Causes and Consequences of Health Inequalities - Essay Example

Critically discuss the causes and consequences of health inequalities at the different stages in the life cycle. Introduction At present, the of global health has been at its most vulnerable. Even as the world has managed outbreaks of highly infectious diseases like SARS, meningococcemia, and the Avian flu, more and more diseases are plaguing citizens, including the ever present problem of AIDS, cardiac diseases, and other chronic illnesses. In different parts of the world, different health issues are seen, and majority of the health issues are highly relative in terms of impact. For the highly developed countries, chronic problems like hypertension, obesity, and diabetes are common; but for the developing states, majority of their health issues seem to revolve around infectious diseases, malnutrition, and vector-related illnesses. This indicates major inequalities in the manifestation of health issues. This essay will now critically discuss the causes and consequences of health inequalities at different stages in the life cycle. Possible causes may involve biological, genetic, and nutritional causes with consequences being social or psychological. This essay will also evaluate how a disadvantaged start to life can have significant consequences on health and well-being. The purpose of this article is to determine why health inequalities manifest differently, in the hope of establishing how health authorities can address these causes and minimizing their impact. Body Infancy years are particularly vulnerable years for most children and infants. These children have a developing immune system which makes them susceptible to infection. These children also do not have adequate strength and knowledge in protecting themselves against infection and health vulnerabilities (Johnson, 2009). As a result, they may pick up infections and other diseases simply by touching contaminated surfaces or eating contaminated food. Their body is also biologically developing and has not developed immunities to various diseases (Johnson, 2009). Vaccinations and immunizations are often administered to these children in order to prevent future infections and complications from immunizable diseases. The above conditions are however only ideal and based on the perspective of developed countries whose health services are subsidized by the government (Kruk, 2010). It is also based on a setting where the parents can afford to have their children immunized and can afford to secure adequate and quality health services as well as nutrition for their children. Studies indicate that inequalities in health would likely increase as children also age. In the UK, Case and colleagues (2008) as well as Currie and colleagues (2007) discuss how inequality is likely to increase until the age of 8, persisting from this age onwards. In effect, health inequality is based on the first years of life and would likely impact on the need for research on health inequalities during early childhood (Case, et.al., 2008). There are two possible explanations for the health gap seen among high income and low income households, and why the inequalities often increase with age. First of all, higher income for parents seems to be linked with a lower possibility for disease affliction. The likelihood is high for material resources available in order to avoid health issues and exposure to health risks (Currie, et.al., 2007). High income parents are more likely to provide clean environments for their children, thereby reducing their exposure to health risks. They are also in better circumstances in securing better nutrition and care for their children. Hence, with advancing age, children from low income families are exposed to various diseases. As a result, the gap between low income and high income children is likely to widen. Income can also reduce the negative effects of health issues (Case, et.al., 2008). High income parents are able to secure resources which reduce the negative consequences of diseases, mostly as they ensure the highest quality of services available for their children. These high income parents are also more knowledgeable about the different options in the child’s care. Previous studies have also indicated that the presence of a particular disease among low income families would often translate to a poor health self-rating (Condliffe and Link, 2008). There is also strong evidence which indicates that children belonging to poor households may not necessarily be open to severe health issues, however, it is undeniable that they are more susceptible to various diseases by the age of five (Condliffe and Link, 2008). They are also at a more adverse risk of being affected by major health issues as compared to their counterparts in high income families. Under these conditions, parental income plays a major role in one’s early vulnerability to health problems. There is also evidence supporting the fact that children from low income families would likely carry adverse health issues from one stage of their life to the next (Case, et.al., 2008). In general, high income children would likely fully recover from their diseases, but low income children have a greater probability of developing complications from their disease or also suffer additional congenital and digestive health issues. Aging is also one of the elements which have to be considered in determining the causes of health inequalities (Fritjers, et.al., 2009). As people age, their body ages as well, and with it, the accumulation of wear and tear makes them vulnerable to different diseases, including diabetes, cancer, hypertension, osteoarthritis, and similar chronic diseases. With the aging of populations in most countries, an important issue which has emerged in recent years include the relationship between aging and inequality (Fritjers, et.al., 2009). The complicated relationship between aging and inequality is very much linked to the also complicated relationship between health, income, and the well-being of the older population. There are various reasons for the existence and persistence of disparities in the health, wealth, and well-being of the elderly (Witoelar, et.al., 2010). First of all, health and wealth change with time throughout the life cycle. Health during one’s early years can affect one’s wellness later in life. Initial investments in one’s health and health shocks or disturbances may have an impact on the health and wellness of an individual during one’s elder years (Witoelar, et.al., 2010). In a similar vein, resources of individuals early in life, and the investments they have made in their life since their early years, including the health shocks and issues they have experienced in their life eventually decide the wealth and the wellness of the elderly (Witoelar, et.al., 2010). Inequalities in health and in wealth which have been seen early in life may eventually persist or even worsen in their older years. On the other hand, health may impact on their socio-economic condition and wellness (Michaud, et.al., 2007). In the same vein, health and health attitudes and behaviour may also be impacted by the resources of individuals and communities. In effect, inequalities in health may also increase the inequalities in other aspects of one’s life. In the past few decades, technological improvements in the research methodology as well as the availability of data on aging and health in developed states have allowed researchers to improve their understanding of ageing and inequality (McArdle, et.al., 2009). Data on developing countries are however still limited and information from them would have been helpful in studying the data on aging and inequality. The data available for developing countries indicate that their populations are relatively young as compared to the developed states; the developing states are however currently also experiencing a significant increase in their older population (McArdle, et.al., 2009). Lack of government and institutional resources available for the older population in developing states and the reduction in the younger population available to assist the older population indicates that securing care and support for the elderly population would be a significant challenge to these countries (McArdle, et.al., 2009). Family resources as well as conflicts within families have an important role to play in influencing the differences in the health and wealth of older adults (McCann and Dean, 2009). Another element to be considered is the fact that the persistent epidemiological transition from communicable diseases to non-communicable diseases in developing states would likely present bigger challenges as compared to those being experienced by developed states (Fritzell and Lundberg, 2007). Minority populations are more vulnerable to environmental hazards which often include limited neighbourhood and community resources. Issues relating to structural and community factors including residential segregation also indicate a persistent trend of disease and stress (Gee and Payne-Sturgess, 2004). The environment, which individuals are exposed to, can affect individual behaviour and cause poor health decisions, later leading to poor health outcomes (Woolf and Braveman, 2011). Minority-dominated neighbourhoods have been mostly dominated with fast food chains and less grocery stores as compared to white neighbourhoods (Woolf and Braverman, 2011). The setups in minority-dominated neighbourhoods also have an effect on families and their ability to secure nutritious foods for their children. The fact that fast foods are also supersized to bigger portions and still marketed at lower prices makes the fast foods easier and cheaper alternatives to these minorities. The lack of nutrition within this population also translates to schools which feature vending machines and highly-processed foods (Woolf and Braverman, 2011). This environmental setup has social implications mostly on shorter life-spans for the current generation affected by this type of diet. In addition, there are also health hazards seen in minority and low-income neighbourhoods, especially as some of these neighbourhoods may be located in toxic factories and similar areas which have poor sewerage structures and streets (Woolf and Braverman, 2011). Such conditions imply health risks including noise and water pollution and the exposure to carcinogens which are likely to increase their vulnerabilities to chronic diseases (Andersen, 2007). The residential environment for low income and minority groups is often poor, with structural damages common issues (Miranda, et.al., 2011). Housing conditions can also lead to different health risks and cause complications in birth as well as cause long-term effects for aging populations (Miranda, et.al., 2011). Occupational hazards are also common in poor housing structures with reports of higher exposure to these hazards among minorities and low income groups. Health inequalities are also founded on differences in access to health care. Differences include limited insurance coverage (Kaisser, 2008). Without health insurance, patients would likely delay medical care and may even go without their essential medical care, including prescription medications which they may make a difference on their general recovery. Minorities and low income groups in countries like the US may also lack the necessary coverage to ensure quality and available healthcare (Kaisser, 2008). The low-income groups may also suffer from limited access to source of care, with patients experiencing major difficulty in care, less doctor visits, and issues with prescription medications. Compared to whites, minorities and low income groups may not seek regular checkups and make do with emergency rooms and clinics for their regular healthcare (Goldberg, et.al., 2004). For some minority groups also, the fact that they may not be in the country legally may be a significant barrier in their health-seeking behaviour. This is especially apparent in the US where there are thousands of illegal immigrants. Inequalities in health and longevity based on socioeconomic status and relations have been considered in different studies (Tubeuf, et.al., 2006). Most of these studies present results which are consistent with previous studies which also point out that individuals with a higher socioeconomic status are in a better position of health. Findings have also prompted a reassessment of the idea that socioeconomic status and health is mostly attributed to issues which relate to poverty (Tubeuf, et.al., 2006). Much support is expressed for the fact that for permanent shocks to the health, cumulatively, the individual’s health would not be as stable during one’s older years. Under these conditions, there are significant benefits in managing health risks in different periods in order to secure protection against various health issues, including its financial impact (Graham, 2009). Such efforts may not however be reasonable with the inadequate insurance contracts currently available. Discounting the risks involved in health financing systems as is mostly seen in majority of Europe’s social insurance and tax-supported systems may help resolve this issue (Therborn, 2006). However it needs the stability across the generations; but this may cause strains on the various generations as the gap between the healthy and unhealthy expands. Where health issues would increase with aging populations, there would also be a greater inequality in health, especially where there are no balancing elements which would offset the generations (Kippersluis, et.al., 2008). Socioeconomic inequality in Europe and in other countries have been firmly established (Kippersluis, et.al., 2008; van Doorslaer and Koolman, 2004), however its causes have not been fully established. Assessments on how socioeconomic element differs in various life cycles can help establish these causes (Smith, 2005). In the study by Smith, (2005), gradients are seen to increase during the age of retirement. This is also apparent with the gradient indicating income loss from disease-related interruptions to work which usually ends following retirement. The European study by Kamrul Islam and colleagues (2007) manifests that the inverse u-shape in the age profile for the health income gradient usually persists after retirement. This is crucial to the current discussion as it seeks to establish whether health and socioeconomic status is based on the process of cumulative advantage (Wilson, et.al., 2007; Kim and Durden, 2007). Discussions on whether health issues which usually manifest in due time are levellers which decrease socioeconomic differences in one’s older years (Herd, 2006). Health distribution may be different across the life span as was already demonstrated above on the discussions involving children and the elderly. The changes in the health system including expanded coverage, improvements in medical technology, and options in the management of age-related diseases are also elements which impact on differences across the life span. Strong evidence is seen on links between early childhood and health experiences in later years (van den Berg, et.al., 2006). The socioeconomic gradient of health would likely be different for various ages especially in relation to socioeconomic differences (Bozzoli, et.al., 2007). These differences impact on age effects, however, they are also a significant interest in their own right. It is crucial to differentiate between inequality in healthcare and inequality in health. A history of assessing inequality in health care through utilization and expenditure measures has long been used by health analysts (Bertin, 2012). For the most part these analysts have been able to establish a positive gradient in relation to expenditures and income when controlling the assessments for health status in the UK (Bertin, 2012). Similar results have been seen in other countries, with some exceptions. Interest in more expenditures directed towards illnesses seem to be motivated among individuals based on access to care. Economists are more eager to consider the preferences indicated, however, the issues are more founded on health care literature (Farrell, et.al., 2008). Choices in health services have also been based on informed decisions. Issues related to health expenditures indicate that higher expenses may not necessarily mean better health outcomes. Professionals have often pointed out that overuse of surgeries to manage patients presents risks for surgical complications (Farrell, et.al., 2008). And for high income patients, they may choose surgery for their children and often expose these children to mortality risks. Health care expenses have also been utilized to establish assessments for full income, mostly those which include money income and government-supported health expenses (Fritzell and Lundberg, 2007). This method was used to assess full income older adults in the US which are eating up a significant portion of their health expenditures and compromising health allocations for the younger generations (Fritzell and Lundberg, 2007). The primary consideration in seeking full income considerations is the impact of health care spending. Health disparities in terms of health outcomes can be seen even where equal health services are made available. Granting that the health system is fair, providing adequate access for all individuals in society, inequality in overall outcomes may still be seen (Farrell, et.al., 2008). One of the reasons why the inequality would still persist relates to genetic differences within the population, mostly founded on income and other elements. However, majority of summary measures relating to income-based inequality discard such inequality by assessing a larger group of individuals (Contoyannis and Jones, 2004). Another source of inequality may be seen due to differences in health behaviour including diet, smoking, drinking, and other elements related to income and socioeconomic status. Contoyannis and Jones (2004) discuss that healthy living in 1984 has been considered strong predictors for favourable health conditions in 1991. This however begs the question on how individuals can separate preferences in terms of health-related actions and income in general. Another cause for income-based inequality is founded on the discussions of the model where income and health outcomes are mostly impacted by early childhood opportunities (Halliday, 2009). The flu epidemic of 1918 for example caused a long-lasting impact on the mortality and financial capabilities for the population who were in utero during the epidemic (Skinner and Zhou, 2004). This situation could have created income-related gradients not affected by other factors. Conclusion Based on the above discussion, health inequalities seem to be associated with income, genetics, age, and stage in the development cycle. For children and elderly adults, they are more vulnerable to health issues. For older adults however, they mostly have to bear the cumulative effects relating to health issues and shocks they have gone through in the past. It is also important to mention that low income individuals are more vulnerable to health issues; and coming from a low income setting during one’s childhood years exposes one to greater health risks in the near or distant future. There is therefore a significant relationship between income and health inequalities, especially in terms of difficulties for low income groups in securing improved health outcomes and conditions. Managing health inequalities therefore must be founded on resolving the bigger issue of poverty and limited access to resources and quality health care. References Andersen, R., 2007. 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Health Affairs 30 (10), pp. 1852–1859. Read More