SH5008QA –  Advancing the Health of the Population

SH5008QA – Advancing the Health of the Population ASSESSMENT BRIEF

For SH5008QA Assignment, you must choose ONE question from the list below:

What are the most effective, evidence based public health initiatives (EBPH) to reduce smoking in high-risk populations in [chosen country]?

The most effective and evidence-based public health initiatives for the reduction of smoking among high-risk populations across the UK involve tobacco taxation, targeted services for smoking cessation, smoke-free legislation, and approaches for reducing harm from smoking.

In this direction, increasing tobacco taxes is amongst the strongest interventions. In the view of the UK Government, tobacco taxation has played a significant part in lowering smoking prevalence. The taxation has discouraged consumption of cigarettes among young people and has also promoted smoking cessation among smokers having low-income. In addition, the smoking prevalence in England dropped from 19.8% in 2011 to 11.9% in the year 2023 (GOV.UK., 2024).

Furthermore, targeted NHS Stop Smoking Services are specifically effective for disadvantaged groups. Moreover, evidence reveals that behavioural support in integration with pharmacological treatments like Nicotine Replacement Therapy (NRT), e-cigarettes or varenicline, significantly increases the success rate for smoking cessation as compared to unaided attempts (NIHR, 2021).

In addition to this, the prevalence of smoking is disproportionately high among individuals who have severe mental illness, reaching about 25–30%, as compared to 13.6% among the general adult people (GOV.UK., 2024a). Further, combining smoking cessation interventions with mental health services is increasingly prioritised.

Further, mass-media campaigns like Stoptober have also revealed high efficiency. Public Health England revealed that 1.5 million attempts to quit smoking are associated with the campaign in the initial ten years (GOV.UK., 2017).

Moreover, for reducing smoking inequalities, resources need to be concentrated in deprived communities where the prevalence of smoking is nearly double that of the least deprived areas (Mabhala et al., 2025). In /;/o}()9]addition, continued investment is needed for defining cessation support and tobacco-control policies (Bafunno et al., 2020).

How can a health-in-all-policies approach improve breastfeeding rates among mothers in (chosen country)?

A Health-in-All-Policies (HiAP) approach can enhance the rate of breastfeeding by addressing barriers across employment, healthcare, education, and local government in a simultaneous way. Moreover, the initiation of breastfeeding in England is relatively high, with about 74% of mothers having started breastfeeding. However, only 48% of females continue breastfeeding between 6 and 8 weeks. Moreover, exclusive breastfeeding at six months is below 1%, despite the recommendations defined by the WHO (Nuffield Trust, 2025; GOV.UK., 2024b).

Further, the healthcare policy needs to ensure universal deployment of the UNICEF Baby Friendly Initiative, which is closely related to increased initiation of breastfeeding and duration. Moreover, consistent support from health visitors, midwives and maternity staff also raises the maternal confidence and continuation of breastfeeding (UNICEF, 2026).

Moreover, employment policies are equally significant, as research indicates that returning to work is a key reason for early cessation of breastfeeding. Extension of the flexible working arrangements, facilities for breastfeeding at the workplace, and paid maternity leave would assist mothers in preserving breastfeeding for a prolonged time (Vilar-Compte et al., 2017).

In this relation, local authorities can contribute to offering funding to peer-support programmes as well as design breastfeeding-friendly public spaces. Moreover, evidence also suggests that mothers who receive peer support have more chances for continuing breastfeeding for more than the first six weeks (Paranjothy et al., 2017).

In this context, the educational policies need to increase public understanding about the benefits of breastfeeding and reduce the social stigma. Further, breastfeeding minimises the risks of gastrointestinal infections among infants, respiratory infections, along with childhood obesity while reducing the maternal risks associated with breast and ovarian cancer (Obeagu and Obeagu, 2024). Adding further, coordinated action across all sectors is needed to meet the structural barriers that presently disrupt the continuation of breastfeeding in the UK.

What are the most significant social determinants of health (SDH) that are standing in the way of achieving the NHS Long Term Plan childhood obesity reduction targets, and what should be done to improve on these?

Socioeconomic deprivation is understood as the greatest barrier to the achievement of the childhood obesity targets defined in the NHS Long Term Plan. In this relation, it is reported by the National Child Measurement Programme that children in the most deprived regions have more than twice the chances of getting obese compared to those in the less deprived areas (Strugnell et al., 2020).

Further, food insecurity is also a significant contributor as low-income families have more chances for buying cheaper and energy-dense foods, which are high in fat, salt and sugar content (Penne and Goedemé, 2021). Moreover, the local food environment also aggravates inequalities, where deprived communities often experience a higher concentration of fast-food outlets with fewer food options that are affordable and healthy (Beydoun et al., 2026). In addition, limited access towards secure parks, active transport routes and sports facilities also minimises the chances of any physical activity (World Health Organization, 2019).

Moreover, for improving outcomes, government action needs to emphasise extending free school meals as well as healthy food subsidy programmes for low-income families (Cohen et al., 2023). Further, strict restrictions on the unhealthy food advertising for children, along with the planning of controls on fast-food stores near schools is also required (Dalton et al., 2017). In addition to this, investment in secure recreational facilities and active travel infrastructure also needs to promote physical activity. Furthermore, addressing poverty and environmental inequalities is also important for cubing the childhood obesity at a scalable level (World Health Organization, 2019).

How can the COM-B model be applied in a health promotion campaign approach to tackling rising rates of chlamydia and gonorrhoea infection amongst young people in the UK?

The COM-B model can help in minimising chlamydia and gonorrhoea infections among young individuals by increasing capability, opportunity, as well as overall motivation (McDonagh et al., 2018). As per the UK-based Health Security Agency, individuals between the ages of 15 and 24 account for 85,757 diagnoses for chlamydia and about 19,114 diagnoses for gonorrhoea in England in 2024 (GOV.UK., 2025).

In this regard, capability can be enhanced by sexual health education, which increases knowledge regarding symptoms of Sexually Transmitted Infection (STI), use of condoms, asymptomatic infections, and regular testing (Khanna and Gobin, 2025). Further, social media campaigns can be effective for delivering this information to young individuals (Dix et al., 2022).

In addition, opportunity can be improved by offering free condoms, extending access to confidential sexual health clinics, as well as enabling online self-sampling services. Further, options for convenient and anonymous testing are also effective in increasing screening approval (Aicken et al., 2016).

Further, motivation can be improved by campaigns that normalise STI testing and decrease stigma. Moreover, peer-led interventions and influencer campaigns can also foster secure sexual behaviours and raise the intentions for testing (Sun, Wong and Wong, 2017).

In this context, deployment of a COM-B-based campaign integrating education, accessible testing services, as well as positive behavioural messaging tends to have more chances for increasing use of condoms, improving the overall testing rates, and minimising the chlamydia and gonorrhoea infections among young individuals living in the UK.

The SH5008QA essay structure is open and creativity is encouraged. Students will collaboratively develop an essay structure for each question, which they will further develop individually and submit to their tutor, on which they will receive formative feedback. Each question is centred around a key theoretical framework or model in public health and this must be explored and applied in the essay. 

Some general suggestions on the development and structure of your SH5008QA essay:

• Introduction
• Provide necessary key definitions
• Provide contextual background information relevant to your topic, using relevant public health datasets and policy
• Provide solutions, answers, and recommendations to your essay questions, applying key theory and literature to explain and justify your thinking
• Conclusion

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