Different Rates of Morbidity and Mortality - Essay Example

SOCIOLOGY Discuss the evidence that either social or gender is a determinant of different rates of morbidity and mortality. Satisfactory explanation for the ubiquitous socioeconomic status-health gradient remains elusive suggesting, in part, that an adequate model of this relation is probably complex and multifaceted. In this answer we provide an overview of data indicating that income is inversely correlated with exposure to suboptimal environmental conditions. By environmental conditions we mean the physical properties of the ambient and immediate surroundings of children, youth, and families including pollutants, toxins, noise, crowding as well as exposure to settings such as neighborhoods, housing, schools and work environments. We will also briefly cite evidence that each of these environmental factors, in turn, is linked to health. Health is defined in its broadest terms to encompass physical and psychological well being. We also note where there are relevant psychosocial processes known to be directly linked to health. For example some physical environmental conditions affect helplessness and individual beliefs about self-efficacy. These psychological processes are well identified precursors to psychological ill health. One can look at environmental pollutants at the tract level and rates of morbidity and mortality. It is important to remind the reader of the problem of the ecological fallacy. The ecological fallacy refers to the collection and analysis of data at one level of aggregation and the drawing of conclusions at another level of aggregation. An overarching problem that plagues much of epidemiology is the difficulty of disentangling environmental from individual based explanations of morbidity or mortality. Many people choose where they live. Individual health, mental, and cognitive status can affect trajectories of exposure to suboptimal environmental conditions. Research and discussion tends to be focused on specific pollutants, toxins, or particular ambient conditions such as housing quality and each respective factors link to income or health The poor are most likely to be exposed to not only the worst air quality, the most noise, the lowest quality housing and schools, etc. but, of particular consequence, the poor are significantly more likely to be exposed to lower quality environments on a wide array of multiple dimensions. In rental units in the United States, 10% percent of households with incomes below the poverty line rely primarily upon hot air units without ducts and 4% use unvested gas heaters as their primary heat source. For rental households with incomes exceeding $30,000 comparable figures are 7% and 1% for ductless hot air heat and unvested gas heaters, respectively (Statistical Universe, 2000). Toxic indoor air pollutants, NO2 and CO, related to combustion processes (stoves, heating, smoking), are substantially higher in low income, inner city residences relative to U.S. averages (Goldstein et al, 1988; Schwab, 1990) The poorer the individual, the greater the deluge of environmental degradation. Most attention to environmental pollutants and income has been focused on hazardous wastes and air pollution, there are several case studies suggesting higher levels of contaminated water among low income populations. Parental smoking which is inversely related to income levels increases children’s’ exposures to a wide variety of indoor toxins. For example, in the United States 65% of preschool children living in poverty have been exposed to cigarette smoke at home in comparison to 47% of those not in poverty (U.S. National Center for Health Statistics, 1991). Mothers who are poorer are also less likely to quit and smoke more than their higher income counterparts (Graham, 1995; Groner et al., 1998). GIS techniques provide a potentially powerful analytic tool to examine this hypothesis in the aggregate, depicting, for example, the overlay of poverty, disease specific morbidity/mortality, and multiple environmental exposure conditions. CONCLUSION: In the study of social factors and health, mortality is the ultimate outcome variable. Are there demographic, social, and psychological factors that determine the lengths of people’s lives? It is well known, for example, that one’s sex influences longevity. Socioeconomic position is related to mortality and morbidity risk. People in lower occupational social classes and people living in more deprived areas suffer more illness and die younger. Leaving full-time education at a younger age is also associated with greater mortality risk . The application of personal-psychological variables, such as personality and cognitive traits, to the study of human mortality has occurred relatively recently and as yet there are few studies. Some such findings came from the Terman Life Cycle of Children with High Ability study, which extended over seven decades. Measured in childhood, the personality traits of conscientiousness, lack of cheerfulness, and permanence of mood (for men only on this trait) were associated with longer lives . REFERENCES: -> Graham, H. (1995). Cigarette smoking: A light on gender and class inequality in Britain? International Journal of Social Policy, 24, 509-527 -> Goldstein, I., Andrews, L. & Hartel, D. (1988). Assessment of human exposure to nitrogen dioxide, carbon monoxide and respirable particulates in New York inner city residents. Atmospheric Environment, 22, 2127-2139. -> Journals on U.S. National Center for Health Statistics, 1991. DETERMINANTS OF HEALTH Drawing on relevant literature discuss what factors outside identified lifestyle behaviors may impact negatively on individuals health potential and discuss a health promotion strategy that may help tackle issues outside the realm of “unhealthy behaviors” The concept of ‘determinants of health’ is problematic (Frankish, Milligan and Reid, 1998).This is because categories classed as ‘determinants of health’ often overlap, such as employment, income and socio-economic status, and the evidence to link specific determinants to specific aspects of health is not always of sufficient quality. However, if determinants are taken as those factors influencing an individual’s health, then age is just. There are a number of other determinants of health of equal if not greater importance than age including lifestyle, education, socio-economic status, genetics, stress, exercise, nutrition, healthcare, etc (Frankish et al, 1998). For example, Frankish et al (1998) report those people with higher socio-economic status have been found in several studies to be those who tend to engage in more active, diverse and intellectually demanding activities, and tend to be those who have the knowledge, resources and time to organize and engage in sports activities, leading to improved levels of health. Income may constrain people’s ability to take part in leisure activities, creating a difference in the types of activities people not in employment engage in. Social support can also be important in determining engagement in active lifestyles, for example, those people with active friends are more likely to be active themselves; and. Furthermore, the social environment can be important in determining people’s physical and mental health and choices to engage in active lifestyles. This is evident in the increases in life expectancy for men and women to 76 years and 80 years respectively in 2002 compared to 45 years and 49 years respectively in 1901 (Office for Natinaol Statistics 2000) A longitudinal study also followed economically and educationally disadvantaged young inner city men in North America from approximately age 14 to age 70 and found personally controllable variables such as lifestyle choices were greater predictors of subjective and objective health in old age (Valliant and Western, 2001). This was compared to uncontrollable factors such as parental class and relatives’ longevity. This again suggests that chronological health is the most important determinant of health, but other controllable factors are also important. There is some evidence older adults undertake similar amounts of exercise to younger adults, implying an equivalent potential for healthy lifestyles. Frankish et al (1998) suggested older adults undertake the same amount of exercise, but the type of activities change; for example, older adults tend to undertake more walking but less team based sports. This suggests the intensity of exercise decreases but not the amount. There are a large number of factors outside identified lifestyle behavior which impacts negatively on individuals health potential. Traditional risk factors—such as diabetes, hypertension, dyslipidemia—and those specific to dialysis patients (anemia and mineral metabolism abnormalities) require regular assessment and treatment as per current recommendations. The relative importance and weight of each of these risk factors in the dialysis population is not known and, in the absence of controlled trials in this population, current recommendations from existing organizations should be followed, with special consideration given to potential risks. Furthermore, lifestyle issues such as smoking, physical activity, depression, and anxiety are the cornerstones of therapy as in the general population. The treatment options are often similar, but the impact of these factors is potentially more profound in dialysis patients. A large number of measures are to be considered in order to avoid the negative impacts of these factors on the health of an individual. A population health strategy needs to be formulated to avoid this type of concerns at a large extent. CONCLUSION: A population health approach addresses the entire range of individual and collective factors that determine health. Population health strategies are designed to affect whole groups or populations of people. The overarching goals of a population health approach are to maintain and improve the health status of the entire population and to reduce inequities in health status between population groups. The outcomes or benefits of a population health approach extend beyond improved health status outcomes. A healthier population makes more productive contributions to overall societal development, requires less support in the form of health care and social benefits, and is better able to support and sustain itself over the long term. Actions that bring about positive health also bring wider social, economic and environmental benefits for the population at large. They include a sustainable and equitable health care system, strengthened social cohesion and citizen engagement, increased national growth and productivity and improved quality of life. Thus such strategies needs to be formulated and implemented in the best manner. REFERENCES : - -> Avison William R. (1994).Stress and Mental Health : Contemporary Issues and Prospects of the Future. -> Frankish,Miligan & Reid (1998).Determinants of Health – Old Age Issue -> Minkler Meredith (1997).Community Organizing and Community Building For Health. -> Hartig Terry (2004). The Residential Context of Health. -> Tones Keith (2002).Health Promotion: Effectiveness, Efficiency and Equity. -> Valliant, Western (2001). Healthy Matters. Read More