Social Health Inequalities - Essay Example

Social Health Inequalities The condition of the health of the population in Britain along with other sectors like education, living standard and the income etc. have seen remarkable improvement in the lat century. The bad memory of Second World War and the penury it brought no longer exists. The over all performance of the population on health index has seen remarkable improvement. Life expectancy level has been improved to the level of one of the best in the world and the dreaded diseases have almost vanished with pro active and preventive approach of the government as well as the society. But despite all measures taken by the Government and the supported agencies, the problem of health inequalities has still a foot hold with widening of gap over general improvement between the people in advantaged and disadvantaged groups (Mielck & Pavis). Those in the disadvantaged groups have to see the least or less improvement in the over all health condition. They are more likely to suffer from diseases and poor health condition and expected to die earlier than the rest of the population. The reasons behind this condition of these people can be linked to a number of circumstances which includes their social and demographic conditions like educational improvement, occupation, and annual income, quality of the dwelling place, gender and finally ethnicity. Apart from these basic factors, health of the disadvantaged group is also dependent on their living habits which includes smoking, drinking, diet and other risk factors which indirectly or directly have an influence over things like life and death (Grahm & Kelly). Social Economic Condition and health If we look into the society of a single place or a number of societies in the whole, we will find that each of them has been stratified along cultural, religious or economic lines. The health and wellbeing of a person is very much a multiple of the three factors mentioned before. The same can be said about some diseases. Let us consider tuberculosis, this disease is very common among people in the lower income group. Even though our physical condition like height, built etc. are genetic in nature but still the over all health condition is dependent on lots of external factors. The general factors begin with Individual Life style factors then social and community networks and finally general socio-economic, cultural and environmental context. These factors can further be given specific identification i.e, education, work environment, living and working conditions, employment status, water and sanitation, health care services and finally housing and food habits. These are all the different determinants of health (Grahm & Kelly). Now looking into the health condition of Britain with above mentioned factors, the social classes which can be said to be at the receiving end of the poor health condition are the class IV and class V. These classes comprise of people who are either partially skilled or unskilled and are manually contributing to the economy. The inequality is very much visible through the statistics related to the mortality. The average life expectancy among male in the social class I is around 5.2 yrs more than that from the social class V. In case of females this difference is somewhat less and the ladies from social class I enjoy a better life expectancy of around 3.4 yrs in comparison to that of social class V. The ill health scenario of the lower class pushes people to go down the occupational ladder and people finally get jobs with less-well paid jobs and consequently the social status and class sees a continuous fall on the health status. Individuals from the lower socio-economic groups have often got influenced by dominant values which have crept in their class for centuries. The inclination of individuals to co-opt according to the social class has often promoted these individuals to adopt lifestyles which may cause harmful effects. They are subjected more towards excessive alcohol intake, smoking and nutritionally deficient diet. So the cause of poor health among social classes IV and V can be attributed to poor environmental as well as material conditions which finally dent the social support systems (Smith, Dorling, Mitchell, Shaw). In Britain, it's the occupation which acts as primary parameter to measure inequalities. With five different classes of occupation beginning from class I in the top to class V at the bottom, the class I is for the most skilled and highest earning group while the class V comprises unskilled manual workers which includes laborers, workers and domestic servants. Though the whole society has shown better performance but the gap between the two extremes of the classes has always widened with time. The disadvantaged group has lagged behind in almost all parameter over which social growth is measured. The ethnic factor has its own role. The factors like educational attainment, employment opportunities and health have often been coupled with ethnicity. The class V can be termed as the most complex of all with people of other ethnicity making the biggest contributor to this section. The poorer health of the class gets contributions from migrants form South Asian, African and Caribbean nations. These people are often exposed to racism while obtaining jobs or work. Social factors, social process behind this health inequality and possible solution Social factors and circumstances play an important role in the over all health and life expectancy of a particular person. The difference in health from top to bottom is clearly visible if occupation is considered as a parameter. The occupational hierarchy can be correlated with the current health status of any individual. Similar differences can be viewed if measurement is done according to people's socioeconomic circumstances. These circumstances can have its occurrence because of the subject's education, income and housing. The government policy to ensure health equality through the reduction of inequality causing factors requires proper study of these factors. The factors discussed above have led to the policy making in two different but logically interrelated directions. The first policy is to focus on poorest circumstances; poorest health and the subject for the policy implementation are those who are the most socially excluded; facing the most of the given risk factors and most difficult to approach. The second approach while deciding policies interlinks some of the conditions or situations taken for consideration while deciding things related to the policy making in first go. Some of the interlinked approaches are those in the poorest circumstance are in the high probability state of poorest health. This probabilistic approach ensures that a large number of people of the lower income group are having poor health condition but it doesn't undermine the possibility of someone belonging to advantageous economic condition but having poor health. So this approach not only includes the extreme cases but also many possible intermediary occurrences. Hence the approach for the second policy takes a whole view of the society to ensure proper health. The large number of people who might be in the advantageous group but unfortunately has many disadvantages in health terms have also been given equal weightage. The study and decision making according to this policy may result in better outcome. The preventive and awareness programs can now have segregated implementation. So the main thing for the government is to reduce social health inequality through the study of different factors which influence an individual's health. A person's health and life chances depend on different social variables right from the mother's womb. Social circumstances stats affecting them even before they are born. Pollution that may be either in form of air or water has its implications on fetus. Smoking has been a very important factor on the weight of a new born child. The act of smoking by a pregnant woman or any other person who lives with her causes lots of adverse effects on the unborn child. There can be a case of birth of an underweight child. The low birth weight is more likely to cause mortality in infancy or lifelong poor health scenario. There is a very good chance of premature birth of the child and the babies are more likely to die in infancy than their normal counterpart or if they remain alive then they will suffer certain health disorders especially respiratory problems like asthma or chest pain. The passive smoking by the child through the exposure to parent's cigarette smoke can also cause long-term health complications. There has been a very close relationship between smoking and socioeconomic status. The percentage of women from the upper classes who continued with their smoking habits during pregnancy was as low as 8 percent while the same in lower social classes i.e. class IV and class V are more likely to smoke with actual percentage getting higher to 29 percent if we look into those who are engaged in manual jobs while the percentage among non working women of the same lower class further rises to 36 percent. So the overall approach to health inequalities encompasses along the fact that health of a person is the result of a very complex function of factors and circumstances that come into existence right from the period he or she is conceived by the mother. In UK, the incidence of low birthweight babies has been highest among single mothers or unwed mothers. This was followed by those children who have got birth in families where the person who is the bread winner is engaged in some routine job with overall nature being manual. But this figure of low birthweight sees a sharp fall among those babies who has got birth in well to do families or those families where parents or better to say father is doing some professional work. Similarly late motherhood is also a very important reason for the birth of low weight babies. Mothers who are young and are in their twenties have given birth to healthy babies (Office of national Statistics). Infant mortality is another issue and is a very strong indicator of over al health of the community. But despite greater improvement of the population on overall social health index, infant mortality rate remained high among lower income group families. The socioeconomic factor continued playing a role and babies with fathers in semi-manual or manual professions are more likely to face the risk of life threatening complications which may result to death or permanent disability. But the case is quite opposite among social groups of class I and II. Infant mortality is lowest and this is attributed to improved living conditions which also include sanitation and diet. Apart from these benefits, the access to better medical facilities and healthcare ensure healthy babies right from the birth to continued infancy (Department of health). Smoking has its effect not only on children but it is also the main cause of higher death rates among those who are in manual occupations as compared to those who are doing non manual jobs (Crosier). Those in manual groups are more likely to smoke and that too from a very young age. It has been observed that level of smoking among manual or semi-manual workforce has been considerably higher than those in non manual jobs irrespective of the adult being a man or the woman. Smoking habit is also visible among migrants. Apart from smoking habit, the thing which has been the major cause of concern is the dependence on nicotine. Frequency of smoking cigarette among manual workers is much more than those working as professionals. The nature of job and working environment is a very important factor in the smoking habit. Manual workers have to work in field jobs or at some open space with similar peer group. The ethnicity of the person also plays an important in the continuance of smoking habit. Bangladeshi has been seen as the most cigarette smoking group with almost 44 percent of the male populations are regular smokers (Raeligh & Polata). The white Irish occupy the second spot with almost 39 percent while the black Caribbeans are the third with 35 percent of them smoking cigarettes regularly. But if we talk of women then it's the white Irish and black Carribbeans who are regular smokers. Smoking by a Bangladeshi woman is quite rare. These migrant specially Bangladeshi and Blacks forms the considerable portion of lowest socio-economic class (Office of National Statistics). Drinking or excessive consumption of alcohol can cause diseases mainly those which damages liver. Other problems like cancer, heart disease etc. can also prove fatal. The pattern is very much different. People in upper social classes are excessive drinkers. This is almost an about turn of what has been observed about smoking habits. Lower income group are mainly moderate drinkers while the number of cases of binge drinking is very high in social class I and II. But when women are considered then those in the manual groups are more likely to indulge in binge drinking there by exceeding the government recommended 14 units. Ethnicity again becomes a factor but this time it shows different trend. Except White Irish who led the chart with 58 per cent exceeding the bench mark, all other ethnic groups are more likely to be non-drinkers or moderate drinkers(Office of national Statistics). Since smoking can cause great harm to one's health but at the same time diets which causes obesity are equally harmful. Developed countries including the UK have been greatly affected by obesity. Obesity is actually the result of fat rich diets compounded with least active lifestyle. With rise in cases of obesity, the society has now put itself in a high risk health condition with increased possibility of coronary heart disease, cancer and diabetes. The Health Survey for England has found out that this obesity is the reason behind the premature death of almost 9000 people every year. This rise in obesity is prevalent in both children and the adult. The source of income is again a factor for this health problem. Though both manual and non manual classes have observed rise in the cases of obese children but among manual classes the rate of increase has been more pronounced irrespective of the child being a boy or a girl. The girls belonging to the social classes of I and II have been least obese with percentage being only five percent. The same percentage rises to eight and nine among semi manual or manual classes. Also obesity prevalence is more in women than in men. And this too is very much according to the class they belong. Obesity among ladies with manual occupation is much higher than those who are doing managerial jobs. Almost 35 percent of the women who are doing routine or semi-routine jobs are obese while only 16 percent of those in managerial jobs can be classified as obese. Ethnicity again comes into picture when cases of obesity is started being a matter of study. Bangladeshi and Chinese men are the least obese people in England but when women are taken into consideration, almost 32 percent of Caribbean and 26 percent of Pakistanis can be classified as obese. Health inequality due to this obesity is again visible with prevalence of obesity among manual social class being higher than those in non-manual class (Office of national Statistics). Mental health has now also been identified as a very important parameter to measure the health condition of a society or a class. People while suffering mental disorders are more likely to face improper physical health and social behavior and hence higher rate of mortality. Presence of neurotic disorders is very much dependent on the person's class. People belonging to poorer class with lower income group are more likely to report neurotic disorders. The poor financial condition often create complicated situation like proper food, shelter and over all happiness. Health inequality because of different social class is again very much visible with a majority of cases of neurotic disorders are coming from the lower social classes with semi-routine or routine jobs (Office of National Statistics). Though all the above mentioned factors have related social differences with health inequality but this fact has been boldly underscored by the data which relates death rates and life expectancy and the social class. The male life expectancy at birth among peoples of social classes I and II has been averaged to 72 years but the same among social class V is just 66.6. Similarly among women, the difference between average life expectancy at the time of birth is 5.7 years with professional ones having better life expectancy. Respiratory disease cases have many more occurrences in lower income group. All this have been attributed to poor working environment among manual workers and hence they are almost five and half times more likely to die than those who are professionally well equipped with clean working environment (Office of national Statistics). Conclusion The over all health of the people has seen remarkable improvement over the last century with higher life expectancy and continuous improvement in medical science and technology. Government initiatives have also played some of the most revolutionary results with many deadly diseases getting wiped out. However the inequality factor has also raised its ugly head with clearly visible differences in the way the health and the medical support have been provided to the one who are from the higher income group and have got the ambiance of one of the best working environment. Those in the social class IV and class V are more at the risk of life threatening diseases like cancer and heart stroke . Reference Graham, H. & Kelly, M. P. Health inequalities: concepts, frameworks and policy. 2004. NHS Health Development Agency 25 Feb. 2007 Smith, G. D., Dorling, D., Mitchell R., Shaw M. Health inequalities in Britain: continuing increases up to the end of the 20th century 2002. J Epidemiol Community Health 26 Feb. 2007 Office of national Statistics. Focus on Social Inequalities 2004 26 Feb 2007 Crosier, A. Smoking and Health Inequalities 2005. 27 Feb 2007 < http://www.ash.org.uk/html/health/pdfs/inequalities.pdf> Raleigh, V. S. & Polata, G. M., Evidence of health inequalities 2004 26 Feb 2007 Department of Health, Review of the Health Inequalities Infant Mortality PSA Target 2007. 01 March 2007 Postnote Ethnicity and Health. 2007. Parliamentary Office of Science and Technology 01 March 2007 Mielck, A. & Pavis, S. 1998 Perception of Health Inequalities in Different Social Classes, by Health Professionals and Health Policy Makers in Germany and in the United Kingdom, Berlin 02 March 2007 Read More