The Possibilities of Living a Healthy Life May Be Determined by a Persons Racial Origin - Essay Example

The possibilities of living a healthy, long life may be determined by a person's racial origin discuss. This paper has discussed that how racial origin effect person's health morality and morbidity. Research shows degree of conformity and commonality of those who share this social and cultural heritage. It include factor such as physical appearance, language, kinship organization, speech patterns, food traditions, long-standing rituals, religious belief systems, and in particular, health beliefs and treatment actions. The main body of the paper has shows the mortality and morbidity ratios for minorities and their health seeking way. A deep and probing inquiry on race along with reasons also discussed. The term 'race' is also been discussed as it appeared in formal English literature in 1580. The Black Report (Townsend and Davidson, 1992) endorsed the underlying principles of the RAWP formula but identifies three inadequacies: Inadequate and inconsistent application of both the principles and the methodology of the formula. Inadequate measure of need in the formula itself. Attention was drawn to housing indicators, such as overcrowding that were omitted. Inadequate attention to the use as well as the level of resources allocated in any region. www.bris.ac.uk/poverty/wales_files/NHS-RAR_6.doc Anthropologically, racial groups are defined as "those who share a sense of cultural and historical uniqueness, and to act as a member of an ethnic group is to express feelings or call attention to that uniqueness" ( Mindel and Habenstein 1981). There is a degree of conformity and commonality of those who share this social and cultural heritage. It is expressed in a variety of ways, such as physical appearance, language, kinship organization, speech patterns, food traditions, long-standing rituals, religious belief systems, and in particular, health beliefs and treatment actions. Thus, Race is a major factor in determining health longevity. Of all the factors that adversely affect the health status, race is one of the major contributors. The roots of the problem can be traced back thousands of years to the very origins of Western life sciences and the health subculture. But racial effects on health outcomes are often ignored and obscured by the very medical and health establishments that purport to aid those afflicted. Mortality variations racial origin differs from variations in morbidity (disease). Although white have lower death rates and higher life expectancy at every age, they are more likely to seek care for illness. Consequently, they are more likely to report suffering acute and chronic illnesses, but often their problems are less life threatening than those among Asian. Race operates in society today more explosively and confusingly than ever before. Many factors confuse and reignite this ever smoldering social issue. They include, but are not limited to, the efficacy of the more subtle racialist mechanisms of economic and social domination and discrimination; a relatively new and modern racialist mechanism built around the erection of a minority culture-based, IQ- and achievement test-oriented "meritocracy" favoring groups with access to privileged environments and quality education and training; the emergence of political and religious conservative movements with their traditions of religious and racial intolerance; the emergence of aggressive feminist and newly empowered Caribbean and Asian groups competing for limited jobs, training and educational opportunities, and political positions previously allocated for non-Europeans and women; and the lack of political, economic, and ideological commitment by the nation's minority leaders to openly address and alleviate the impact of racism in U.K. society. All these potent forces threaten to overpower the interests of Britain's largest minority group. For a variety of reasons, racial and ethnic polarization seems to be intensifying. How does race affect contemporary U.K society-particularly health care As evidenced by persistent race -based health disparities and segregation in the health care system, a new "hostile and unequal" racial climate profoundly affects African Caribbean and Asian health and health care. In 1989-92 mortality ratios for deaths, including perinatal mortality, from all causes for nearly all migrant groups were higher than average. However, those born in the Caribbean had a lower than average mortality ratio. For each group, except women born in Scotland, mortality from all causes fell between 1971 and 1991. Cause and age specific mortality varies by country of birth. For instance, mortality from coronary heart disease is higher than average for people born in South Asia, Ireland and Scotland and lower than average for those born in the Caribbean and men born in West Africa. Mortality ratios for cerebrovascular disease are significantly higher than the average for all migrant groups except those born in East Africa. By contrast, mortality ratios for lung cancer are low in migrant groups born in the Caribbean, Asia and Africa and high in people born in Scotland or Ireland, whereas cervical cancer mortality is high for women born in the Caribbean (Harding S, Maxwell R., 1997, Balarajan R, Soni Raleigh V. 1995). Mortality from suicide is also unusually high in young South Asian women born in India (Soni Raleigh V, 1996). Mortality ratios for accidents in people under the age of 15 years and over the age of 65 years are greater in migrants from Ireland and the Indian sub-continent than those born in England and Wales (Balarajan R, 1995). http://www.archive.official-documents.co.uk/document/doh/ih/part2h.htm Overall people from minority ethnic groups are more likely to describe their health as "fair" or "poor" than the ethnic majority, although this difference comes from the poorer self-reported health of Pakistani and Bangladeshi people, and, to a lesser extent, African Caribbean people (Nazroo J, 1997). Chinese people consult less with their general practitioner (GP) than whites and African Asians are as likely to have consulted with their GP as whites. All other groups consult more (Nazroo J, 1997). A variety of conditions show differences between ethnic groups. For example, South Asians have a tendency to central obesity and insulin resistance which may pre-dispose them to diabetes and coronary heart disease (McKeigue P, Sevak L, 1994). On the other hand, African Caribbean people have low death rates from coronary heart disease despite their high prevalence of diabetes and hypertension (Wild S, McKeigue P. 1997). Depression appears to be more common in African Caribbeans than in whites (Nazroo J, 1997). Tuberculosis is more common in Pakistanis, Bangladeshis and Black Africans than in whites, and the incidence of tuberculosis in these groups is rising (De Cock K, Low N, 1997). There are limited data on morbidity in white minority ethnic groups, and they were included with the white majority in the Fourth National Survey of Ethnic Minorities, the source of much of the recent data on the health of minority ethnic groups. However available data support the view that Irish people have higher rates of morbidity as well as mortality. Analysis of the long standing illness question in the Census, for example, shows rates are higher for those born in Ireland (Owen D. 1995). Rates of hospital admission for psychiatric disorder are also high in Irish people (Cochrane R, Bal S, 1989). Smoking is more common in African Caribbean and Bangladeshi men where the rates of smoking (42 per cent and 49 per cent) exceed those in white men (34 per cent). Indian and African Asian men report the lowest rates (19 per cent and 22 per cent). By contrast, in women rates of smoking are low (5 per cent or less) for all groups, except African Caribbean women, where the rates (31 per cent) are similar to those in white women (37 per cent). Alcohol consumption tends to be lower in all minority ethnic groups for both men and women compared to that in the white population. Comparable information is lacking for Scots and Irish people living in England and Wales. Total abstinence is common amongst Muslim groups, predominantly within the Pakistani and Bangladeshi communities (Nazroo J, 1997). In a survey of reported physical activity fewer men and women aged 16 to 74 years from minority ethnic groups than from the general population reported levels of activity which would benefit their health (defined as at least 30 minutes of moderate intensity physical activity on at least five days per week). For instance, amongst South Asian men aged 16 to 74 years, 67 per cent of Indians, 72 per cent of Pakistanis, and 75 per cent of Bangladeshis reported that they did not take part in enough physical activity to benefit their health, compared with 59 per cent of men in the general population. For South Asian women, the corresponding figures were 83, 86 and 82 per cent compared with 68 per cent of women in the general population. Furthermore, men and women from minority ethnic groups were more likely to report being sedentary than men and women from the general population (Health Education Authority, 1997). http://www.archive.official-documents.co.uk/document/doh/ih/part2h.htm A deep and probing inquiry on race is necessary for all of these reasons. One prerequisite is to factor in the effects of the centuries-old relationship between race, Western medicine, science, and health care. racial theorists and philosophers such as Patricia Turner and Lucius Outlaw have recently attempted to disentangle the new and complicated mix of race relations in the Britain. Their efforts at clarification are often complex and challenging. (Martin R., 1998) The word race appeared in formal English literature in 1580 according to Webster's Dictionary and other sources. Webster's definitions of race are broad and so variegated they become somewhat nebulous. The first definition is "a breeding stock of animals," alluding to current biological definitions. Webster's also defines race as "a family, tribe, people, or nation belonging to the same stock" and as "a class or kind of people unified by community of interests." This accumulation of various definitions demonstrates the broad range of intellectual territory necessary to cover the concept of race in the modern era. The word simultaneously refers to a biological term, a means of classifying different groups of people possessing common characteristics, and a socio-cultural concept. Moreover, all of these usages are correct and proper in this modern era of racial thought. (Anderson I, Kemp P, Quilgars D., 1993, 32) Studies also prove that Caribbean, Bangladeshi's, Indians and Pakistani's health -seeking process is quite different from local majority people. This behavioral pattern includes steps taken by an individual who perceives a need for help as he or she attempts to solve a health problem. Their Preventive health practices vary widely with each individual and group and are directly related to one's socio-cultural situation. Preventive health practices are also related to one's folk health belief system. What individuals think about maintaining good health and how they go about it are directly related to their folk/traditional preventive health care pattern. An individual's symptom definition develops when the degree of discomfort becomes noticeable and acknowledgeable by his or her cultural group. If the illness receives a cultural stamp, then a health care action follows. Cultural stamp refers to an agreed upon understanding and acceptance of a situation by those who share similar beliefs and values. Their illness related shifts in role behavior refers to the change or adaptation in the behavior of the sick or ill person. Whether the individual continues his or her daily activities or not is highly dependent on the ethnic/cultural group's definition of an ill/sick person. They lay consultation and referral, is the individual's familial, friend, or social network in seeking health care information. The lay consultation and referral network outside the household is likely to derive initially from friends and/or relatives as opposed to health care professionals. The major reasons individuals may utilize extensively their informal lay consultation and referral network for health care problems is that 1. the reciprocal give-and-take relationship between the individual and family, friends, neighbors, or acquaintances can act as a buffer between the individual and the stressful situation; 2. these sources can alleviate the stress by helping the person instrumentally or by helping the person psychologically better cope with the situation; and 3. there is the opportunity for everyone to be involved in the healing process. Studies have shown that ethnic minority populations tend to consult an alternative or native health practitioner primarily because of 1. their attempt to cope with health problems within the context of their resources and socio-cultural/ethnic environment; 2. their belief that alternative health practitioners have some control over the forces that cause anomalies in a person's life, whereas Westernized physicians cannot help certain cause of illness and misfortune; and 3. lower monetary expense associated with such treatments. (Siegrist J.1996, Karasek R, Theorell T., 1990) Their overall health seeking process illustrates how socio-cultural and ethnic factors may influence an individual's health care action. This framework of ethnic health beliefs and treatment actions provides a basis for understanding the ethnic and socio-cultural bond an individual may develop toward his or her health beliefs and treatment actions. The health -seeking process model should be considered only a framework for understanding ethnic health beliefs and treatment actions, not an absolute, structured model for understanding the multifaceted approach connected to health seeking (Levi L., 1992). Especially, In Caribbean and Asians, an individual's symptom definition develops when the degree of discomfort becomes noticeable and acknowledgeable by his or her cultural/ethnic group. If illness receives a cultural stamp, a health care action follows. Chinese medicine, for example, may be divided into three distinct, but related, types: classical Chinese medicine, medicine in contemporary China, and Chinese alternative medicine (Gould Martin and Ngin 1981, Pp. 130 - 171). The use of traditional Chinese medicine varies widely according to gender, age, class, region of the United Kingdom, generation (first, second, and third), and degree of assimilation to mainstream society. Classical Chinese medicine is a doctrine based on ancient texts and the principle of the yin and yang. The three most famous texts are the Huang Ti Nei Ching (The Yellow Emperor's Classic of Internal Medicine), the Shang Han Lun (Treatise on Fevers), and the Shen Nung Pen Ts'ao Ching (Shen Nung's Classic Pharmacopeia) (Gould-Martin and Ngin 1981). Chinese medicine in contemporary China draws ideas from both classical and folk traditions but is a pragmatic and progressive system. The scientific methods of phytochemistry are applied to traditionally prescribed herbs in a search for their active ingredients. Patients preparing for open chest surgery learn ancient breathing exercises. Moreover, minority who make it to the oldest ages despite environmental stress and relatively high death rates for most causes do seem "destined by natural selection to live an especially long life." Differences between races as a whole in education, income, health care, and other aspects of socioeconomic status produce higher death rates among blacks in the younger ages that winnow out the least durable individuals, leaving less variation in the health conditions and survival potential among the oldest blacks than the oldest whites. This is reflected not only in the crossover in the oldest ages, but also in the gradual narrowing of the minority and majority mortality gap after age 45 or so, when the aging process and morbidity become more alike for the races, until elderly minority finally gain the advantage. Since the crossover has roots in racial mortality variations in the younger ages, the crossover actually reflects three conditions: (1) greater social, economic, and health disadvantages for minority; (2) markedly higher age-specific death rates for minorities than for whites through middle age, essentially because of the disadvantages; and (3) a slower rise in the death rate of minorities than whites after middle age, until the two rates converge in old age and the convergence finally produces the crossover. Since the foundation of the NHS, equitable allocation of resources, particularly between regions, has been a challenge for policy makers almost throughout its history. In 1975, the Resource Allocation Working Party (RAWP) established a weighted capitation formula to address regional inequalities in health and ensure an equitable distribution of resources according to need. The Black Report (Townsend and Davidson, 1992) endorsed the underlying principles of the RAWP formula but identifies three inadequacies: Inadequate and inconsistent application of both the principles and the methodology of the formula. Inadequate measure of need in the formula itself. Attention was drawn to housing indicators, such as overcrowding that were omitted. Inadequate attention to the use as well as the level of resources allocated in any region. http://www.bris.ac.uk/poverty/wales_files/NHS-RAR_6.doc. In its analysis of health inequalities following the Black Report, The Health Divide (Whitehead, 1992) draws attention variations within regions and to sub-regional areas of deprivation that were actually worse off under the revised weighted capitation system introduced under the Conservative Government in 1992. The Review of RAWP established in 1985, intended to fine-tune the RAWP formula, marked an important step in developing policy decisions on resource allocation based on empirical data on levels and types of need rather than on informed judgments. The Acheson Report (DOH, 1998b) makes four specific recommendations (38.1-38.4) on resource allocation: A pace of change policy to enable health authorities furthest from their capitation targets to make faster progress. An extension of the needs based weighting principle to non-cash limited GMS resources and an assessment of the size and effectiveness of deprivation payments. A review of the size and effectiveness of the Hospital and Community Health Services formula and consideration of a stronger focus on health promotion and primary health care. A review of the relationship of the private sector to the NHS, with a suggestion that this compounds existing inequalities. www.bris.ac.uk/poverty/wales_files/NHS-RAR_6.doc The Acheson Report also recommends that Directors of Public Health produce regular equity profiles and triennial audits of progress towards achieving objectives of reducing inequalities in health. It also focuses on local partnerships to reduce inequalities and recommends that there should be a "duty of partnership between the NHS Executive and regional government to ensure that these partnerships work effectively (DoH, 1998b Para, 39.1). Key initiatives in reducing inequalities in health The UK Government has introduced a number of measures that aim to reduce inequalities in health. The 1998 Green Paper, Our Healthier Nation (DoH, 1998a), and the White Paper, Saving Lives: Our Healthier Nation (DoH, 1999a), identify the following key aims: To improve the health of the population as a whole, by increasing the length of people's lives and the number of years people spend free of illness; To improve the health of the worst off in society and to narrow the health gap" (DoH, 1998a, p5). www.bris.ac.uk/poverty/wales_files/NHS-RAR_6.doc Thus, Mortality and morbidity comparisons by race and other characteristics show how strongly socioeconomic factors are implicated in the differentials. I believe Level of education seems a more strategic factor than income, occupation, and other indicators of socioeconomic status, partly because education is a fairly fixed index of status for most persons after age 25 or so, whereas the other factors often vary substantially throughout adulthood. Unfortunately, however, the data on age-specific mortality by any of the socioeconomic variables, including education, are quite limited and enable only a brief look at their influence. Today, racial group are faced with a number of health -related issues. Many of the old ways of diagnosing and treating illness have been modified and changed. Yet it is still important to understand the framework of traditional health beliefs and treatment actions in order for any intervention to occur. References: Gould-Martin K., and C. Ngin. 1981. "Chinese Americans." In Ethnicity and Medical Care. A. Harwood, ed. Pp. 130 - 171. Cambridge: Harvard University Press. Sidel Victor and Ruth Sidel. 1984. Reforming Medicine: Lessons of the Last Quarter Century. New York: Pantheon Books. Martin R. Regional dimensions of Europe's unemployment crisis. In: Lawless P, Martin R, Hardy S, eds. Unemployment and social exclusion: landscapes of labour inequality. London: Jessica Kingsley Publishers, 1998. Anderson I, Kemp P, Quilgars D. Single homeless people. London: HMSO, 1993. Siegrist J. Adverse health effects of high effort/low reward conditions. Journal of Occupational Health Psychology 1996;1:27-41. Department of Health and Social Security. 1980 Inequalities in Health: Report of a Research Working Group (The Black Report) ( London : Department of Health and Social Security ). http://www.archive.official-documents.co.uk/document/doh/ih/part2h.htm Soni Raleigh V. Suicide patterns and trends in people of Indian sub-continent and Caribbean origin in England and Wales. Ethnicity and Health 1996;1:55-63. Harding S, Maxwell R. Differences in the mortality of migrants. In: Drever F, Whitehead M, eds. Health inequalities: decennial supplement: DS Series no.15. London: The Stationery Office, 1997. Balarajan R, Soni Raleigh V. Ethnicity and health in England. London: HMSO, 1995. Nazroo J. The health of Britain's ethnic minorities: findings from a national survey. London: Policy Studies Institute, 1997. McKeigue P, Sevak L. Coronary heart disease in South Asian communities. London: Health Education Authority, 1994. De Cock K, Low N. HIV and AIDS, other sexually transmitted diseases, and tuberculosis in ethnic minorities in United Kingdom: is surveillance serving its purpose British Medical Journal 1997;314:1747-31. Owen D. Irish-born people in Great Britain: settlement patterns and socio-economic circumstances. Census statistical paper no.9. Warwick: University of Warwick, Centre for Research in Ethnic Relations, 1995. Cochrane R, Bal S. Mental hospital admission rates of immigrants to England: a comparison of 1971 and 1981. Social Psychiatry and Psychiatric Epidemiology 1989;24:2-11. Health Education Authority. Guidelines: promoting physical activity with black and minority ethnic groups. London: Health Education Authority, 1997. Balarajan R. Ethnicity and variations in the nation's health. Health Trends 1995;27:114-119. Wild S, McKeigue P. Cross-sectional analysis of mortality by country of birth in England and Wales, 1970-92. British Medical Journal 1997; 314:705-710. http://www.bris.ac.uk/poverty/wales_files/NHS-RAR_6.doc. Karasek R, Theorell T. Healthy work. New York: Basic Books, 1990 Read More