physical health and has significant mental health advantages, which is especially important considering the emphasis on well-being (NHS 2021). Dudley can improve the quality of life for its residents, lower healthcare expenses, and promote a prosperous and healthier community by emphasising these healthy behaviours.
The National Better Health campaign in the United Kingdom reinforces the case for prioritising health behaviour modification and enhancement in regions like Dudley. This national campaign emphasises the importance of fostering healthy behaviours while addressing significant challenges such as obesity and smoking (Frimley Health and Care 2023). Furthermore, data from the Health Profile for the West Midlands 2021 shows that instances of obesity in Dudley are more significant than the national average, and smoking prevalence remains a concern (OHID n.d) These results demonstrate the critical need for comprehensive strategies that address these health behaviours to improve overall health outcomes and wellness for the adult population in Dudley.
Prioritising chronic disease management and prevention for the adult population in Dudley is a well-founded choice, given the substantial evidence supporting its significance (Dudley District nd.).
The DBMC, in its 2020 report, reveals alarming statistics, with higher rates of premature mortality from cardiovascular diseases, cancer, and respiratory diseases in Dudley compared to the national average. This stark local prevalence data underscores the urgent need for chronic disease management and prevention interventions. The economic burden of chronic diseases is also a pressing concern (DBMC, 2020). The report emphasises the substantial healthcare costs associated with treating chronic conditions. For instance, Overweight prevalence in Dudley has been statistically considerably higher than in England during the last six years. 25.5% of 4-5 year olds measured in 2018/19 had an overweight BMI. Chronic diseases significantly affect the quality of life for individuals in Dudley. Effective management and prevention can empower individuals to lead healthier, more active lives, ultimately enhancing their overall well-being and addressing this crucial aspect of their health (DBMC, 2020).
Dudley First, a separate NHS institution, is committed to promoting a truly integrated approach to healthcare delivery. Their goal, "Dudley first: a community where possible; hospital when necessary," displays a dedication to prioritising the community's well-being. Their mission is to connect with Dudley's varied population to help them live longer and healthier lives. People first, enabling service users to be active decision-makers, supporting employees, simplifying complex processes, stimulating innovation, ensuring accountability, and promoting inclusivity and diversity are among Dudley First's primary commitments. To serve the Dudley community effectively, they encourage active listening, responsiveness, and proactively connecting with quieter voices and 'hard-to-reach' persons. (NHS n.d).
Albert Bandura's Social Cognitive Theory plays a pivotal role in the success of health promotion initiatives. By building individuals' confidence in managing their chronic conditions, this initiative empowers them with the knowledge, skills, and regular support needed to take control of their health. This, in turn, bolsters their self-efficacy, facilitating healthier choices and treatment adherence (Islam et al. 2023). Employing role models and peer support within the partnership produces an effective foundation for observational learning. Success stories and shared experiences allow participants to learn from one another, promoting motivation and exchanging chronic disease management solutions (Thompson et al. 2022). Social support is fundamental to the Social Cognitive Theory, and collaboration provides several opportunities. Individuals can interact, share their adventures, and offer mutual assistance through group sessions, community gatherings, and online forums. This sense of belonging and shared experiences are essential for continuing health-promoting behaviours (Liu et al. 2019)
Let's Get Healthy Dudley is a vital community service that provides an integrated, community-centred lifestyle program. Its major goal is to encourage and safeguard the general well-being of the people, both physically and mentally. It is available to individuals residing, working, or enrolled with a local GP. This comprehensive program offers a wide range of lifestyle assistance services via a single phone line. This streamlined method offers quick access for anyone looking to start making healthy lifestyle changes, underscoring the service's dedication to providing health and well-being services that are easily accessible to the local community (Dudleyci 2023).
The Health Belief Model is critical in creating health promotion efforts like Let’s Get Healthy Dudley to increase people's awareness of their susceptibility to chronic diseases and the severity of these conditions. Health assessments and educational programs make individuals aware of their risk factors and the repercussions of harmful behaviours. This effort emphasises the advantages of adopting healthier lives, such as better well-being and a lower risk of chronic diseases, while addressing perceived hurdles. Time limits, access to nutritious foods, and an absence of support are all addressed with strategies and tools (Ruthsatz and Candeias 2020. To urge people to engage in health-promoting behaviours, the Let’s Get Healthy Dudley initiative uses numerous cues to action, such as personalised health plans, reminders, and incentives. These cues prompt them to begin and maintain healthy lifestyles (Dudleyci 2023).
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