Tuesday, December 3, 2019

What Are The Advantages and Disadvantages of Brand Stretching Essay Example

What Are The Advantages and Disadvantages of Brand Stretching Paper In addressing the above question it is first important to establish what a brand is and the implications this gives to both existing products and products that may be laundered using existing titles. This essay will examine articles written concerning the stretching of brands and identify which brands have been successful and unsuccessful in this pursuit and why. It will also examine the financial motives for companies to penetrate existing markets using already established new products or services has lead to prosperity or disaster. The American Marketing Association refer to branding as the use of a name, a term, a symbol or a design to identify the goods or services of one seller and to distinguish them from those of the competition (WK4 Lecture). This use of branding is said to create an identity of the product that quickly allows consumers to identify a desired item and also gives a guarantee of quality of the product. Branding is also seen as being mutually beneficial to Manufacturers as protection is offered from competition, it allows maintenance of a premium price, promotion is made more efficient because the brand helps to evoke an image, and it also helps in the introduction of new products with the same brand name (WK4 Lectures). We will write a custom essay sample on What Are The Advantages and Disadvantages of Brand Stretching specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on What Are The Advantages and Disadvantages of Brand Stretching specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on What Are The Advantages and Disadvantages of Brand Stretching specifically for you FOR ONLY $16.38 $13.9/page Hire Writer King (1971 p.3/4) writes of the rise of power of manufacturers by branding their products, thus taking control of the market from the wholesalers, by allowing retailers and consumers to more easily identify products they wanted. This process was moved further forward by manufacturers creating direct links with the buying public through the use of advertising. King states that the basic motive for this was to stabilise demand, thus allowing regular large-scale production, free from the whims of the wholesaler. Partly because of this the advertising tended to be based on the idea of reliability and guaranteed quality. (1971 p.3). It was due to such strategies (according to King) that the manufacturers dominated the market from about 1900 to 1960. However since the 1960s the market has turned a full cycle, returning control to the retailers (although maybe not so much to the wholesalers). This is illustrated by Caulkin (1987) who states that over the last two or three decades there has been a massive shift in the balance of power form manufacturing towards the retail end of the economy (p.46). This Caulkin states, is particularly notable in food and fast moving consumers goods. Large supermarkets such as Tescos, Asda and Sainsbury started to implement own-label goods which over time sharply reduced the manufacturers share of the market within only a few exceptions (such as baked beans and pet food) (Caulkin 1987). In an attempt to combat what is discussed above many manufacturers are returning to what was described in an article in the Economist 10/90 as an old standby of marketing; brand-stretching (p.105). This based on the principle of using an existing established brand name to help the launch of new products into the market. However, the potential for this sort of practice is said not to be unlimited. Peter Philips of CPC International commented in the Economist article If you get brand-stretching right , you can travel further for less money. If your get it wrong, you risk weakening the core values of the original product (10/90 p.105). Although it is important to note that stretched brands have a better chance of survival than new brands, OC and C found that, of products launched by the same multinational six years ago, only about 30% of new brands exist today while over 50% of stretched ones do (10/90 p.105). With statistics such as these, one can see that it indeed may be advantageous to a company to exploit its name in the promotion of new products and when expanding into new markets. The Economist article stresses the popularity of brand-stretching in the areas of food and drink. Advantages may also be sought when one considers the point made above that the cost of promoting new products with already established brand names, which is said to be considerably cheaper. The Economist article (10/90) points out that promotional costs for stretched brands are in fact 36% cheaper when compared to completely new products. This is presumable due to the public already having an awareness of the brand name, so the only real cost incurred is raising awareness of the existence of the product itself. The use of a brand name also implies assurance of quality (King 1971). It may further be considered that the use of a brand name on its own may persuade people to try new products, such as the Mars Ice Cream Bar. This may be considered in particular when one looks at the larger supermarket chains such as Sainsburys. Over the last two decades Sainsburys have produced own brands to compete with nearly every product that they stock. Due to the image conveyed by Sainsburys that implies (or in fact, guarantees) quality, it has been possible for them to penetrate nearly all areas of the food market successfully. This success may be attributed to the analysis of what a product is as defined by Nickels (1978). Nickels sees a product as an intangible sense of value that a consumer perceives when he or she weighs the benefits and drawbacks of making an exchange. It may therefore be viewed that the success of Sainsburys is mainly due to the consumer seeing little difference in quality between branded goods and Sainsburys own label goods, with Sainsburys holding th e advantage when price is considered. This point is reiterated by Caulkin (1987), who states that growing public perception that the best own-brands are no longer cheap alternatives to the real thing, but comparable in quality as well as price with the main manufacturers lines. The phenomenon of brand-stretching has not been unique to the manufacturing and retail sectors, but has in fact been used by those in the sector of public service. Nickels cites areas, such public libraries that have sought the advantages of brand-stretching. He refers to increased success of libraries that reconsidered what to offer by viewing the service they provide from the perspective of the public. This has resulted in a marked change of service in some American libraries which now provide services such as the loaning of domestics pets, childrens toys and the provision of music rooms and access to such things as a printing press, (1978 p.195). Nickels continues to state that the product of a library today may be anything that will satisfy the needs of selected market segments Libraries are much more successful today because they have designed their products to fit the needs of people (1978 p.196). It can therefore be seen that brand-stretching can be of great advantage when a n eed or area of market penetration is correctly recognised. However, when a company seeks the advantages of brand stretching, they must take great care to ensure that they get it right. The Economist article (10/90) points out that brands are not endlessly elastic. Stretching can also undermine the credibility of the original product. Consumers may not believe that the new product shares any of the cachet or characteristics of the old, or they may simply forget what was attractive about the original item, (10/90 p.105). However, when one considers this comment, it may well be true to say that not all stretched brands will be successful, but that does not seem to generally render original brands obsolete. If one is to consider the failure of David Hunter, (a stretch by Levis), it does not seem to of had an adverse effect on Levis. The problem seems to have aroused simply due to the manner that the stretched brand was marketed, i.e. those who bought classic tailored clothes would not buy them form Levis and not vice versa. It seems more simply, that it was inappropriate for Levis to have used their name to penetrate this particular market. This story seems to be reiterated by Van Den Burghs and Jargons low calorie salad dressing that failed using the name of flora. This, however does not seem to have harmed flora margarine in its place of market leader. It should be noted though that it is felt by many in the field of marketing that a failed product could cause disastrous effects for established products. Prof. Birger Wernerfelt of the MIT Sloan School of Management stated in the Economist article that Umbrella branding means putting up the reputation of the old product as a bond for the quality of the new one (10/90 p. 105). However in the field of well established brands, stretching by own-brand manufacturers has not been so successful. Items such as baked beans are said to have made little headway and that Heinz still hold half the share of the market. The same is said to also apply to pet foods, with Mars Pedigree Pet Foods not having been toppled form their No 1 spot (1987 p.47). A further point that has been made concerning brand stretching as a disadvantageous pursuit was made by Messrs Al Ries and Jack Trout (Citied in the Economist 10/90 p.106). In their book Bottom Up Marketing they argue that by companies widening their products, (even those who have been successful) they have hurt their brand equity. This they attribute to the nature of communication in Western Society being so large that they feel that, you are lucky if your brand can mean one thing. Almost never can it mean two or three things, (10/90 p.106). Thus confusing consumers of an established image of original brands. From the above discussion it can be seen that brand-stretching can be a good way of penetrating new markets. by good use of an established brand name considerable savings can be made in the field of promotion, as there is already an existence of brand awareness so promotion can more easily be centred around the product itself, with the added bonus that consumers may feel more inclined to give an initial trail of products displaying brand names they already know, ( such as the Mars Ice Cream Bar). This too is now the case with established own-brand labels, such as Sainsburys which offer marginally cheaper prices of products now perceived to be of equal quality to that of established brands. However inappropriate stretches, or those which do not offer good quality products have a danger of undermining the credibility of already established brands. Although from the research this sort of practice on the whole seems to lead to failure of the stretched brand, generally leaving the origina l in tact.

Saturday, November 23, 2019

Whole Foods Market

Whole Foods Market Discuss the trends in retailing of organic foods and the impact of these trends on Whole Foods Market The retailing business of organic food in the United States of America is on the rise; this has been facilitated by enlighten of the American on the health advantages brought about by organic food consumption as well as a realization of danger likely to be brought about by eating non-organic foods.Advertising We will write a custom essay sample on Whole Foods Market specifically for you for only $16.05 $11/page Learn More In 2005, there were14000 small and medium scale outlets of organic and natural foods; the estimated sales of the 14,000 units totaled to $18Billion; the market offered a variety of products that shoppers could choose from, the establishments were mostly small scale, however giant stalls were established to tap the growing market. Some of the giant malls that were introduced between 2005 and 2008 are Wal-Mart and Whole Food Company. The rais ed demand for organic food in the American food industry forced Whole Food Company to change its business approach and target to tap the growing market; generally the trend in a market has an effect on the kind of products that a company stocks and the area that the company will concentrate on. Whole Food Company had to focus on the new market demands and started to stock products like wild oats, fresh produce and millet. Evaluate the competitive environment of the firm: Apply Porter’s model and analyze each factor relative to the company Since 2000, before the wave to organic foods, many companies in the food industry were experiencing a reduced business and they recorded losses; an example of a company that recorded a loss was Whole Food Company: the competitive environment of the company looks as follows (using porter’s five forces): Buyer’s Bargaining Power The market is driven by the demands made by the customers, it is the customers who decided they needed organic and fresh foods, the supermarkets and small scales stores had no option that supply the commodities. In the market, the buyer’s power is more evident and strong.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Suppliers bargaining power Suppliers of organic foods have increased with the demand of the foods; however, the production of the foods is dependent with the climatic conditions, which may sometimes not be favorable. However, the markets benefit a great deal from the growth of international market, which has continued to supply organic foods to the supermarkets and small outlet chains. Threats of substitute Although consumers have access to cheaper non-organic foods, they have strongly opted to use organic foods for the benefits it has on their health. Threats to substitute are manageable if the company has a constant supply of organic foods. Threat of New En trants In every business, there is a threat to entry of new businesses, however Whole Food Company is a giant in the industry thus it has an upper hand to be able to maneuver in the market despite entry of new players. Competitive Rivalry in the Industry Since the industry is consumers driven, the success of a company is dependent on how well it can meet consumer’s needs. A strong business like Whole Food Company has no worries to have since it has the financial base, the reputation and the will to succeed (Hughes Beatty, 2005). Discuss which environmental factor poses the most significant threat to Whole Food and what the company can do to combat it The environmental factor that offers Whole Food Company the greatest challenge is Suppliers bargaining power; the reason for the above is because suppliers in the market are growing but their effect and the rate they are producing is also affected by climatic conditions in the country. The world is facing threats from global war ming and seasons are not precisely predictable, the suppliers have the likelihood of not being able to produce the quantity wanted by the market. The effect on climate is not limited to the United States however; it cuts across other organic foods producing countries. The dependency that the company can have on international trade is limited to international relations affecting the world; if the relations do not support production, then the effect is negative and the country will miss the much-needed suppliers. The rising demand has led to a rising needs for the produces; there are a number of companies with different packages evading the market; they are likely to lead to a hiked prices of the produce.Advertising We will write a custom essay sample on Whole Foods Market specifically for you for only $16.05 $11/page Learn More Whole Food should develop a good business relationship with its suppliers, as this will assist in making sure that there is reliabil ity in the supply of materials. Suppliers in the company fall in the category of contractors and those companies in the business of supplying raw materials and semi finished goods. This will ensure that the company manufacturing is kept with the right materials always. On the other hand, it is easy to get goods at a better price and market data from suppliers whom the company has established good business relations. Complete a SWOT analysis and identify significant opportunities and threats facing the organization Strengths The company has a strong financial base and enjoys a wide range of customers; it can use this advantage to buy products from suppliers at a slightly higher price that the one offered by competitions. The management is futuristic and makes effective and strategic decisions when called upon to. Weakness The company seems to depend on suppliers who cannot be fully dependent on; it would have been better if the company had a farm of its own where it is producing the commodities for its stores. Opportunity The main opportunity facing the firm is an increased demand for organic foods and massive campaigns by third parties on the goodies of eating organic food Threats The company is threatened by unreliable international relations; this threatens the companies continued supply of organic goods. Discuss how Whole Foods can use it strengths and opportunities to achieve a sustained competitive advantage in the marketplace The company has a strong brand name and a reliable financial base; it should use these strengths to enlarge its business via stocking of a variety of products in its shopping malls. With increased sales, the company can be able to buy from suppliers at a fair price and enjoy the benefits of economies of scale.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More The growing demand for organic products is offering the company an increased demand of its products; thus, the company can diversify its operation in the niche of the market and enjoy increased sales. Globalization and growth in international market offers the company an increased market base and increases the material sources (Adam, Jochim Cutting, 2008). References Adam, L., Jochim, D., Cutting, T. (2008). The art of strategic leadership: A proven approach to optimizing your organization. New York: Beck. Hughes, R., Beatty, K. (2005). Becoming a strategic leader: Your role in your organization’s enduring success. San Francisco: John Wiley Sons.

Thursday, November 21, 2019

Dream School Term Paper Example | Topics and Well Written Essays - 1750 words

Dream School - Term Paper Example Therefore, activities and materials used in the school will be design to provide the preschool children with a wide range of experiences in all developmental stages. Consequently, these can facilitate their growth and give them numerous opportunities from which they can choose from to carry out preferred tasks. As such, these materials and methods in the school will reflect the philosophy of Piaget and incorporate the most appropriate materials of other educators in order to assist the learning process of children. Similarly important would be the children’s teacher, hence the presence of well qualified teaching staff members to positively contribute to the personal development and fulfillment of preschoolers as well as instill the values of care and love. The following sections will then look into the educational philosophy, curriculum, physical building and facilities, and the choice of teachers in the ideal school that aims to emphasize the developmental learning of prescho olers. Educational Philosophy The educational philosophy of the school would place an emphasis on interactions between adults and children as well as relationships in school and at home. The school will also incorporate developmentally appropriate practices that have been established by professional organizations that support early childhood education, such as the National Association for the Education of Young Children. As developmentally appropriate practice entails, teachers must be knowledgeable regarding the different stages of a child’s development as well as their implications. Such knowledge consequently becomes the principle from which they share information, construct the content of the curriculum, evaluate what has to be implemented, evaluate what the children have learned, as well as determine how their curriculum will be adapted to meet the individual needs, interests, and strengths of children in preschool age (Bredekamp and Rosegrant, 1992). In addition, teache rs should know the children they are teaching as well as their families to increase their awareness of the latter’s cultural and social settings. The school’s principles are centered on the recognition and responsiveness towards preschool children who are in the preoperational phase of development, as noted by Piaget. They recognize that objects do exist without touching them and can develop their own set of symbols, such as words and images, as representations of the real world. The school also recognizes that lessons will take place through assimilation, adaptation and accommodation. When children are introduced to new occurrences, they will try to understand these by associating them with the things that they have already known. Once they have obtained experience with such new phenomenon, their thoughts, feelings, and approaches may change to accommodate the attributes of this new phenomenon. Implications then point towards the need for children to be exposed to new experiences which can be associated with previous ones but, to some extent, should also bring about challenges for their way of thinking. Therefore, in order for this ideal school to maintain practices that are appropriate for children’s development, they must establish a secure, stimulating, and nurturing environment as well as develop a flexible curriculum, reflecting the themes and activities of teachers and children. These young

Wednesday, November 20, 2019

Parenting Styles and the Chinese Tiger Mother. Why Chinese Mothers Are Essay

Parenting Styles and the Chinese Tiger Mother. Why Chinese Mothers Are Superior - Essay Example The authoritarian style is characterized by parents who may be depicted as being absolutely in control mode in dealing with their children. Orders are to be carried out unquestioningly, and no explanations are given. The child has no freedom to make any choices. The parents set the bar for performance exceptionally high, and insist that the child meets those standards. Any failure in rising to these expectations is met with harsh criticism. In the case of authoritative, or democratic, parents, control is tempered with affection. The emphasis is on firm guidance and not on punishment. The child is encouraged to share the responsibility for the decisions taken, and is given reasons and explanations for any behavioral expectations. On the other hand, permissive parents grant the child unlimited freedom of choice. This involves a very hands-off approach, in which the parents set no rules, have no expectations, and make no effort to discipline the child. This style is based on uncondition al acceptance. Amy Chua’s parenting style, as evidenced by her article Why Chinese Mothers are Superior, is obviously based on authoritarianism. Chua is in absolute control of her daughters lives.

Sunday, November 17, 2019

Karl Marx and Capitalism Essay Example for Free

Karl Marx and Capitalism Essay In this paper I will examine how Karl Marx views capitalism and, more specifically, the criticisms he has regarding capitalism. In the first part of the paper I will reconstruct and explain the philosopher’s argument. In the second part of the paper I will offer my critical evaluation where I will demonstrate how these critiques are still appropriate in today’s society by providing examples of how capitalism is affecting the lives of American workers even today. However, I will first explain the definition and structure of capitalism. Capitalism is an economic system that is most common in the United States and much of Western Europe today. It is represented by privatization of companies for production of goods or services for a profit, competitive markets, and wage labor (â€Å"Capitalism†). These individual skills were initially developed from skills that grew out of the economic time period known as feudalism and has evolved into individuals who possess certain skills that can demand payment. Although this may seem like it would be an ideal situation for workers and provide a platform to provide a service in return for payment of some sort, it soon became evident that there were people who would use this new system of economics to their advantage. Instead of doing the work themselves, they would find skilled workers to provide the service or product under the umbrella of their organization to which they would market and sell the goods for profit. The business owner would make a profit and, in turn, pay the worker a portion for his services provided. Unfortunately, there were others who were unable to make the system work for them in such an advantageous manner. Karl Marx had two basic criticisms of capitalism – especially in his lifetime of the beginning of the industrial revolution and the formation of factories. His first was the thought that the worker suffered from alienation on several different levels. As a capitalistic society succeeds by gaining profit for the companies and business owners, the overall cost of goods needed to live also increases. If the wages earned by workers went up consistently with the profits of society and, thus, the increase in the cost of living, all would be good and balanced. However, that is not the case in most circumstances, in fact, as Marx points out, â€Å"the worker becomes an ever cheaper commodity the more goods he creates† (Johnson 261). In other words, as the production increases the cost to produce is lowered. The business owner sees those profits in the gross profit obtained by the sale of goods; however, the worker is generally not compensated in a fair and equitable manner. This turns a skill which may or may not have been a passion at one time into something that the worker is forced to do whether they desire to do so or not. Even if a worker enjoyed his occupation, chances are, he or she is being forced to comply with guidelines or standards set by someone else. As a worker you are still not truly free to produce your work according to your standards so you are, in essence, alienating yourself from the product of your work. According to Marx, capitalism has also produced an alienation from nature. He states that the capitalistic society conceals this alienation because it does not examine the direct relationship between the worker and production (Johnson 263). Essentially, the labor of the worker may produce wonderful and beautiful things for the wealthy individuals but oftentimes the working class population may never get to experience the beauty for themselves. Furthermore, the workers identity is often lost within their job and they do not have the means to express their individuality. This is identified by Marx as being alienated from yourself and from your labor. Most people do not proclaim their uniqueness in ways that focus around their occupation. Even in a highly sought after job you may, for a time, feel as if that encompasses who you truly are, but it is only a small part of your being – your essence. This also ties in to another alienation theme of Marx which is the alienation from your species as a human being. According to Marx, â€Å"the worker feels himself to be freely active only in his animal function – eating, drinking, and procreating, or at most also in his dwelling and in personal adornment – while in his human functions he is reduced to animal† (Johnson 264). In other words, as workers we are often free only when we are allowed to do what we want to do instead of what is demanded and required of us at our jobs. When this happens, we are often reduced to a more animalistic approach to fulfilling our needs. Finally, Marx contends that in a apitalistic society, the worker is alienated from others. Because there is so much competition in capitalism – which is the driving force for production and profits – it causes a hostile environment among workers. Many are competing for the same position or the same customer or account. This competition causes a friction within the frame of society that pits individual against individual which is what leads us into the next matter of contention with Marx in his views of capitalism which is exploitation. He claims that â€Å"private property has made us so stupid and partial that an object is only ours when we have it, when it exists for us as capital or when it is directly eaten, drunk, worn, inhabited, etc. , in short, utilized in some way; although private property itself only conceives these various forms of possession as means of life, and the life for which they serve as means is the life of private property – labor and creation of capital† (Johnson 266). People have become so materialistic in our capitalistic society that they are driven to all means by which to obtain their measures of status. Because of this, the workers are driven to give into demands made by their employers in order to make the wages necessary to maintain their standard of living. Since the workers are plentiful, the products are also plentiful, which discussed earlier creates a larger bottom line for the profit of the company or business owner. However, even though the profits are increased for the business owners of the capitalistic society, the wages are often not as high as the profit. Thus, the value of the product is high while keeping the value of the worker low. This is a classic example of exploitation. I think that the criticisms offered by Marx are still applicable in today’s society in the United States. I think that the worker is indeed alienated from his true identity as an individual. Before the onset of industrialized production there was a certain pride associated with one’s occupation; whether that was as a craftsman in wood, as a blacksmith, tailor, or bricklayer. No matter your profession, you were able to express your individuality and impart your character into the product of your work. Sadly, this is not the case with the workers of today. They are often subject to limitations and expectations that hinder their creative ability and they are forced to produce that are a poor representation of their ability or personality. Most people are forced into positions they don’t even want to be in professionally because they need to make a certain amount of money to pay for their wants and needs. This creates a frustration and dissatisfaction that reaches far beyond the walls of the factory or office. It is no wonder that most workers today dread Monday mornings and count the days until five o’clock Friday afternoon. Again and again, the energy level increases as the weekend approaches. There is a common sentiment that states everybody is simply working for the weekend. This is because workers are dissatisfied with their jobs and feel undervalued and taken advantage of in many circumstances. Once the workday ends, the freedom begins for the worker. This is often why the bars have a â€Å"happy hour† as this is where the worker can forget the troubles of the day and throw back a drink or two and finally relax. The economic conditions of living in an industrialized society has turned the ordinary worker into a materialistic consumer that generally far outreaches his or her ability to afford to keep up with the Jones’. Because many feel the pressure of this forced societal expectations to possess certain items, live in a certain neighborhood, d rive the right car all while wearing the right clothes and accessories we as workers in the United States have been put in the unfortunate and unbalanced position of much more want than means by which to provide it. As long as that continues, we are stuck in a cycle of never ending wants that never truly satisfy because they are not meeting what is truly needed in our lives. Marx claims that â€Å"the human being had to be reduced to this absolute poverty in order to be able to give birth to all his inner wealth† (Johnson 268). In a capitalistic society it is encouraged, and even necessary, to consume what is being produced in order for capitalism to continue to grow. Today’s worker can do this in moderation, without putting themselves or their families in such a position to further add to the frustration of meeting expectations and demands at a workplace that is unfulfilling to their existence. Furthermore, I think that labor unions were formed in the early 1900’s in order to protect workers from exploitation of greedy business owners. At the turn of the century, many workers were expected to work long hours almost every day of the week. There were unsafe working environments s well as high quotas being placed on workers from employers with minimal compensation to the workers. All of this was so the profits could rise as production was increased. There seemed no reason to pay more in wages by adding workers or in higher salaries for the existing employees when the business owners could simply demand more from their current workforce. Also, working conditions were often unsafe while trying to maximize workspace with the maximum number of workers without actually increasing the area being used. Because of labor unions working conditions have improved greatly for the worker in America; there are 40 hour work weeks with compensation for additional hours worked; guidelines have been implemented to make for safer working conditions; and there is more room for negotiation for fair wages without fear of retaliation by employers. Although labor unions are still in existence today, they have much less impact than they had in the past. Politicians are close bedfellows with the corporate executives across our nation and policies are ever changing to benefit the corporation and business owners while causing the worker to suffer the consequences. Even though there have been great improvements in regard to the criticisms of alienation and exploitation that Marx had against capitalism, I believe they still exist. Marx may have not been of this century but I feel his observations are still valid in today’s world.

Friday, November 15, 2019

Epidemiology in relation to health promotion

Epidemiology in relation to health promotion This assignment will define epidemiology, list and describe some of its main aspects and assess the significance of those aspects for their effect on health promotion. The example of lung cancer will be used throughout. Definition Epidemiology is the study of how diseases are distributed among populations and the factors that affect this distribution. Epidemiologists try to predict risk factors that may lead to a particular disease and identify strategies that could be used to prevent its occurrence. (Naidoo Wills 2008: 4) The following questions drive epidemiology: Who becomes sick or is most likely to be affected? Why do particular people become sick? When are people most likely to be affected? Where has the disease occurred or is most likely to occur? How effective are available treatments and preventative strategies? (Crichton Mulhall in Naidoo Wills 2008:74) Epidemiology has the following main aims: To describe patterns of disease in the population, or the disease distribution, across age, gender and geography. To indentify the aetiology, or determinant, of the disease: risk factors or prior events associated with the appearance of the disease or condition. To analyse frequency, or how many cases occur, over a given period. To provide the data needed for the planning of preventative measures and treatment. Epidemiology is concerned with rates: the focus is on groups rather than individuals and aims to highlight trends. (Naidoo Wills: 2008:74) Epidemiology has two main approaches: Descriptive Epidemiology is concerned with the patterns of distribution of disease according to people, place and time and uses mortality and morbidity statistics as well as population data. Analytical epidemiology explores cause and risk factors and asks why did it happen? Successful prevention rests on identifying risk factors which can be reduced or eliminated. (Hubley Copeman, 2008:40) History In the past epidemiology has helped to explain the transmission of diseases, such as cholera and measles, by discovering factors shared by individuals who became sick. Modern epidemiologists have contributed to an understanding of factors that influence the risk of heart disease and cancer, which account for most deaths in developed countries today. Epidemiology has established the causal association of cigarette smoking with heart disease and lung cancer; shown that AIDS is associated with certain sexual practices and demonstrated the value of mammography in reducing breast cancer mortality. (Sci Tech, 2009) Aspects of Epidemiology An aspect is a part or facet of a particular subject area. Aspects of epidemiology which will be assessed are as follows: mortality and morbidity rates, statistical analysis, cohort studies, correlation, causation and questionnaire/survey. Mortality and morbidity rates. Mortality rate is a measure of the number of deaths (in general, or due to a specific cause) in a population. Data is collected from the compulsory registration of death and its cause. Cause is the disease or injury which initiated the train of events leading to death. Information can be divided according to age, gender and cause. Morbidity rates are either the number of new cases of a disease (incidence) or all cases at a point in time (prevalence). Data is collected from hospitals and GPs and includes: cancer registrations, notification of infectious disease, sexually transmitted disease, HIV/AIDS and congenital anomalies. (Tones Green: 2008:45). A central tool of epidemiology is rate comparison: population data collected by census is used for this purpose. Lung cancer: figures confirm that lung cancer has an enormous impact on national mortality and currently accounts for 7% of all deaths and 22% of all deaths from cancer in the UK Incidence rates: Lung cancer UK Males Females Persons Number of new cases (UK 2006) 22,381 16,646 39,027 Rate per 100,000 population* 60.8 37.1 47.4 Number of deaths (UK 2007) 19,637 14,872 34,509 Rate per 100,000 population* 51.5 31.3 40.1 One-year survival rate (for patients diagnosed 2004-2006**, England) 27% 30% Five-year survival rate (for patients diagnosed 2001-2006**, England) 7% 9% (Cancer Research UK) Cohort studies A sample of people is followed overtime and their lifestyle and exposure to hazards and the incidence of disease is monitored. A cohort of people has a characteristic in common e.g. the same disease or the same employer. Causation The investigation of a relationship between one event and another by weighing up a body of evidence. A number of methods are used to investigate causation including cohort studies. Relative risk is the ratio of the rate of a disease to the number of those exposed to a risk factor. It indicates how likely it is that an individual exposed to a particular environmental or lifestyle factor will go on to develop a particular disease. Lung cancer The most famous example of a cohort study was the British Doctors cohort study. Dr Richard Doll enlisted forty thousand male Doctors and followed them for fifty years. The results published in the 1950s showed that many more Doctors who smoked went on to develop lung cancer than those who did not.. The study provided clear evidence for a causal link between smoking and lung cancer. (Hubley Copeman: 2008) . Correlation Correlation is a statistical measurement of the relationship between two variables. Lung cancer research has shown a correlation between smoking and social class with people of less affluent groups smoking more. Correlation has also been demonstrated between the smoking habits of close family members: young people are more likely to take up the habit if their parents smoke.(Ewles:2005) Questionnaire and survey A set of questions addressed to a statistically significant number of subjects as a way of gathering information. Lung Cancer: The 2005 general household survey indicated that manual workers start to smoke at an earlier age, with 48% of men and 40% of women in manual occupations regularly smoking by 16, compared with 33% of men and 28% of women in managerial and professional occupations. (Cancer Research UK) Statistical analysis Used to determine likelihoods or probabilities. Lung Cancer Statistical Analysis provides a wealth of data and information. Available smoking statistics include incidence of cancer linked to number of cigarettes smoked per day and history of smoking. Also smoking statistics by age, socio-economic group, ethnic group, geographical variations and children are published. As an example, this graph illustrates the prevalence of smoking by age over three decades and shows the decline following the linking of smoking with cancer and the subsequent health promotion programme. Today, tobacco consumption is recognised as the UKs single greatest cause of preventable illness and early death with more than 114,000 people dying each year from smoking-related diseases including cancers. Â   (Cancer research UK, 2009) Before the dangers of cigarette smoking were widely known, smoking prevalence varied little by socio-economic group. Today there are clear differences due to the differential decline in smoking by social class that occurred in the 1970s and 1980s. By 2007, 25% of adults in manual occupations smoked compared to 16% of those in non-manual occupations. (Cancer research UK) The influence of these aspects of epidemiology on health promotion using lung cancer and smoking as an example. The World Health Organisation (WHO) defines health promotion as the process of enabling people to increase control over and to improve their health. The mortality rates for cancer in general, and in particular lung cancer, highlight this as a health issue of significant importance and worthy of focus and resources. The Doll cohort study demonstrated the correlation between smoking and lung cancer. Naidoo Wills in Key Topics in Public Health say, The single most critical area for action to reduce cancer is smoking. It is estimated that 1 in 2 smokers will die of a smoking related illness. If current smokers can be encouraged to quit mortality will be reduced: discouraging young people from starting to smoke will reduce smoking-related deaths during the second half of the twenty-first century. (Cancer Research UK) Health promotion to reduce the levels of lung cancer has therefore focussed on smoking cessation. Health promotion strategies have three components: education, service improvement and advocacy. Using lung cancer and its correlation with smoking as the example again: Education involves increasing awareness of the risks, the benefits of quitting and practical ways of stopping. Service improvement involves actions of primary care such as clinics and availability of nicotine patches. Advocacy involves enforcement of controls such as laws preventing sale of cigarettes to under 18s and the ban on smoking in public places. (Hebley Copeman, 2008) Statistics show which groups are more likely to smoke and the greater degree of risk they face. The correlation between smoking and social class, indicated by the Household survey, highlighted that smoking rates are highest amongst manual workers. The need to target this group is recognised in the Government white paper Choosing Health: Making Healthier Choices Easier which sets a target for reduction of smoking prevalence in this group. Smoking is a key contributory factor to health inequalities between socio-economic groups in the UK and accounts for a major part of the differences in life expectancy between manual and non-manual groups and is a key focus of the current government. (Department of Health, 2009) Other current priorities are; the very young who are at risk of uptake and the problem of passive smoking. Evidence suggests a correlation between young people smoking and the smoking habits of their parents. People who start to smoke in their teens do so because they adopt the social pattern of their family. The habit quickly becomes an addiction, which is very difficult to break. It is easier to stop a young person from starting to smoke than getting someone to quit. Specific measures are in place to focus on the very young including the banning of sales to under 18s. This group is also highly influenced by advertising and as a result TV advertising has been outlawed. The effects of passive smoking on children, in particular, have been highlighted in a graphic T.V. campaign which demonstrates to parents the harm they are causing their children. Examples of other, current, health promotion initiatives aimed at smoking cessation include: * Point of sale promotion has been severely restricted. * In July 200, the advertising of cigarettes at sporting events, including Formula 1, was banned. * On July 1st 2007, it became illegal to smoke in a public place or workplace including pubs. * All cigarette packets must carry a health warning covering a specific percentage of the front and back of the packet. * Media campaigns have been graphic and disturbing. The fish hook advert highlighted the controlling nature of tobacco. Primary Care Trusts run cessation programmes, one to one support, group sessions, quit smoking helpline, education events in schools and provide free nicotine patches. The government levies ever increasing taxation on cigarettes to increase prices and give a financial incentive to individuals to quit. (Ewles, 2005:63) October 2009, MPs agreed a ban on cigarette vending machines. (BBC News, 2009) Annual no-smoking day. (Nosmokingday,2009) Epidemiological research also confirms the success, or otherwise, of health promotion strategies. Between 1970-2000, British men experienced the most rapid decrease in death rates from lung cancer in the world as a result of the success of the health promotion measures and smokers quitting the habit. (Ewles: 2005) Â  In the early 1900s, lung cancer was a rare disease causing fewer than 10 male deaths annually in every 100,000 men. By the 1950s, the lung cancer death rate had risen six-fold, prompting the first epidemiological study that linked tobacco smoking and lung cancer in Britain. By the 1980s, the death rate for lung cancer was over 100 per 100,000 men. From the early 1980s onwards, following extensive focus of efforts on smoking cessation, the male lung cancer mortality rates have fallen continuously. The striking mortality trends by age over the past fifty years for men in England and Wales are shown below: (Cancer Research UK) Conclusion By identifying factors that increase the risk of disease, epidemiologists provide crucial input into the formulation of public health policy. (Sci Tech, 2009) Measuring health is important for health promotion as it establishes priorities, assists in planning, enables prioritization of actions with high-risk groups, justifies use of resources and demonstrates the efficiency (or otherwise ) of health promotion initiatives. (Naidoo Wills, 2009). In many studies a categorical answer is never produced as there is never 100% proof of the outcomes, only evidence to suggest. For example, not everyone who smokes will contract lung cancer and some non-smokers do contract the disease. (Naidoo Wills, 2005) The epidemiological research which proved the link between smoking and lung cancer, and the subsequent health promotion strategies, have reduced the prevalence of smoking and consequently the incidence of lung cancer significantly over the last thirty years. Health promotion priorities and strategies are continually reviewed as new evidence to suggest is produced from ongoing epidemiological research.