Health and disease in communities health and social care essay

The different bureaus responsible in placing degrees of wellness and disease in communities are the undermentioned: WorldHealthOrganisation, Health Protection Agency and the Primary Care Trusts. This three may hold different particulars in footings of their aims and marks but they are normally working on towards a safer and wellness risklessenvironment.

The World Health Organisation ( WHO ) maps are chiefly in supplying support and services to the different wellness attention establishments around the Earth particularly those who chiefly need it e. g. low executing wellness attention suppliers on a per state footing, freshly debilitated countries and the likes. The administration besides joins forces with other necessary wellness attention administrations in order for them to get aid in the execution of certain programmes or activities locally. Their outreach workss are most particularly recognized during national catastrophes, catastrophes, eruptions and other global dismaying state of affairss.

Another bureau that aids in detecting degrees of wellness and diseases is the Health Protection Agency ( HPA ) . Harmonizing to HPA ( 2010 ) ‘The maps of the Agency are “ to protect the community ( or any portion of the community ) against infective diseases and other dangers to wellness ” ( HPA Act 2004 ) . ‘ This means that any alterations in the degree of wellness in a certain community particularly those which are caused by the engagement of a certain individual to unsafe materials/chemicals/equipments is being watched by the HPA. The bureau is specifically designed to provide this sort of concerns and are tasked to forestall harmful incidences from happening and to avoid jailbreaks if such state of affairs occurs.

On the other manus, Primary Care Trust ( PCT ) is fundamentally more specific in footings of attention proviso since they focus on a certain country assigned to them. For illustration, if Wandsworth is the country coverage of a certain PCT so they are specifically tasked to run into the demands of the people shacking in that said topographic point. They must make their best to make out to every individual occupant and supply them the attention that they need since this is seen as one of the wellness searcher ‘s privilege. When outbreaks go on PCT is besides responsible for placing the community ‘s position.

Word count: 351

Answer 1 – 1. 2

An epidemiological survey last 2007 in Africa showed a important addition in incidence rate as seen in Appendix A table 1 [ page 20 ] . Over all, from the twelvemonth 2006 to 2007, there was an extra 0. 9 % of instances added go forthing the incidence informations markedly higher than the figure of prevalence instances. The 2015 mark prevalence rate was set to 384 per 100, 000 population. The current surveillance displayed 692 instances per 100, 000 population. The figure of deceases related to the TB disease even displayed a more fickle rate. Mortality rate was 230 per 100, 000 population per twelvemonth with a mark figure of 39 for this approaching 2015. This means that Africa still has a long manner to travel in cut downing the figure of instances ( deceases and incidence ) , eight old ages might be well plenty from sensing to direction procedure but all are still in the custodies of the wellness attention suppliers, administrations and programmes involved with it.

Mentioning still to postpone 1, multidrug-resistant TB instances ‘ per centum is at the same clip spiking together with the incidence rate. The lone positive projection showed by the tabular arraies is the DOTC instance sensing rates which have been run intoing the coveted ends of the anti-TB programme. Additionally, there is a steady addition in new phlegm vilification ( positive/negative ) , new extrapulmonary, backsliding and retreatment presentments. On table 2 [ page 20 ] , the unfavorable results per centums resulted to decease, failures, defaults, transportations and non rating. Large rates of new phlegm smear positive instances lead to decease, defaults, transportations and nonevalutaion while new sputum smear negative instances lead to immense figure of deceases and defaults. Same thing goes with new extrapulmonary instances but few instances resulted tofailureentirely. Retreatment instances were besides high which resulted to all unpleasant factors. The DOTS coverage have been executing good since 2003 and above, but intervention programs did non travel good throughout the important period although instance sensing rates were all good. The job significantly lies on the intervention direction and behavior. Case sensing rates were already found to be greatly improved which means countries on direction programs are now going the oculus of aims.

Diabetesrates in Africa were n’t that high ( see Appendix B image 1 page 21 ) . Table 3 Appendix B shows the population sample for the diabetes instance anticipation. Merely 3-5 % in ages 35-64 old ages old is affected although this can increase significantly or duplicate up in several old ages. Africa did non either come in the axial rotation of taking states who are likely to be portion of the universe ‘s highest diabetes instances for both twelvemonth 2000 and 2030 anticipation. Compared to the TB disease rates, diabetes is more likely lupus erythematosus of a concern for the wellness administrations and all attempts must be concentrated on TB bar and obliteration.

Word count: 454

Answer 1 – 1. 3

The TB ( TB ) instance study show a gradual one-year addition from the twelvemonth 2005 to 2009 on the figure of people infected in United Kingdom with exclusion on the twelvemonth 2007 where the instances dropped down to -0. 7 % . England has the largest figure of TB instances making to several 1000s while the other states are merely holding an norm of 100s and less. The state that got the lowest rate of instances was Northern Ireland with twelvemonth 2005 as the highest. The tabular array showed that the steps taken to take down down the incident rate were clearly effectual. This state of affairs was, nevertheless, opposite with Scotland, England and Wales. Although the 2nd and 3rd states aforementioned showed a little dip in the per centum of instances for one peculiar twelvemonth, the consistence of disease generation outweighed the happening of the little unappreciable fluctuation.

The 2nd chart sing the regional instances of TB seems to hold the ability to catch the reader ‘s eyes. Obviously, London has the highest figure of instances and this is rather expected and logically true. The metropolis is known for its multicultural and multidiverse race, this means that the attack can go a batch harder since each civilization has its ain alone features towards wellness attention. When a certain act is done in order to cut down the figure of incidence, different people with distinguishable imposts will respond to this unreproducibly and this is one factor that can greatly impact the end of the national wellness bureaus to take down down and extinguish such disease. South East, West Midlands, Yorkshire and the Humber showed a changeless ascent in the figure of instances. South West and North West both have a steady rate with the twelvemonth 2009 as the highest. East Midlands, East of England and North East had unpredictable fluctuations. By and large, the spread of instances between London and the other parts range from 2500 to 3000. The diagram clearly gave out a decision that the range of country and population mass are merely few factors that can give out a good relation on the incidence rate.

Word count: 345

Answer 1 – 1. 4

The effectivity of the different attacks and schemes in commanding fleshiness ( a noncontagious disease ) and malaria – a catching one, is greatly shown on the ability of public wellness squads and administrations to forestall and command the spread of the certain disease in a community. Since the mark is laid locally per Se, the method becomes more efficient particularly when a national station execution study is done to look into whether the state of affairs has calmed down. Aiming for a group-by-group intercession can do the planned solution and even the epidemiological survey more specific and viewed as a case-to-case footing. The epidemiological survey is one really of import scheme since it determines the incidence and prevalence of such disease in a given country. The consequences of the epidemiological survey are so used as a footing for be aftering for actions, implementing activities and determination as to whether the disease happening has become extended or non. Due to this information gathered, the extension in footings of figure of instances of such disease can be halted. Assorted programmes will be implemented by several administrations. After some period of clip, another study will be done to look into for betterments or deterioration of the identified incident.

For noncontagious diseases such as fleshiness, besides known as the taking factor for high blood pressure and diabetes, activities will more likely be related to information airing through wellness publicity and instruction. Normally, programmes will be divided into the undermentioned classs: publicity, bar, healing and rehabilitation. This will let better consequences since this can forestall farther happening through publicity of wellness and bar, eliminates instances through healing attack and prevents decease rates through rehabilitation. Bogle ( 2007 ) states that ‘Prevention is finally the most effectual scheme. ‘ This is non merely applicable to one disease but to the remainder of the identified diseases every bit good. Catching diseases, nevertheless, does the same programmes but are a batch more extended and thorough since the rate of addition is greater compared to those diseases which are noncontagious.

Due to several attacks and schemes done by the public wellness administrations, diseases which are considered to be really damaging have been isolated and controlled. However, some of these schemes are proven to be less efficient in TB control establishing from the given chart of TB septic people in the United Kingdom.

Word count: 376

Answer 2 – 2. 1

There are current precedences in service proviso for those people infected with Chlamydia peculiarly in United Kingdom. One precedence recognized comes in increasing epidemiological surveies which involves finding the bestdiagnosticprocedure/test. Greenhouse ( n. d. ) states that:

[ T ] he hapless sensitiveness and specificity of clinical marks in diagnostic pelvic infection have long been demonstrated by laparoscopy, which is often normal despite hurting and proved infection. [ 4 ] Laparasocopy has been shown to be inaccurate when audited by fimbrial histology, [ 5 ] projecting uncertainty on the findings of some authoritative epidemiological studies. A

A more extended research and survey must be implemented in order to for good eliminate diagnostic mistakes which are proven to be one of the chief hinderances in better quality wellness attention proviso. Service enlargement late underwent a alteration through implementing a national showing plan since the assignment of such duty to the local sectors did non give out a good consequence despite the lengthy and expensive steps undertaken ( ‘Parliamentary concern ‘ , 2010 ) . The first intercession turned out to be a failure in the sense that the PCTs were n’t able to properly manage the given duty. However, this was n’t the Primary Care Trust ‘s mistake since harmonizing to the Chairman of the Committee of Public Accounts, Edward Leigh ( n. d. every bit cited in ‘Parliamentary concern ‘ 2010 ) :

… the duty for presenting a national enterprise is pushed down to local degree, with small idea about the mechanisms and intercessions needed at national and regional degree to keep efficiency and impulse.

Another precedence identified is the effectual clinical bar services and high quality sexual wellness. Prevention is ever the key to a most cost effectual scheme. Further seen precedence is most likely focused on the healing procedure since when such infection is non treated ; it can ensue to lay waste toing wellness jobs e. g. pelvic inflammatory diseases, chronic hurting, sterility.

Approaches to serve proviso for people with Chlamydia have become more approachable due to the presence of PCTs. Screening and intervention have been widely dispersed ; spreads and other necessary preparations have been continually identified and developed in order to avoid the chance of incorrect diagnosings, wrong interventions and wastage of resources. The service proviso have become countrywide and this thoroughly helped towards the end of the National Chlamydia Screening Programme ( 2010 ) which is to ‘ … run into current marks of 17 per cent testing in community outside GUM and work towards degrees of 35 to 50 per cent overall in the community and GUM. ‘

Word count: 398

Answer 2 – 2. 2

Determining the HIV prevalence rate for wellness attention proviso becomes the footing in formation of planning and activities to be implemented. Knowing the root cause of such disease incidence helps in aiming the specific issue, this assists in doing the designed programmes to go speedy and efficient. It ‘s like extinguishing the demand to travel around the shrubs by cognizing one direct responsible way. The demands needed for wellness attention proviso will ever depend on how the initial procedures turned out. For illustration, if a certain country has been found to hold an alarming figure of HIV infected instances so this would necessitate expert resources. Bing able to hold a partial mentality on the current status of the eruption can assist in apportioning the resources good, implement prioritization and supply the right information that the public demands. The ‘Human Sciences Research Council ‘ ( n. d. ) states that ‘The HIV and AIDS and STI Strategic Plan recognises monitoring and rating ( M & A ; E ) as an of import policy and direction tool. ‘ Just how expressed the schemes and methods of the UK in combating against HIV are, this is precisely how stiff the wellness attention service proviso are excessively. The degrees of HIV prevalence will state which province actions are so taken by the whole sectors and administrations involved. Consequently, this will pick the necessary demands to decently turn to the wellness concerns and the identified causes will be closely monitored, farther probe will even be done to look into whether new signifier of transmittals has developed. More preventative steps will besides be implemented since this can avoid happening.

The importance of finding the evidences for HIV disease growing besides lies in the significance of being able to properly educate the people ( portion of the demand execution scheme ) and place steps that can assist avoid such happening by educating the identified vulnerable group. Designation of steps lucifers up with the causes of HIV. In general, the relationship between HIV prevalence, causes and demands are intertwined and one country will ever look up the other country or else there will be trouble in the agencies of eliminating the job.

Word count: 349

Answer 2 – 2. 3

The impact of baccy smoke in the wellness service proviso planning in the hereafter is the addition in greater bar investing harmonizing to the ‘NAO Report on undertaking wellness inequalities: Mentions tosmoking’ ( n. d. ) . The uninterrupted addition on the figure of baccy tobacco users must hold made the consciousness run become stronger due to the version of the phrase ‘prevention is ever better than remedy ‘ . Health functionaries are cognizant of the disputing state of affairs that nicotine nuts must get the better of, that is why there is no better manner than forestalling the people from prosecuting in this sort of frailty.

One survey besides proved the necessity of fleshiness decrease in relation to the good worsening rates of tobacco users. Harmonizing to Stewart ( 2009 ) , it is necessary that both of the issues must be addressed with importance wholly because ‘If past fleshiness tendencies continue unbridled, the negative effects on the wellness of the U. S. population will progressively outweigh the positive effects gained from worsening smoking rates. ‘ This suggests that the impact of baccy smoke non merely touches one country of a wellness service programme which is the nicotine dependance obliteration since the consequence can besides destroy other wellness service concerns such as the anti-diabetes/obesityrun. Due to the ability of smoking jobs to act upon other bing wellness attention jobs, the impact to future wellness service proviso planning might ensue to a more stiff and tight policies. This can go a good land for publishing a compulsory consequence that consists of a mark end. The key to the ability of the full state to implement such ambitious actions or intercessions would come from the willingness of the wellness functionaries, administrations and squads to present the planned services and schemes immediately. We are already running out of clip since the disease tendency itself is showing a gradual addition, there shall be no more alibis made and everyone must besides be called to work hand-in-hand.

Word count: 316

Answer 2 – 2. 4

Peoples who have been enduring from fleshiness require professional aid particularly that today ‘s tendency with respects tounhealthy lifestyleeffects have been increasing. One administration that can efficaciously present out a service for free is the National Obesity Forum ( NOF ) . Most of today ‘s wellness ogranisations have been going alarmed with the deficiency of preventative steps that people must be exerting. NOF is one scheme implemented due to the dismaying disease rates, harmonizing to them:

[ tungsten ] vitamin E are peculiarly concerned with the deficiency of focal point on bar and structured direction of corpulence and corpulent persons in primary attention and the consequence this has on society. Obesity, as a disease, is an issue which affects non merely the wellness service but has a knock-on consequence for the economic system, industry, instruction and government. A

Aside from the preventative services, direction is besides one factor that needs to be taken into consideration. A batch of corpulent people are holding a difficult clip in seting to their life style ( eating wonts, exercising and etc. ) . This factor makes it so nerve-racking for corpulent patients since changing wonts can be hard. The NOF has late released a new criterion for pull offing wellness service users viz. the Very Low Energy Diets. Whichever establishment a client may take to get the wellness services needed, this criterion can be helpful since this is where other private establishments are traveling to establish their manner of attention.

Another manner of direction is the fleshiness surgery ; this can be acquired from any establishment of pick and has been proven to be an effectual manner to extinguish fleshiness although this has n’t been found to be a cost-efficient step. Harmonizing to the BBC News ( 2006 ) , other steps that can be helpful for fleshiness obliteration are the wellness cheques, inclusion of athleticss installations on lodging undertakings, free fleshiness surgery services, revenue enhancement of nutrient high in Calories and supplying rhythm lanes.

Word count: 311

Answer 3 – 3. 1

Precedences for the kids ‘s well being must be based in conformity to the common wellness issues that the younger age groups are confronting and are forecasted to be confronting. Issues that kids normally face are infective diseases, risky environment, maltreatment and malnutrition. Infectious diseases such as the H. Pylori which is normally acquired by kids in the low socioeconomic group are to be detected on kids holding the symptoms and treated early. Infectious diseases can ensue to enfeebling long term effects and hence appropriate wellness solutions such as bar and immediate remedy are of import. A risky environment can include kids holding parents who are smoking baccy on their presence, a non kid safe room construction e. g. approachable hot surface and the likes. Accidents account for a big figure of kids who are handicapped and of mortality rates. The Child Safety Week ( 2010 ) provinces:

[ s ] erious accidents can do hurts to kids that take months or old ages to mend. The psychological harm caused to kids and their households frequently lasts a life-time. Yet many of these accidents can be prevented by taking merely a minute, to travel a hot drink, look into a fume dismay, lock the medicine cabinet, exchange off the drier or take your pes off the gas pedal.

A great trade of attending must besides be given to this country in order to protect the kids really good. Abuse is another issue that does n’t merely ensue to physical hurt but injuring including the emotional facet of the kid. Health services such as theChild ProtectionAgency are the animal trainers of this issue and services provided are non merely limited to one country since this require a uninterrupted and multi service proviso.

Another wellness status that is rather taken for granted is the malnutrition issues that kids are confronting. Fleshiness is going a major concern and most of the instances involved people who have been overweight since birth. There ‘s no better manner than turn toing the job by aiming the early ages since control is still better handled compared to corpulent people who are already populating a considerable sum of old ages in their life. Generally talking, all of these wellness jeopardies can be decently managed, controlled and prevented by the community attention establishments that are responsible for attention proviso. Equally long as programs, intercessions and ends are all taken earnestly, wellness precedences for kids will be met.

Word count: 392

Answer 3 – 3. 2

The effectivity of policies implemented for the well being of the kids can be seen on the incorporation of Torahs to Centres which involve kid attention. Several bureaus which are regarded as a large subscriber to implementing kid wellness attention were besides being tapped and now are presently working together in one end. Harmonizing to Great Britain Department for Children, Schools and Families ( 2010 ) , partnerships of administrations have been structured and designed in order to let early incorporation of kid wellness attention services, this includes the engagement of PCTs and other local wellness governments. Due to the alterations made in the wellness continuity attention scheme, several services peculiarly those which targets kid attention have been found to be really effectual. Alterations besides resulted to the birth of other policies or polish of regulations in order to make a better manner of attention proviso.

However, although some of the schemes and systems have been found to be effectual in covering with the jobs refering the kids, there are still several countries that call out for immediate and stiff intercession. Such instances would include betterment of results for looked after kids and bettering coaction with wellness sectors. These countries have proven to be rather unsatisfactory in run intoing the desired results. Governments have been invariably happening ways in order to advance the schemes which were being set. Parental support is besides incorporated as a manner to efficaciously turn to the issues of the kids ‘s public assistance. Community programmes have been invariably monitored and being remodeled particularly on today ‘s turning crisis. The manner of attention is being matched up with the current state of affairs in order to increase the feasibleness of the designed programs, schemes, policies and systems. Overall, the impact of the ordinances that are set in order to increase the advancement of results on the kid ‘s attention has been reasonably effectual. Several ordinances need to be reconstructed and reviewed while other policies need more action.

Word count: 317

Answer 3 – 3. 3

Several alterations still need to be implemented for the kids ‘s good being. These alterations include ‘promoting the societal and emotional well-being of kids in primary instruction ‘ ( National Institute for Health and Clinical Excellence, 2008 ) , educational information airing aiming kids ‘s parents, societal reform, restructuring of inter organizational cooperation and broadening of societal programmes on communities. The primary instruction has been considered to be one of the important phases of kids since this is the point where their values are being honed and how their emotional response is being triggered by the legion societal elements present in their environment. Human behavior is shaped harmonizing to how people are being raised and the constitution of a more sold foundation is the key to diminish wellness behaviors which are really unsafe.

Educating parents must besides be done in every community since this is one of the effectual ways to assist and steer the direct carer of the kid ‘s well-being. Social workers must besides concentrate non merely to the kid ‘s status entirely but besides in looking after how his/her environment has been impacting the kid. Rearing programmes and activities in coordination with other worker administrations can be done since this can assist employers go sensitive to the demands of their workers. The current environment right now is already necessitating alone ways to near every quandary. Pressures coming from the working environment that are impacting every workingfamilyparticularly parents are really much affected with this type of state of affairs. There is excessively much demand from work go forthing other duties in life abandoned which are seen to be purportedly a batch more of import. We can non deny the importance of occupations now a yearss and pretermiting them on the other manus is neither the best option. The greater solution would be to let the different sectors to fall in together and collaborate so that each side will be reasonably heard, considered and met. Having this done, we can state that a societal reform and inter organizational linkages have been built. Adopting a “ kid friendly ” logo in all countries can perfectly assist decrease the load that kids are now unconsciously confronting.

Word count: 350

Answer 3 – 3. 4

Note: Please mention to the tabular array cited in Appendix C [ page 22 ]

Inculcating the significance of exercising early on the kid ‘s life style non merely increases their well-being during theirchildhoodyearss but it besides allows them to be acquainted with such wellness health pattern. Even during the kid ‘s babyhood, inactive exercising had already been found to be a really effectual manner to develop the kid ‘s muscular and skeletal growing. Primary kids are particularly known to be hyper active in footings of activities and doing exercising as one of their daily activities can assist them non merely physically but in all facets. One of the ends enumerated is the importance of the kid to show a positive attitude towards exercising ; this can promote the kids to go concerted and it helps construct a positive consequence on them therefore leting them to love the feeling of holding their organic structures on the move. Teachers must besides ever indicate out what advantages they will be acquiring in a simple mode or in a method wherein kids would appreciate and understand. This can be done by puting a image of a kid ‘s organic structure in a board while exerting ; every motion would so be matched up with the certain portion of the organic structure that has benefited the move.

Implementing a particular hebdomad for a household athleticss fest wo n’t merely aim the kids ‘s well-being but it besides fosters parental or household bonding. This can be made successful by inquiring coordination with household administrations that exists in a community. Social community attention administrations or sectors can besides be invited and let this chance to go portion of the pilot testing of the effectiveness of the planned plan. This sort of activity can assist both related sectors to work together and go one or unified on their end. It besides increases the effectiveness of the ends targeted for the different sectors involved. Continuity of the exercising activity can even travel every bit far as holding interscholastic competitions ; this can be introduced to primary and third degree establishments.

Word count: 325

Mentions

BBC News, 2006. Obesity ‘could ruin the NHS ‘ [ Online ] . Available at: hypertext transfer protocol: //news. bbc. co. uk/2/hi/health/6180991. stm [ Accessed 26 July 2010 ]

Bogle, V. , 2007. Haringey Obesity Strategy 2007-2010 [ Online ] . p. 12. Available at: hypertext transfer protocol: //www. haringey. nhs. uk/services/specialist/care_pathways_and_guidelines/obesity/obesity_strategy_adults. pdf [ Accessed 26 July 2010 ]

Child Safety Week, 2010. The ‘Make clip for safety ‘ theme [ Online ] . Available at: hypertext transfer protocol: //www. childsafetyweek. org. uk/child-safety-week/ [ Accessed 26 July 2010 ]

Great Britain Department for Children, Schools and Families, 2010. Certain Start kids ‘s Centres: statutory counsel: response to the audience [ Online ] . London: Great Britain. Department for Children, Schools and Families. Available at: hypertext transfer protocol: //www. scie-socialcareonline. org. uk/profile. asp? guid= 5bcdbe7b-0d02-46f4-a984-33f856a7ef34 [ Accessed 26 July 2010 ]

Greenhouse, P. , n. d. The 4th Bandolier Conference: Chlamydia. Positions from the infirmary [ Online ] . Available at: hypertext transfer protocol: //www. medicine. ox. ac. uk/bandolier/bandopubs/bandocon4/chlamyd. html # Heading4 [ Accessed 26 July 2010 ]

Health Protection Agency, 2010. What the Health Protection Agency Does? [ Online ] . Available at: hypertext transfer protocol: //www. hpa. org. uk/AboutTheHPA/WhatTheHealthProtectionAgencyDoes/ [ Accessed 25 July 2010 ]

‘Human Sciences Research Council ‘ , n. d. Social Aspects of HIV/AIDS and Health [ Online ] . Available at: hypertext transfer protocol: //www. hsrc. ac. za/SAHA. phtml [ Accessed 26 July 2010 ]

‘NAO Report on undertaking wellness inequalities: Mentions to smoking ‘ , n. d. Key Recommendations [ Online ] . p. 1. Available at: hypertext transfer protocol: //www. ash. org. uk/files/documents/ASH_736. pdf [ Accessed 26 July 2010 ]

‘National Chlamydia Screening Programme ‘ , 2010. Commissioning [ Online ] . Available at: hypertext transfer protocol: //www. chlamydiascreening. nhs. uk/ps/commissioners/summary. html [ Accessed 26 July 2010 ]

National Institute for Health and Clinical Excellence, 2008. Promoting kids ‘s societal and emotional well-being in primary instruction [ Online ] . p. 3. Available at: hypertext transfer protocol: //www. headsupscotland. co. uk/documents/PH012Guidance. pdf [ Accessed 28 July 2010 ]

National Obesity Forum, n. d. Welcome to the National Obesity Forum [ Online ] . Available at: hypertext transfer protocol: //www. nationalobesityforum. org. uk/ [ Accessed 26 July 2010 ]

‘Parliamentary concern ‘ , 2010. Report examines chlamydia testing plan [ Online ] . Available at: hypertext transfer protocol: //www. parliament. uk/business/news/2010/01/report-examines-chlamydia-screening-programme/ [ Accessed 26 July 2010 ]

Stewart, S. , Cutler, D. & A ; Rosen, A. , 2009. The New England Journal of Medicine. Forecasting the Effects of Obesity and Smoking on U. S. Life Expectancy [ Online ] . 361, p. 2252-2260. Available at: hypertext transfer protocol: //www. nejm. org/doi/full/10. 1056/NEJMsa0900459 [ Accessed 26 July 2010 ]

Wild, S. , Roglic, G. , Green, A. , Sicree, R. & A ; King, H. , 2004. Diabetes Care. Global prevalence of diabetes [ Online ] . 27 ( 5 ) , p. 1048. Available at: hypertext transfer protocol: //www. who. int/diabetes/facts/en/diabcare0504. pdf [ Accessed 30 July 2010 ]

World Health Organization, 2010. Global Tuberculosis Control WHO Report 2009 [ Online ] . p. 145. Available at: hypertext transfer protocol: //apps. who. int/globalatlas/predefinedReports/TB/PDF_Files/zaf. pdf [ Accessed 29 July 2010 ]

World Health Organization, 2010. Prevalence of Diabetes [ Online ] . Available at: hypertext transfer protocol: //www. who. int/diabetes/actionnow/en/mapdiabprev. pdf [ Accessed 29 July 2010 ]