1

TOBACCO SMOKING AMONG YOUNG ADULTS IN BARKING AND DAGENHAM

by [Name]

Course

Professor’s Name

Institution

Location of Institution

Date
 2

INTRODUCTION

The HNA explores an emerging concern of cigarette smoking by youth in their

adolescents years, mainly aged between eighteen and twenty four years in London boroughs of

Barking and Dagenham. These are intended to evaluate the extent to which this group of people

smoke and the reasons for it as well as adverse effects on their well-being. This appraisal relies

mainly on data and perceptions from trustworthy institutions including CDC, PHE, and

WHO. The HNA will investigate the intricate aspects of tobacco smoking, such as the

socioeconomic, demographic and environmental conditions that drive it with a view to

supporting evidence-based interventions. This report highlights some of the direct and indirect

effects that smoking have on youths and suggests solutions supported by research data. The

HNA calls for a comprehensive approach that requires participation by healthcare professionals,

schools, community organizations, and policymakers to advocate for a collaborative solution. In

the end, the evaluations will serve as an avenue for formulating strategies geared towards

promoting the well-being, and general health of adolescents in Barking and Dagenham hence

providing a way forward through which informed decisions can be made about public health.

CHAPTER 1 : ACCOUNT OF THE CHOSEN LOCAL AREA/AUTHORITY (BARKING

AND DAGENHAM)

Barking and Dagenham is an East London borough with a diverse population. It is

comprised of different ethnicities such as black, Asian, and Minority Ethnic (BAME). The young

adult population aged 18-24 is highly influential to a vibrant borough like Barking and

Dagenham(Moore et a.,2023, p.100172).Other than that, there is strong sense community

involvement among residents living in Barking and Dagenham. Various cultural celebrations are
 3

conducted within these areas thus presenting the diversity of practices. However, it still has

pockets of deprivation and social inequalities that influence its overall wellbeing especially for

younger people.

Figure 1:aerial view

Tobacco control is a central thing in order for Barking andDagenham to achieve its aim

and objective of becoming a healthy borough.In order to achieve this goal, we need to take out ill

health as a result of smoking. People living in Barking and Dagenham do not have good health

which they can be proud of. They are dying at relatively young ages from cancers, heart diseases

and other long term conditions when compared to other areas of the country. Addressing health

inequalities and their root causes forms part of the collective responsibility of promoting the right

to life, increasing life expectancy, protecting all our residents especially children.At present the
 4

smoking prevalence in Barking and Dagenham is 20.4% which equates to approximately 35,337

smokers. This compares poorly with London’s and England’s rates thus showing that smoking

leads to many more health problems in the borough than any other burden does. Every year

smoking costs the local economy approximately £52.8 million.Smoking is still one of London’s

highest public health issues when it comes to Barking and Dagenham hence there is a need for

further efforts aimed at reducing smoking rates across the borough. Barking and Dagenham are

currently ranked fifth on London’s list of high prevalence of smoking, but now that it is no

longer top-ranked in London, there is still much work left.Such factors as this are why smoking

leads to a high proportionate mortality among under-75s in Barking and Dagenham.The highest

mortality rate for people aged 35 years and over due to smoking is recorded in Barking and

Dagenham above the national average.The number of deaths from cancer among those under 75

years has been falling in.

Figure 2:smoking demograph of young people

 5

In Barking and Dagenham; however, lung cancer death rate per 85.1 per 100,000 remains

higher than average.smoking accounts for around 17% of deaths from heart disease, and over

80% of deaths from chronic obstructive pulmonary diseases such as bronchitis and emphysema.

Smoking also causes birth defectsiii, impotence and sperm abnormalities in men..

Barking and Dagenham continues to face socio-economic challenges despite welcoming

development efforts targeting local economy.Nothing much has changed since unemployment

level remains high while educational achievements have remained stagnant among some cohorts

of young adults leading to disparities in terms of health status. Many people are also worried

about their ability to access affordable houses.The combination between lifestyle choices,

socioeconomic factors and access to medical care influences the health outcomes among young

adults living in this region. One citation would be smoking prevalence among this age group

which is known to cause long-term chronic conditions. Furthermore, mental health problems are

worsened by socio-economic factors hence impacting negatively towards young people’s general

welfare.

The CCGs along with Health Commissioners in Barking and Dagenham are focused on the

peculiar health issues of young adults that smoke tobacco. Clinical Commissioning Groups

(CCGs) and health commissioners prioritize addressing the tobacco smoking challenge among

18-25 years old young people in Barking and Dagenham. In doing so, they advocate preventive

measures as well as education programs for this age bracket to enable them to be aware of the

dangers of using tobacco. This also involves working with schools and colleges to integrate anti-

smoking messages into the curriculum and arrange awareness campaigns. Consequently, health

commissioners work closely with local organizations, community leaders, and youth groups to

ensure that there is a supportive environment for anti-smoking efforts. Moreover, affordable
 6

accessibility of cessation services both traditionally and digitally is very important. Thus, socio-

economic characteristics that may have contributed towards these behavioural patterns include

allocation of resources to all people without consideration of economical challenges.

Tobacco smoking rates among young people are regularly being monitored while

researches are being conducted to determine the factors that contribute towards such behaviors

so as to guide decision making based on evidence. This has been facilitated through collaborative

endeavors with other stakeholders such as non-governmental organizations and local government

authorities which have enabled coordination of efforts needed in curbing tobacco smoking

menace. Lastly, comprehensive approaches towards disease prevention could be achieved

through evaluation of interventions against smoking using specifically-targeted public awareness

initiatives.

Figure 3:percentage of young kids smoking

Intervention measures, smoking cessation plans, and counseling services for mental

health rank highest when it comes to resolving problems associated with young adult smokers. In
 7

addition, they also emphasize on the importance of collaboration with local community

organizations and educational institutions towards creating holistic approaches to healthcare.

Several recent initiatives specifically target reducing tobacco use among 18-24 year-olds living

in Barking and Dagenham.

long-term and current issues that affect the health of its residents in Barking and

Dagenham, which being a distinctive local area have experienced changes. One of the challenges

facing this borough is the high rates of smoking among 18-25 year olds. In this regard, the

community has had to grapple with a persistent issue that necessitated targeted interventions and

an over-arching approach to bringing down smoking levels and improving people’s health. The

borough must therefore tackle these misconceptions about tobacco use and address any cultural

factors that may contribute to the normalization of smoking.

Figure 4:causes and impact of smoking

 8

However, recent transformations bring forth various opportunities and challenges as well.

Nonetheless, one can see ongoing activities aimed at de-normalising smoking culture through

education initiatives in local schools, colleges and communities. This preventive message model,

phased according to different educational stages shows their commitment towards addressing

their unique needs amongst young people. Focusing on selected high prevalence wards indicates

how responsive local health bodies are towards varying health interests across different parts of

Barking and Dagenham.

Some of these strengths include its commitment for members’ involvement in the

community and spartnerships with different stakeholders like councils, NGOs or youth schemes.

Emphasizing accessible services as well as branding for young persons recognizes that

interventions need to be adapted to meet diverse needs among this category of individuals. For

instance, secondary schools and colleges pilot smoking cessation services in order to identify

upcoming smokers through early intervention.

Despite these strengths there are some areas which need improvement as well. However,

monitoring NICE harm reduction guidance only addresses fragmentary problems while ignoring

changing health recommendations for other matters. Moreover, socio-economic factors

underpinning smoking remain intricate hurdles needing consistent efforts towards equitable

access to cessation resources. Barking and Dagenham is a special locality grappling with tobacco

use by young adults that has both past problems as well as new developments affecting overall

population health status. The highlights in the area are focused on community involvement,

tailor-made interventions and early prevention programs while the disparities that exist in

cultural beliefs, health guidance and socio-economic conditions have not been fully addressed.

Ultimately, it is necessary to ensure that any ongoing interventions in Barking and Dagenham
 9

take into account both historical context and present initiatives for long-term population health

change.

CHAPTER 2: THE PROBLEM (THE HEALTH NEEDS): TOBACCO SMOKING

AMONG YOUNG ADULTS IN BARKING AND DAGENHAM

Tobacco smoking among young people aged 18-24 years old in Barking and Dagenham

is the most prominent. The prevalence and incidences of the tobacco use is the data that can be

obtained from existing HNA reports, Public health profiles, and CDC. Looking at trends, it

becomes clear whether or not a problem increases or decreases over time.Locally, there are

clusters of smokers in the borough with regard to the spatial distribution of tobacco smoking.

However, ethnic, age, and socioeconomic patterns also give deeper insight into what determines

this behaviour among some people. The interaction between these spatial patterns can be

analysed using PHE data and borough council information to enable a tailored focus for

intervention strategies
 10

Figure 5:2016 smokers location

Prevalence of Tobacco Smoking

A major concern in Barking and Dagenham is the high prevalence of tobacco smoking

among young adults. This habit is so general that it threatens the immediate and long-term health

of the people living within the society(Government of UK,2023,p.2). Moreover, as they suffer

from problems like chronic bronchitis, persistent coughing, and diminished lung function, young

smokers are adversely affected by this persistent illness which affects their lives on a daily basis.

Additionally, tobacco smoking greatly increases the risk of cardiovascular diseases like

hypertension and blood clot formation thus threatening the heart health of young adults within

the locality. Probably most worrisome are its lifelong implications since such uses predispose to

many forms of cancer especially those affecting lungs and throat. Also, weakened respiratory
 11

system caused by smoking makes one vulnerable to respiratory infections leading to an

additional burden on healthcare resources. Moreover, tobacco smoking among youths carries a

social-economic burden to the community prompting interventions by health commissioners.

What is crucial at this point is that it should be a comprehensive approach involving programs

for cessation of smoking, educational campaigns and community engagements that will help

reduce tobacco use among others things so as to improve overall health and well-being of local

population.

socio-economic Factors

The socio-economic fabric of Barking and Dagenham plays a key role in the prevalence

of tobacco smoking among young people, which in its turn has a great impact on the general

health status of the community they live in(Fardghassemi and Joffe 2021). The nexus between

low income levels, restricted educational opportunities and high unemployment rates creates a

situation where there is fertile ground for higher levels of tobacco use among the youth.

Economic challenges faced by individuals with low income can increase stressors making them

adopt smoking as a way to deal with stress; thus increasing the incidence.Poor educational

opportunities are an additional issue since deprived access to comprehensive health education

leads to a lack of awareness concerning harmful impacts of tobacco smoking. Also, this study

revealed that higher community unemployment rates not only lead to financial pressures but also

contribute to a context where tobacco use becomes socially acceptable or helps with coping

strategies during stressful times.

Realization and resolution of these socio-economic determinants are fundamental

prerequisites to any meaningful strategy aiming at improving health. Strategies targeting

 12

economic upliftment, increased access to education, minimizing employment rates should be part

of comprehensive approach towards reducing smoking prevalence among youths. Economic

empowerment activities can ease financial burdens while educational programs enhance

knowledge on dangers related to tobacco such that it creates an educated society which makes

healthier decisions.

Considering socio-economic factors is consistent with overall health improvement. Public

Health practitioners and policy makers who address these determinants are not just dealing with

immediate problem of smoking but contributing towards peoples’ well-being within Barking and

Dagenham boroughs. This holistic approach describes how social and economic factors interact

with health outcomes, implying that interventions have to go beyond individual behaviors toward

wider changes leading to long term population health improvements.

Access to Healthcare Services

Accessibility and availability of healthcare services are crucial determinants of health

outcomes in the context of tobacco smoking among young adults in Barking and Dagenham. The

ability to access smoke cessation programs and mental health support is crucial in helping

individuals stop smoking. It is therefore possible to use the availability of these resources as a

pointer to the successiveness of health interventions. This way, health commissioners will be

required to evaluate how far existing healthcare services are reaching for anyone in the

community that wants help quitting tobacco.

Marketing and Advertising

Public health officials are concerned about the influence of tobacco advertising and

marketing strategies on young adults in Barking and Dagenham. It also includes advertisements
 13

directed towards youth that could normalize or glamorize smoking behaviors when they are

exposed to them. This paper details the role such influences play in designing effective public

health campaigns and interventions so that they can work better. Additionally, commissioners

should impose strict rules and counter-marketings to limit the power tobacco adverts have over

kids thereby making a healthier society.

Community Engagement and Education

The community involvement level and awareness about dangers of smoking tobacco plus

available cessation resources cannot be overestimated. Proper education programs, as well as

community activities, act as good ways to prevent further increase or even reduce tobacco usage

for young people. Commission should always assess whether these initiatives align with what

their target audience is thinking. With more informed communities, public health officers can

build an environment that provides people with useful information when it comes to deciding

whether to smoke or not while promoting better practices.

Longstanding or Recent Changes

Studies shows that looking at long- standing or recent changes concerning policies,

economic situations or social factors influencing tobacco use helps when creating targeted

interventions(Tucker-Seeley et al., 2019, pp.S88-S93). A locality’s laws regulate whether

smoking rates decrease or go up among Barking juniors who continue getting fatter every day;

besides this is a dynamic society. As such, health commissioners must be watchful and tailor

their strategies to the current tobacco use landscape in the community.

Strengths and Weaknesses of Existing Interventions

 14

Assessing existing interventions is a crucial step in addressing tobacco smoking among

young adults. It has provided improvements on where weaknesses have been observed from

ongoing campaigns against tobacco. This way, health commissioners can identify interventions

that work well and those that need to be improved upon to suit the particular local needs and

challenges.

Collaboration with Stakeholders

To ensure a comprehensive approach towards addressing smoking of tobacco, there is

need for collaboration between health commissioners, local authorities, schools, community

organizations among other stakeholders. Such a move will help in ensuring that resources are

brought together properly and strategies designed to attend to the many factors surrounding this

subject matter. Partnerships fostered by public health officers help them utilize various

competences and resources thereby affecting the overall efficiency of tobacco control programs.

Health Inequalities

It is important to deal with health inequalities of the area in relation to fairness in health.

By knowing the difference between social-economic groups and different demographics, it can

be tailored to suit every resident’s health care needs and resources. Barking and Dagenham’s

health commissioners can focus on attaining health equity that will help them reduce disparities

on tobacco use prevalence as well as other related health outcomes for young adults.
 15

CHAPTER 3: THE CURRENT INTERVENTIONS (CURRENT HEALTHCARE

SERVICE PROVISION AND UTILISATION)

A commitment to holistic care and preventive interventions aimed at reducing tobacco

smoking among young adults aged 18 to 25 years is reflected in the current healthcare service

provision in Barking and Dagenham. Primary healthcare providers are leading the way by

offering smoking cessation programs and advice for this age group. The success of these

services, however, depends on usage rates among young adults, which is a demographic that

generally develops smoking habits. According to studies conducted, a decline in overall tobacco

consumption has been witnessed in England; hence the interventions are geared towards creating

an environment that discourages young people from smoking through awareness programs,

cessation support as well as efforts to reduce availability and affordability of tobacco products

(World Health Organization, 2023).

Services provided

The current healthcare service provision in Barking and Dagenham illustrates a whole

systems approach to reducing smoking by tobacco among 18-25 year olds. Primary care has

taken the lead through cessation offers and individual information targeted specifically for this

group. This is achieved through preventive interventions that involve holistic care and

community-based initiatives, going beyond conventional clinical settings into

communities(Government of UK,2023,pp.22). School programs are important in fighting against

smoking throughout different educational levels. The level of prioritization is dynamic, with

particular focus on the most affected wards within the local authority. Concerted efforts are also

made towards busting myths about tobacco, addressing concerns over illegal supply chains,
 16

alternative substances, and side effects. The ongoing monitoring of NICE harm reduction

guidance and research ensures that interventions follow evidence based practices by adapting

strategies to changing health recommendations. Community engagement activities include

working with various youth schemes to reinforce messages on preventing tobacco use as well as

meeting most vulnerable young people’s needs within the locality. Services could be reached

through branding specific for young people such as piloting smoking cessation services in

secondary schools and colleges. Empowering young individuals to become Young Health

Champions represents a proactive approach to advocacy for tobacco control and healthy

lifestyles. The outlined communication approach involves developing exemplary strategies for

different target groups, including young people, faith groups, BME communities, routine and

manual workers, individuals experiencing mental health conditions, and pregnant women. To

sum up, there are multifaceted interventions delivered across different levels which build a

comprehensive and targeted response towards youth smoking in the local area.

The Level the Services are provided

In Barking and Dagenham, health care for 18-25 year-olds who are smoking tobacco is a

current provision offered at different levels. Primary health care services are the first point of

contact offering stop smoking programs and tailored advice that reflect the interests of this age

group. It is at the primary level where these services take place ensuring convenience and direct

contact with the health professionals.Besides clinical settings, efforts on preventive measures and

community-based initiatives are extended to community spaces and schools. School programs

aimed at destigmatizing smoking are instituted in different academic institutions starting from

primary schools to thosse that offer tertiary education. In order to provide targeted interventions,

the local authority prioritizes certain wards.

 17

The school-based educational initiatives address misconceptions about tobacco use with

reference to things like illegal supply chains, alternative substances, and side effects.This

education outreach encompasses several levels within communities so that diverse populations

get informed.Continuous compliance with NICE harm reduction protocols and monitoring of

research helps in keeping pace with intervention strategies that are in line with recent evidence

based practices. This kind of monitoring takes place strategically across the organization thereby

providing an opportunity for changing health recommendations as they evolve.

Through partnerships with youth projects, community engagement activities are carried

out at this level.These schemes include reiterating messages on preventing tobacco use among

young people who live in vulnerable neighborhoods.The services are being made easily available

to young individuals through targeting branding specifically meant for their age group such as

piloting smoke cessation service within secondary schools and colleges. The choice of this

measure ensures that services reach individuals within the educational systems who will reap

from it most.

Young Health Champions empower young people to act as advocates for tobacco control

and healthier living lifestyles. On a grassroots level this empowerment fosters leadership abilities

in addition to advocacy skills among these generations.The present healthcare system in Barking

and Dagenham provides healthcare at primary care, community, educational, and neighborhood

or grassroots levels. This multi-tiered approach is aimed at a comprehensive and focused attack

on tobacco use by young adults that takes into account the peculiarities of the local society.

The level of services utilisation by the population target group

 18

To assess the effectiveness of any current smoking interventions among young adults

aged 18-25 years in Barking and Dagenham, it is essential to consider the level of services

utilization by the target population.This in turn helps to determine how much each service is

utilized by whom and how regularly, consequently providing feedback on their impacts and

overall success of the programs.While there may be some variation in utilization rates,

generalized participation from this age group should be encouraged. However, when they choose

to quit smoking, young adults often seek help at primary healthcare facilities where smoking

cessation programs are provided together with personal advice.The outcomes of these campaigns

are determined by whether this young audience actively engages with these services or

not.Utilization levels for school-based programs depend on the effectiveness of educational

efforts towards de-normalizing smoking. The expectation is that youth across different education

levels including primary schools to further education institutions will participate actively and

receive prevention messages that are relevant to their age groups.

For community-based initiatives as well as collaborations with youth schemes, this

utilization level hinges on whether young people are engaged outside the school system. They

serve as avenues for repeating messages about tobacco prevention targeting vulnerable youths.

The success of these initiatives depends greatly on participation by target populations in

community events and programs.

Also branded specifically for secondary schools and colleges, these services aim at being

piloted for use by young adults within those learning institutions. Accordingly, when developing

cessation services aimed at this demography, they must ensure that they make them easy to

access besides being attractive increasing usage rates.Young persons will only become Young

Health Champions depending on their willingness to participate in advocacy for tobacco control
 19

and health living. In this case, the level of utilization reflects how involved young individuals are

in roles of leadership and promoting good health behaviors among other people within their

surroundings.

To facilitate active searching for available healthcare provision among young adults

continuous monitoring and evaluation of service utilization is necessary so that factors restricting

such efforts be identified. Thus, understanding of the reasons affecting the utilization will enable

health care providers and policy makers to optimize them in line with the needs of the population

under target.

Evidence Explaining Service Provision and Utilization in Barking and Dagenham

The evidence base for service provision and utilization in Barking and Dagenham to

address smoking among young adults aged 18-25 years is a comprehensive approach with the

use of various indicators that assess the effectiveness of interventions. Primary healthcare

services are key, evidenced by monitoring how many people have used smoking cessation

programs and personal advice in these settings. High utilization rates show that young people

who use these services have similar preferences. Attendance, engagement and participation

levels are used to evaluate educational programs as proof of the effect of preventive messages.

Community engagement initiatives can be gauged by evaluating participation rates on events as

well as collaborations with youth schemes. The success of branded services within learning

institutions is monitored through enrolment numbers and usage, which act as indicators of their

effectiveness in reducing smoking prevalence. Tracking active involvement in advocacy and

leadership roles is proof that Young Health Champions are empowering young individuals. Thus,

continuous ongoing evaluation and monitoring should examine trends and barriers, thus giving
 20

evidence that interventions had to adapt themselves to the ever changing health needs. In

conclusion, the evidence confirms that current services provided are effective for addressing

health problems among young adults especially those related to tobacco smoking rates reduction

and positive changes in behavior within the community.

Identification of Unmet Health Needs

While there are many interventions in place to address the problem of tobacco smoking

among young people in Barking and Dagenham, there is still evidence of a few unmet health

needs in this age category(El Asmar et al.,2023). Some programs have lower than anticipated

utilizations, which means that some individuals may not be properly engaged, or targeted by

existing strategies. This could question the reachability, knowingness, or attractiveness of these

services. Additionally; as most young adults continue smoking, it would seem that the existing

interventions do not adequately serve their subtle requirements or preferences. In addition to this,

the perspectives of community members who are dissatisfied with the system make a further

addition to identifying unmet health needs. Knowing what matters to society is important for the

development of interventions that will be more aligned with young adult expectations and

preferences. There is a recurring theme around accessibility issues indicating that some segments

of the population face challenges such as physical access and affordability when trying to utilize

them. It is important to evaluate how relevant these existing services are so that they can be

improved or modified in order to cater for different needs among the young people in this age

group.

Level of unmet health needs

 21

In Barking and Dagenham, the levels of unmet health need in tobacco use regulation

among the young adults reflect on many dimensions of healthcare delivery and community

involvement. In primary healthcare setting, low usage rates for smoking cessation do not tell

much about the accessibility or effectiveness but instead show that there may be a gap in services

provision. The presence of unmet health needs can be seen in school settings when prevention

programs and cessation initiatives fail to engage students or modify smoking prevalence;

necessitating more focused efforts in educational institutions. Initiatives oriented towards

communities face problems related to reaching out to specific populations, thereby underlining

the importance of recognizing unique attributes that are associated with different communities.

This detailed analysis through levels such as primary healthcare, education and community

provides insight into unmet needs which can help better design targeted interventions that take

into account diverse tastes and preferences of youth in Barking and Dagenham.Evidence of

unmet health needs comes from monitoring and evaluation data, feedback mechanisms, and

community assessments. Surveys and focus groups can provide insights into the reasons behind

low utilization or dissatisfaction. Additionally, tracking the prevalence of smoking among young

adults over time can identify persistent challenges and unaddressed health needs.

Drivers and Challenges Influencing Service Provision and Utilization

The healthcare landscape in Barking and Dagenham is intricately shaped by a myriad of

drivers and challenges influencing the provision and utilization of services targeted at addressing

tobacco smoking among young adults. Proactive community engagement emerges as a pivotal

driver, fostering a shared sense of responsibility and ownership within the community, thereby

enhancing the effectiveness of interventions. Evidence-based practices stand as another crucial

driver, ensuring that healthcare strategies are rooted in robust research and aligned with the
 22

evolving needs of the young adult population. Continuous monitoring serves as a dynamic

driver, empowering healthcare providers to adapt strategies based on real-time data, staying

ahead of emerging trends. However, challenges loom in the form of limited resources, posing

constraints on the breadth and depth of service delivery. The persistent stigma surrounding

seeking help for smoking cessation poses another formidable challenge, hindering open

engagement with available services. Additionally, disparities in service accessibility present a

multifaceted challenge, necessitating a targeted and inclusive approach to ensure equitable

distribution. Navigating this intricate interplay of drivers and challenges is essential for

healthcare stakeholders to forge a resilient and adaptive approach, promoting a smoke-free

environment in the community.

Influence of the Healthcare System

The role of Barking and Dagenham’s healthcare system is paramount in shaping how

services are delivered and utilised. The six building blocks of health systems – service delivery,

health workforce, information, medical products, financing, and governance – collectively

determine efficiency, effectiveness, equity, and overall impact of interventions. For instance

limited resources (financing) can limit the scope or reach of service delivery thereby affecting

equity. Governance and information systems decide how well healthcare system can respond to

emerging needs ensuring that interventions are in line with evidence based practices.

Addressing Equity and Health Inequalities

Equity and health inequalities will be addressed as part of healthcare planning in the

borough. It is important to ensure there is fairness in the distribution of services across

neighborhoods and demographic groups. Equality programs take into account socio-economic
 23

factors during their design. The system’s effect on equity then becomes clear when one sees that

the most affected are targeted for interventions aimed at reducing disparities in access to care and

health outcomes.

Therefore,the healthcare system in Barking and Dagenham gives priority to solving

problems associated with smoking among young adults; however there are still some gaps left

unaddressed. Drivers and challenges influencing service provision and utilization demonstrate

the intricate relationship between various components of a health care system. These challenges

need an all-rounded understanding of the six blocks of a health care program that makes it

efficient, effective yet equitable enough for minimizing health disparities within our immediate

community.

CHAPTER 4: FUTURE LOCAL PRIORITIES FOR SERVICE PROVISION AND

UTILISATION

Targeted Interventions Based on Epidemiologic Insights

In the future, priorities should be focused on building and implementing targeted

interventions that are driven by epidemiological insights. Understanding trends in smoking rates

such as; prevalence, incidence and patterns over time in different dimensions of geography,

ethnicity, age and socio-economic status is an essential step to developing tailored interventions

to suit particular sub-populations. This targeted approach acknowledges the diverse nature of the

young adult population and aims to address health inequalities by considering demographic and

spatial patterns.

Strengthening and Expanding Healthcare Services

 24

Rather than focusing on tobacco smoking among young adults, the future focus should

build on the present service delivery system. The goal includes assessing level of service

utilization at present as well as strategically enhancing access points so that not only are there

interventions available but also they are actively used by the target population. It is important to

identify unmet health needs at different levels like primary healthcare, schools, community

programs.

Addressing Determinants and Risk Factors

Future priorities should include a comprehensive approach that addresses determinants

and risk factors contributing to tobacco smoking. This entails use of multi-faceted strategies

beyond traditional healthcare settings that take into account social, cultural and economic factors.

Collaborative efforts with local communities, educational institutions, and advocacy groups can

be instrumental in creating a supportive environment where initiation of smoking can be

discouraged while aiding in cessation.

Tackling Challenges and Enhancing Equity

To address some challenges like limited resources, stigma or disparities in accessing

services one must take a proactive stand. In addition to these, future initiatives will be geared

towards overcoming these bottlenecks through innovative solutions such as resource

optimization driven strategies for communities. Furthermore , achieving equity in service

provision requires sustained commitment towards understanding and addressing health inequities

based on socio-economic status , geography variations , cultural distinctions .

Continuous Monitoring and Evaluation

 25

There has also been an element of continuous monitoring and evaluation in planning for

future needs. This means that the interventions should be regularly assessed to determine their

effectiveness, efficiency and impact. The health system can also remain agile and responsive to

emerging health needs and challenges by incorporating feedback loops and adjusting strategies in

real-time.

CONCLUSION

In conclusion, this Health Needs Assessment (HNA) Report for Barking and Dagenham

illuminates crucial insights into the health landscape of the local area, particularly focusing on

tobacco smoking among young adults aged 18 to 24. The comprehensive examination of

demographic profiles, socio-economic circumstances, and population health highlights the

unique features and challenges shaping the well-being of residents.

The epidemiologic and demographic discussion in the second part unveils the

multifaceted nature of tobacco smoking, emphasizing its prevalence, incidence, and patterns of

distribution across spatial, ethnic, age, and socio-economic dimensions. The analysis extends to

mortality, morbidity, and disability, unraveling the complex interplay of determinants and risk

factors influencing the health needs of the target population. The evident health inequalities

underscore the imperative for tailored interventions that address the diverse expressions of these

needs within the local authority.

The third part delves into the current state of healthcare service provision, revealing a

commitment to holistic care and preventive interventions. However, the discussion also unveils

potential barriers to effective utilization, suggesting unmet health needs and the influence of
 26

drivers and challenges within the healthcare system. Issues of equity and health inequalities

within the borough serve as focal points, demanding continuous attention and strategic planning.

As we shift towards the fourth part, the future local priorities for service provision and

utilization emerge as a beacon for transformative change. Targeted interventions, strengthened

healthcare services, and proactive approaches to address determinants and risk factors are

identified as key strategies. An emphasis on continuous monitoring and evaluation, coupled with

a commitment to overcoming challenges, paves the way for a more responsive and equitable

healthcare system.

In shaping the future landscape, an implementation strategy is proposed, acknowledging

the challenges of funding, resource allocation, and service capacity. Recommendations

underscore the need for collaborative efforts among stakeholders, including the Clinical

Commissioning Group (CCG), service commissioners, the borough council, and other key

players. The call to action is clear: prioritize the identified local area priorities, empower

communities, and forge a path towards health equity and sustainable well-being.

This HNA Report not only provides a comprehensive understanding of the current health

needs and service provision but also serves as a catalyst for informed decision-making, policy

development, and future research endeavors. It stands as a testament to the commitment towards

a healthier and more equitable future for the residents of Barking and Dagenham.
 27

References

Fardghassemi, S. and Joffe, H., 2021. Young adults’ experience of loneliness in London’s

most deprived areas. Frontiers in Psychology, 12, p.660791.

Government of UK . Tobacco control strategy - LBBD, 2023.

https://modgov.lbbd.gov.uk/internet/documents/s115478/6a%20-%20TC%20Strategy

%20V6.pdf.

Moore, G., Fardghassemi, S. and Joffe, H., 2023. Wellbeing in the city: Young adults'

sense of loneliness and social connection in deprived urban neighbourhoods. Wellbeing, Space

and Society, 5, p.100172.

Tucker-Seeley, R.D. and Thorpe Jr, R.J., 2019. Material–psychosocial–behavioral aspects

of financial hardship: a conceptual model for cancer prevention. The Gerontologist,

59(Supplement_1), pp.S88-S93.

World Health Organization, 2023. WHO report on the global tobacco epidemic, 2023:

protect people from tobacco smoke.