Healthy people 2020 (HP 2020) explores the question of what makes some people healthy while others are unhealthy and how we can develop a society where everyone has a chance to live a long and healthy life. HP 2020 does this by establishing objectives that focus on the relationship between the health status of a person and individual behaviour, biology, health services, social factors, and policies ( Manderscheid, 2009) . Secondly, it focuses on an ecological approach to health promotion and disease promotion. According to HP 2020, several determinants affect and determine an individual’s or population health. These include; policymaking of a state, social factors surrounding a population, accessibility to health services, individual behaviors/lifestyle and biology and genetics of an individual. Certain populations or individuals are more vulnerable to disease due to a deficiency in one of the determinants of health (West & Jeffery, 2018) . To help us understand more about these determinants, we will analyse women facing gender-based violence as a vulnerable population.
Violence against women is complex but somewhat familiar public health pandemic that occurs in every culture and social group universally. Statistics reveal that one in every three women has been beaten, coerced into sex, or otherwise abused in their lifetime. In most societies, women usually have lower social status than men, resulting in unequal power relations do. It is for this reason that women and girls mainly are vulnerable to human rights abuses and suffer poor health outcomes as a result. Gender-based violence against women mainly involves three parameters; sexual assault, domestic violence, and stalking. All these jeopardize women’s bodies, physiological integrity and eventually their health status.
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Women are more pre-exposed to certain diseases than men due to their physicality and sex. One of the HP determinants of health is biology and genetics. Women are more prone to reproductive conditions than men because of how their system is designed and functions. In most societies, birth control methods are highly used because of many socio-economic factors that might limit a population from giving birth to many children. Some of these methods of birth control and contraception’s are unnatural and may involve hormonal injections or administration of pills. Majority of these methods are designed for women, and therefore they expose them to the side effects or conditions that might arise from the use of this contraception. For instance, some women might suffer excessive bleeding, which can lead to anaemia; some may be rendered barren, overweight, underweight and some even die. Therefore, women using contraceptives are more vulnerable to health conditions than men (Disaia etal 2017).
Domestic violence in women includes physical, psychological assault, sexual, economic deprivation, forced isolation and any other reason than that might cause a person to live in fear and despair. Women especially girls, are more likely to be abused than men and are at high risk if this happens when they are below 24 years, abused as children or if they live in rural areas. Mostly, violence is most cases are often a continuous act repeated over a period rather than a unique one-off case. Abuse can cause physical damage to a woman’s body, which renders her unhealthy, and it can even lead to death.
Perhaps, the most unexpected effects of domestic violence go beyond physical damage. Women who undergo continuous abuse suffer severe psychological damage, loss of personal belief and freedom, and a diminished ability to participate in life. Most of these effects are lifelong and may affect a woman for the rest of her life. Violence affects the emotional well-being of a person. Some of the effects of violence are stress and depression, insomnia, loss of appetite, feeling unwanted, mental crisis and even suicidal thoughts. These conditions affect a woman’s state of mind. All these factors can expose a woman to certain lifestyle diseases like high blood pressure, ulcers, mental conditions, depression, and stress or even mental conditions. Unfortunately, most cases of domestic violence go unreported meaning that it remains a hidden problem with a vast number of associated health care cost and concerns.
Women also face sexual assault and rape. Sexual assault can be physical or non-physical assault through verbal intimidation. Rape and sexual assault are acts of crime with sex used as a weapon that can be committed by dates, spouses, relatives, friends, partners, acquaintances and strangers (Aizer, 2010) . Rape can expose women to physical damage, sexually transmitted diseases and HIV and AIDS. Over and above, the physical effects women experience emotional affects ranging from; confusion, difficulty concentrating, denial, nightmares, flashbacks, anger, rage, revenge, difficulty eating or sleeping and extreme guilt and self-blame. Rape can be subjected both ways, but the majority of the cases are subjected to women. Most of the psychological effects of rape can expose a woman to serious health conditions, which is even life threatening.
Women facing gender-based violence are still a vulnerable population to attaining a healthy life; this is because most cases go unreported and secondly, Policies and organizations that have been put up to address this have not been very successful in doing so. The cause of gender-based violence is rooted in the societal norms, poverty levels, level of education and they vary from case to case. However, several organizations have come up to address the issue; a particular organization is Women helping women (WHW) Cincinnati, which has been very instrumental in helping victims of domestic violence. WHW is an organization that serves southwestern Ohio as a unique provider of crisis intervention and support services for victims of direct and indirect sexual assault and domestic violence (Matambanadzo, Manyard, & Matambanadzo 2018) .
One of the primary objectives of HP 2020 is to achieve a high quality, longer lives free of preventable diseases, injury, disability and premature death. WHW employs preventive measures to ensure that this objective is maintained. The organization offers 5 or 10 days programs in schools and other youth serving in organizations. Their program is referred to as the prevent and empower curriculum which explores signs of healthy and unhealthy relationships, lessons on sexual assault and harassment, bystander interventions, resources to help a friend or loved one who falls victim and knowledge on communication skills geared to promote healthy relationships. WHW is also actively involved in the formation of youth prevention teams who act as champions of violence within their peer groups. When youth get information, they are empowered to steer through healthy relationships in future free from domestic violence, which eventually enhances health promotion in women.
Another objective of HP 2020 is ensuring health equity and improving health for all groups. WHW tries to achieve this by offering crisis intervention measures and sessions to deal with after-effects of domestic violence. Survivors are provided with counselling and referred to a community –based counselling program or therapists. The organization also assists victims to access legal advocacy and support. They assist victims in filling out cases. WHW conducts support groups to help survivors deal with the aftermath of sexual assault. These interventions promote recovery for many victims and prevent them from suffering for long periods, which makes them vulnerable to health complications. Effective solutions for domestic and sexual violence can only be achieved through collaboration; it is for this reason that WHW has collaborated with several stakeholders to accomplish this. Some of them include hospitals, police departments, prosecutors’ office and many more others.
WHW has been effective in improving the plight of women and reducing domestic and sexual violence. However, there is stillroom for opportunities for the agency to enhance in reaching the HP 2020 objectives. The reason why gender-based violence still affects the health status is that of fear and stigmatization. The agency needs to do more in encouraging victims to report the cases so that the effects can be controlled. The suspects should be punished accordingly, and information made public to deter others from this act. The agency needs to do more campaign awareness of the vice and put pressure on the policymakers to come up with measures that can cut down domestic violence. They can also exploit more the power of social media in selling their agenda.
In conclusion, the health status of a person is different from the other based on some fundamental determinants that vary for each. Some population is more vulnerable to diseases because of differences in the social-economic conditions that they face. Despite factors such as the biology and genetics of a person, which are uncontrollable, some HP 2020 determinants of health can be controlled and improved to promote health and disease prevention behaviours. Most of the interventions that can be employed revolve around education, equality, provision of health care for all and sound policymaking by legislators that promote better health standards. Women facing gender violence are more vulnerable to certain health conditions, but with proper engagement of the HP 2020 objectives, this notion can be minimized. It requires intervention in education through empowering women, gender equality, and provision of healthcare and appropriate legislation to deal with the same (Minerson, 2011) . Therefore, the issue of health promotion and disease prevention behaviour is a matter that requires a collaborative effort as it cuts across all levels of the society.
References
Aizer, A. (2010). The gender wage gap and domestic violence. American Economic Review , 100 (4), 1847-59.
DiSaia, P. J., Creasman, W. T., Mannel, R. S., McMeekin, D. S., & Mutch, D. G. (2017). Clinical Gynecologic Oncology E-Book . Elsevier Health Sciences.
Manderscheid, R. W. (2009). Aiming for a healthier population by 2020: moving our fields toward prevention, early intervention, and population health. Behavioral healthcare , 29 (1), 51-53.
Matambanadzo, A., Manyard, M., & Matambanadzo, T. (2018). Implementing a Replicable Model for K-12 Health Literacy to Promote Positive Youth Development. Journal of Consumer Health on the Internet , 22 (1), 8-24.
Minerson, T. (2011). Issue brief: Engaging men and boys to reduce and prevent gender-based violence.
West, G. F., & Jeffery, D. D. (2018). Utilizing selected social determinants and behaviors to predict obesity in military personnel. Public Health Nursing .
