The NHS and Inequality - Essay Example

The NHS and Inequality Introduction Whilst the best of intentions exist within the NHS, there is still widespread evidence of inequality of care, which the NHS is attempting to address. According to the 2001 UK Census, the population in the UK grew by 6%, 73% of which was due to black and minority groups (1.6 million), compared to whites (600,000). Some basic statistics presented by the NHS reveal that Asian women age 65 and older have the highest rate of limiting, long-term illness (64.5%) compared to 53.1% of all women age 65 and older (Department Of Health, 2005). In terms of infant mortality, Pakistani women experienced a significantly higher number of newborn deaths at 10.5 of 1,000 births, compared to 8.5/1000 infant deaths from mothers of Caribbean origin. Gypsies and travellers are reported to have significantly poorer health yet are less likely to visit a GP, nurse, dentist or other NHS health care professional. How is the NHS coping with an increasingly diverse population This paper will explore some of the problems and proposed solutions. Gender Inequality There is a marked difference in the health needs of men and women, partly because of the biological differences between them. Socioeconomic factors also come into play; single mothers have significantly higher risks of depression and stress related illnesses, especially if they are poor and not able to provide enough food for themselves and their children. Poverty stricken women with children are less likely to seek health care assistance due to economic restrictions as well as the cultural restrictions mentioned above (Sir Donald Acheson, 1998). Men have higher mortality rates in terms of accidents, certain cancers and cardiovascular disease. Men also have a higher rate of health problems due to alcohol and drug abuse. Women of advanced age have more incidents of disability, due to osteoporosis and other illnesses related to menopause and post-menopausal complications. The recommended policies for changing the inequalities of gender-based health care include promotion of healthier lifestyles (walking, exercise, improved diet, smoking cessation programmes), Recommendations for programmes for single mothers who are financially disadvantaged are aimed at financial assistance as well as availability of foodstuffs that will promote the health of expecting women as well as the mothers of young children, promoting health in the next generation in order to decrease nutrition-based problems later in life. Race Inequality This is admittedly a complex issue when dealing with a diverse population; firstly, many immigrants to the UK, the Commonwealth and the United States are deficient in the English language. Second, differing religions can dictate that a person visits a health practitioner of the same gender, religion and race. Third, economic disadvantages to minorities can be a deterrent, if the individuals do not live close to an NHS facility. Due to these factors, the results from surveys and studies regarding discrimination against minorities in terms of receiving health care cannot be judged as entirely trustworthy. The table on the next page will show the standardised mortality ratios, by country of birth, selected causes, men and women aged 20-69, England and Wales, 1989-92 (Acheson, 1998). Whilst it displays the ratios according to country of origin and gender, we must take the above factors of language, religion/culture and proximity into consideration. Also we must consider that some cultures do not understand the concept of preventative care. All of these factors could lead to false assumptions of discrimination; yet we must also not ignore the fact that this discrimination does still exist. Information gleaned from inequality and health care reports indicate that the culprit to health inequality is the ever-widening divide between socioeconomic factors. Blacks and minorities have long been occupying the lower end of the economic spectrum, and consequently the lack of education and proper medical care from infancy onward has created ill health amongst these groups. Coupled with the increased population of children as compared to adults, the long-term must be considered when looking at minority groups in terms of a healthy, productive population. See the table below: The above table reflects the proportion of adults to children, all grouped within the category of living below 50% of average income after housing costs (Hilary Graham, 1999). The unfortunate truth is that those exposed to poor health conditions in early childhood will tend to continue poor health into adulthood, creating a health inequality for years to come. According to Graham's research, adult conditions such as coronary heart disease and cancer in the lower socioeconomic strata can be traced to experiences and exposures in childhood. With the increase in child poverty, we can only expect to see these morbidity rates rise as well, without implementing aggressive countermeasures. Conflicting reports from surveys taken in the past few years muddy the clarity of what exactly is needed; for instance, a report licensed by ISQua (2004) shows that of about 370,000 people surveyed in four categories across 480 NHS organisations, the following data was presented: '- The patterns were markedly consistent across the four surveys, - There was a strong age effect. Older respondents answered more favourably than younger respondents, - Men tended to respond more favourably than women, - In the outpatient, A&E and PCT surveys, there were marked differences between ethnic groups, with white British and Irish respondents reporting more favourably than other ethnic groups, including other white and mixed groups. South Asian (Indian, Pakistani and Bangladeshi) respondents reported the poorest experience, followed by those of Chinese origin. Ethnic differences in the inpatient survey were largely eliminated once the effects of other factors were taken into account, although South Asians continued to show a poorer experience in some domains, - There was some evidence that respondents completing full-time education at an older age (a proxy for social class) commented more negatively than those leaving school at 16 years or earlier, - In the inpatient and A&E surveys, those who rated their health as poor responded markedly morenegatively about services than those who rated their health as good, - The variables examined accounted for a relatively small ( Read More