Contemporary Issues in Health and Social Care - Coursework Example

Contemporary Issues in Health and Social Care Introduction This brief essay seeks to analyse five issues that are of current concern within the health and social care. The paper reviews these issues and then selects one for which an examination of how the media presents it is tenable. The aim of the paper is to evaluate how the ordinary public assesses reliable and valid media information about the health and social care today. The paper thus explains the ways in which such information is usable in influencing social attitudes and the behaviour of people as far as health and social care is concerned. The paper finally analyses how these shaped attitudes and behaviour can influence the realization of developments in the health and social care sector before drawing a tenable conclusion. According to World Health Organisation (WHO), the term health refers to a state (not quality) of having complete mental, physical and social well-being, one entailed by the mere absence of a disease or infirmity (WHO, 1946). This definition has not been revised since 1948. Some scholars have termed the definition as deficient in that it does not define how the state of health is achieved (Graham 2000). To such critics, health refers to a general condition of the human person in all aspects, or a level of metabolic and or functional efficiency of any organism (Graham 2000). Nonetheless, WHO’s definition is the universal definition of health used by most contemporary literature and the one adopted by this paper since it is the state that requires definition and not its acquisition process. In this regard, the term health and social care is taken to refer to all the services dealing with the attainment, recovery and maintenance of a healthy state, offered by facilities in formal set ups and social settings (Mackenbach and Kunst 1997, pp. 757-771). Health and social services include the prevention, diagnosis and treatment of diseases, or simply as the promotion, restoration and maintenance of health. Within the UK, the term health and social care broad refers to the set of integrated services availed by a region’s health and social care provider networks (Department of Health 1998c). A Review of Contemporary Issues in Health and Social Care Health and social services according to World Health Organisation are the single most visible functions and symptoms of a health system to users and even the general public (WHO 2010a). By service provision, we refer to the how such inputs as staffing, money, equipment installation and drug availability are collectively made accessible so as to allow prompt and readily available delivery of necessary health interventions (WHO 2010a). There is a consensus that overall health can only be achieved by striving for physical, social mental and well-being (Department of Health 1998c). These three elements of health are together referred to as the optimal Health Triangle (Department of Health 1998c). Literature review in this area helps qualify five contemporary issues of health and social care that are being subjected to massive coverage in media platforms. The five are inclusive of public housing, education, income, unemployment and poverty. While the four factors introduced above are equally pertinent to the discussion, this essay focuses on how poverty influences health and social care (Department of Health, 1998a). For this essay, the area of study is the UK and how poverty is relevant to contemporary media coverage of health and social care. Poverty in Health and Social Care This paper seeks to discuss poverty as a determining factor in health and social care. Poverty can be classified both in relative terms or absolute terms. What is usually discussed by most debate forums is relative poverty. Relative poverty refers to a comparative measure of how one individual or group is placed in an economic continuum with other individuals or groups (Bardsley and Morgan, 1996). This is contrastive to absolute poverty, which is universally accepted levels of lack and destitution where individuals are unable to meet basic needs. As such, while relative poverty may influence how regions and individuals are served by health and social care services comparatively, absolute levels of poverty mostly accrues when individuals or sections of the community cannot afford health and social care irrespective of how other individuals and communities access the same services. This paper shall concentrate purposively on relative poverty and not absolute poverty. Continued economic improvement of the UK economy has elevated the UK populace from extreme poverty levels (from absolute poverty that is) as compared to other regions of the world, although there still remains a worthwhile mileage to be covered (Mackenbach and Kunst 1997). Essentially, relative poverty here refers to the levels of inequalities and their effect on the provision and or access to health and social care (Bardsley and Morgan 1997, pp. 142-159). Some scholars have been able to identify a social drift in which people who frequently suffer health maladies also gradually decline in their socioeconomic positions (Department of Health, 1998a). A change in social class almost always triggers a change in access to health and social care services (McLoone and Boddy 1994, pp. 1470-1474). With this being the background of the paper’s focus, it is evident that the socioeconomic class can be linked to existing health inequalities across the UK populace (Mackenbach and Kunst 1997, pp. 757-771). This link has been exhaustively reviewed by many researchers since the 19th Century (Department of Health, 1998a). For instance, in 1842, Edwin Chadwick conducted a research on social inequality and how it affects public health (WHO, 2010b). He published the book, ‘General Report on the Sanitary conditions of the Labouring Population of Great Britain’. The book indicated that Liverpool’s average age at the time of death was 35 for the well-to-do professionals occupying the higher social stratum (WHO, 2010b). The average dying-age for labourers and servants was 15. Life expectancy rations have greatly improved in Britain since then for all the social classes, but the high level of inequality has remained (WHO, 2010b). The Fair Society, Healthy Lives Marmot Review of health inequalities as released in 2010 detailed the necessity of social equality (WHO, 2010b). In this modern perspective, poverty as a determiner of health covers political, material and psychosocial empowerment. The report stresses on the importance of creating conditions for the ordinary people to control their own lives (WHO, 2010b). The Marmot Review describes health inequality as the situation and or conditions in which differing social classes expect to different health outcomes. According to the Marmot Review, there is a clear cut social gradient linking health with deprivation and or being advantaged in health and social care and as determined by evident stratification of the society (WHO, 2010b). The report was actually developed from another Marmot report called “Closing the Gap in a Generation” which was commissioned by WHO and reached almost the same conclusions as regards poverty and health (WHO, 2010b). For both of these reports, health inequalities are deemed evident in the society. Further collating evidence, investigating measurements and identifying indicators or targets of that inequality is the only means of realizing improvements (WHO, 2010b). Such an exercise helps to suggest the most ideal strategies of implementing the desired reduction in socioeconomic health inequality (Bardsley and Morgan 1997, pp. 142-159). Importantly, the Marmot report was construed from a philosophical standpoint of creating ‘progressive universalism’ (WHO, 2010b). This means that the best intervention options are those that differentiate health and social care needs across the social gradient, where greater focus is given to the least well-off segments of the society. This according to the report, is the only way to create greater social justice attainments and lesser health inequalities (WHO, 2010b). The notions of ‘Health Equity’ as conceived by the report capitalises on the link between relative poverty levels and the health and social care provision in the context of searching for healthy living standards (WHO, 2010b). Notably, the report makes 6 core recommendations as the most appropriate intervention measures in eliminating adverse poverty-borne inflictions on health and social care standards (WHO, 2010b). These include, giving all children a good start in life, enabling every child, young person and adult to maximise his or her capability to control his or her health, creating fair and conducive employment for all, ensuring healthy living standards for all, creating and sustaining healthy environments for all communities, and finally strengthening ill-health prevention mechanisms (WHO, 2010b). The 1980 Black Report indicated that the UK have had a continued improvement of health for all social classes consequent to the 35 years that the National Health Service has been operational (Department of Health and Social Security 1980). Nonetheless, there remains a corelation between the social classes themselves (Department of Health and Social Security 1980). This inequality is registered in infant mortality rates, access and use of medical services and life expectancy. As the Black Report pointed out though, social class is itself a very complex construct incorporating social status, culture, wealth, employment and background (Department of Health and Social Security 1980). Independent Inquiry into Inequalities in Health Report (The Acheson Report) as published by the Department of Health’s Stationery Office in 1998, also delved into health inequalities in the UK after almost two decades since the Black Report (Department of Health, 1998a). The Department of Health had commissioned the Acheson report to explore numerous determinants of health and social care provision and to recommend on suitable policy aimed at overcoming health inequalities (Department of Health, 1998a). The report found that inequalities in health were pronounced by relative poverty levels in the populace, where the inequality determinants showed persistent differentials of income as well as social class in such measurements as mortality rates (Department of Health, 1998a). It would be very naive, the report says, to take a causal look at the relationship between social classes and preference of ill health. Individuals experience variant influences to their health most of which can be categorized within the social class umbrella (Department of Health, 1998a). These includes poverty levels, housing conditions, resource distribution, health services access, education provision, high health risk occupations, living environment etc, as they vary between social classes (Department of Health, 1998a). Important to note here is that poverty (being in the lower levels of a social inequality continuum) is demonstrably very influential to health. However, these material explanations by which poverty is denoted are not in themselves sufficient to explain how class differences afflict in health. This brings in the issue of how the media covers issues of poverty and regards health and social care services. The way that the media presents inequality (relative poverty rations) and health concerns are of utmost importance since as detailed in the argument above, it can easily be presented wrongly (Department of Health 1998b). For instance, a media report can rightly attribute low life expectancy ratios in poor, less developed nations to poverty (Department of Health 1998b). Nonetheless, there are diseases that afflict life expectancy rations adversely not necessarily because of poverty. A good example is the lifestyle diseases which are prevalent in richer nations of the West than in undeveloped nations (Department of Health 1998b). This is clearly not solely attributable to poverty (Department of Health 1998b). Media Presentation of Poverty in Health and Social Care circles Today in the UK, the most rampant media forms that help present health information to the public include print media (newspapers, magazines, brochures, books, tablets etc), film, radio, TV and the internet. A survey of a cross section of these media forms indicates that the media largely assumes an alarmist perspective in the presentation of health and social care information. What is mostly to be found in the mainstream press for instances are only news about high disease transmission rates in certain areas, number of deaths in a particular period consequent to health related maladies, dangers and risks for particular diseases etc (Isaacs, Stephen and Schroeder 2004, pp 1137-1142). Rarely can a news item be about prevention of ailments and maintenance of health. Indeed, rarely will media outlets cover the achievements of a community or government in reducing health inequality or making health and social care services to a less fortunate section of the community (Isaacs, Stephen and Schroeder 2004, pp 1137-1142). What makes news is what is alarming, the bizarre happenings, the failures of the government and such emotion-eliciting information. As a result, this perspective of presenting information triggers moral panic in the society. This trend is frequent in the press, radio and TV coverage of health related news (Isaacs, Stephen and Schroeder 2004, pp 1137-1142). In essence therefore, the manner in which the media presents information is rarely ever objective, reliable and or credible. Lack of objectivity means that the information presented has ulterior motives to subjectively influence public attitudes and behaviour towards a particular not necessarily noble goal. This accrues not just in the content of the information presented but also in the manner it is presented, the presentation format. Typical presentation style that is evident in all the media forms but which is overly frequent in the internet is the use of statistics as the basis of making an observation, recommendation and claim. The problem with this approach is that, as it is frequently repeated by most analysts, statistics can be used for almost any purpose by almost anybody. Some media information can use unemployment figures to imply that health and social care is inaccessible to most people in the community. The same figures can be used by another author to imply that poverty helps some people avoid such lifestyle diseases as obesity. Another observation is that almost all the statistics that get to be printed and aired as part of the information presented by the media constitutes big numbers in infection, death, uninsured, transmission etc. in most cases, this adds up to a great preference of misinformation. There is a lacking element in the information that the media presents to the public, that of educative role especially in the public’s own responsibility in maintaining their own health (Department of Health 1998b). An important area of interest is how this lack of objectivity in presenting information related poverty effects on public health and social care is the existence of variant views on what should be done about the current health inequalities, who is responsible for perpetuating it and should take the responsibility of resolving them (Isaacs, Stephen and Schroeder 2004, pp 1137-1142). Typical of the media currently is a blame game scenario where the ‘us versus them\attitude becomes the norm in which such information is crafted. In the resultant blame game, core issues that are pertinent in addressing poverty as an adverse influence on health and social care services provision are ignored (Isaacs, Stephen and Schroeder, 2004). The internet has become the singular most entrenched and fastest growing media form in the history of mankind. It has permeated every aspect of the society today and become a central platform for communication, interaction, education and product/service exchange. On the good side, the internet had made information readily available to every member of the society unlike when such information resided in secluded libraries. Deserving praise in this regard is the health and social care journals available online which present peer reviewed research information that is highly reliable and credible since it is collected by experts in various fields of health a and social care. The fact that the public can access information regarding disease symptoms, prevention and treatment options are very progressive indeed (WHO, 2010b). The internet also hosts some specialized sites for various health issues (poverty, health policy etc), diseases (cancer, diabetes, obesity etc) and health and social care administration (such as government departments of health, WHO etc). This makes the internet a comprehensive repertoire of crucial information that may help resolve some of the health inequalities evident in the society. This becomes vitally significant when one notes that most of the other media outlets such as the press and electronic media also source most of their information from online sources currently. These media outlets also have their own websites where any of their reported news is featured and archived for permanent storage and access. However, the same internet has become the dissemination medium of health related hearsay, propaganda and misinformation. The slightest incorrect information peddled in some websites can be recycled and redistributed infinitely until it becomes the gospel truth. The Swine Flu scare in 2008/9 is an example of when the internet (especially social networking sites such as Face book) helped perpetuate the scare globally. In most cases the fact that such sources omitted explanations to the effect that the disease is preventable, treatable and that it is not as severely transmissible as suggested by most intent sources, is telling of the dangers of information exchange via online platforms most of which are never reviewed, regulated, monitored and ferreted. This scenario is replicated when it comes to presentation of how poverty affects or influences health and social care. Most media outlets presents such health inequality influences as to result from governments not doing enough to safeguard the interests of the marginalized sections of the community. In most cases, these inequalities are presented by the media as a government failure to cater for the poor. As already noted most of these sources are unreliable in objective presentation and will mostly use statistics to validate their claims. When such a perspective is taken, there are far reaching social impacts (Isaacs, Stephen and Schroeder, 2004). Social Impact of Poverty in Health and Social Care Health care is an incredibly diverse, complex and multi-dimensional concept with far reaching tentacles into the social dynamism of today’s living (Department of Health and Social Security 1980). Health had dramatically shifted from a symptomatic state of the body and or the mind as was the case when health only referred to not having an illness or having good mental abilities (Graham 2000). Today, health has become much more pervasive to include the availability of health maintenance information, preventive measures and management ability (Graham 2000, pp. 117). Incidentally, in these days of terminal illnesses such as diabetes, provision of services, information and treatments that help manage the disease appropriately is indicative if better health and social care services. Yet in this case, the disease is still present not absent, it is just being managed effectively. In most cases, modern concepts of health-poverty link involves the society at large, thus inducing the element of collective health as the wellbeing of a people rather than of an individual, especially when health and social care are concerned (Graham 2000). Access to such services is mainly conceivable from the perspective of the society and not of an individual. And in this, the media fail since most media outlets especially the news platforms have the tendency of presenting health and social care issues from an individualistic point of view, thus making the issues look gigantic and alarming (Graham 2000). Such coverage lacks the broad social aspect requisite in covering health and social care issues (Graham 2000). For instance, saying that an individual living in Liverpool today has a 40% chance of contracting one type of cancer or the other in his or her lifetime is erroneous and yet what the media is so very fond of voicing. The appropriate considerations to contextualize such a claim, which is absent in the media coverage for space and airtime is precious, is the role of host of other social factors that interrelate with that statistical measure such as availability of health and social care facilities in the area, rate of diagnosis and the demographics involved, availability of educative and public awareness information, economic determinism in contraction rates, differential effects of poverty and other social conditions as occupation etc (Bardsley and Morgan 1997, pp. 142-159). That is why The Marmot report intentionally dealt more with the social conditions affecting health and social care (WHO, 2010b) than with traditional concepts of ‘complete’ health perse as defined by WHO in the introduction. This report was correctly reminiscent of the attitude many Victorian philanthropists, social reformers and health equality advocates that while fighting deceases was an important step in amplifying health and social care, it had to be done alongside other socially uplifting measures like reduction of slums, publishing of relevant and reliable information, social awareness campaigns, economic liberation of the minorities, responsible leadership etc (WHO, 2010b; Phillimore, Beattie and Townsend 1994). It is when health is approached from such a broad perspective (incorporating all the social aspects that are determinant of health and social care), that contemporary issues such as poverty can be addressed conclusively (Graham 2000). This is the ideal perspective that media should take in presenting information on health and asocial care, but which as detailed above is lacking (Graham 2000). Importantly too, health and social care and the poverty link must be conceived from the perspective of health and care workers needs since they are the ground soldiers who implement any reform program (Department of Health, 1998a). This means that to make a program socially tenable, it must include determination not just of the beneficiaries but also of the implementers and their interests. Another facet is that of the care environment in which the program is administrated (Department of Health, 1998a). In this perspective, health and social care involves a diverse set of stakeholders namely individuals within a society, social groups, entire communities, health professionals, civil pressure groups, policy and funding lobbyists, health care marketers, policy makers and others (WHO, 1988; Phillimore, Beattie and Townsend 1994, pp. 1125-1128). Behavioral and Cultural Impacts of Media Coverage of Poverty in Health The earlier section of the paper has hinted on the cardinal role played by the media in respect to representing issues of health and social care such as relative poverty inflictions. The reports reviewed above all underscore the importance of the media in developing public and government understanding of the ranging factors influencing health (Graham 2000). If such awareness is developed, it triggers public debate in those matters affecting health and social care (Department of Health, 1997). Media in its basic utility, media shapes public opinion, prioritizes social issues and inspires reform and creates a monitoring/watch dog arm that safeguards public interests in the hands of governments. The manner in which the media presents information about health and social care impacts on how people respond to or assimilate to the information (Eames, Ben-Shlomo and Marmot 1993, pp. 1097-1102). It is important that the cultural context in which such health and social care is implemented (Eames, Ben-Shlomo and Marmot 1993, pp. 1097-1102). The media fail to be averse as it should be in presenting information in a way that it can be interpreted equally across the assorted cultural contexts (Eames, Ben-Shlomo and Marmot 1993, pp. 1097-1102). The issues the media chose and how these are presented have unique meaning to different cultural contexts such as religion grouping, gender rankings etc. Important here is the ability to make certain segments of the society to feel like the socially excluded group in health and social care especially due to poverty (Eames, Ben-Shlomo and Marmot 1993, pp. 1097-1102). Some people will simply resign and wait for death the moment they are diagnosed with certain diseases (i.e. kidney failure) since the media portrays such diseases as expensive to treat such that only the filthy rich can recover from them (Eames, Ben-Shlomo and Marmot 1993, pp. 1097-1102). How the public is informed on poverty’s relevance to health determines how they will act after receiving that information (Bardsley and Morgan 1997, pp. 142-159). In instances that the media has positively vouched for development of health and social care without playing blame games, there have been phenomenal developments in such areas as legislation, provision of better services, greater access to quality service, professionalism among practitioners and even adoption of codes of conduct in the industry (Department of Health 1997). Conclusion This essay has briefly analyzed the five contemporary issues being highlighted by the media as concerns health and social care. These include housing, income unemployment, education and poverty. After the brief review of these five issues, the paper then selected poverty as one for the issues needing a focused examination especially on how the media presents its information to the public. The aim of the paper was to evaluate how the ordinary public assesses reliable and valid media information about poverty’s infliction on health and social care today. The paper started by explaining a number of ways in which such information is disseminated by the media such as TV, radio, print media and the internet. The paper found that the media prefers alarming news in its portrayal of poverty’s influence on health and social care, coupled by presentation subjective, incorrect information inform of propaganda, misinformation and untruths. Nonetheless, it emerged as the paper detailed, that in some instances some forms of media dissemination such as of the internet are reliably accurate and written by experts. The information has been determined usable in influencing social attitudes and the behaviour of people as far as health and social care is concerned. The media have been characterized in a variety of ways in which it shapes attitudes and behaviour in such ways as can influence the realization of developments in the health and social care sector. References Bardsley M and Morgan D 1997. ‘Deprivation and health in London: An overview of health variations within the capital’. The London Journal. Vol. 22. pp. 142-159. Bardsley, M and Morgan, D 1996. ‘Health’ Chapter 4 in: Edwards, P and Flatley, J (Eds). The capital divided: Mapping poverty and social exclusion in London. London: London Research Centre. Department of Health, 1998 (a). The Acheson Report: Independent Inquiry into Inequalities in health report. London: HMSO. Department of Health (1998) (b). Modernising Health and Social Services: National Priorities Guidance 1999/00 – 2001/02. London: HMSO. Department of Health (1998) (c). Our Healthier Nation: A Contract for Health. London: HMSO. Department of Health (1997) Health Services in London – A Strategic Review. London: HMSO. Department of Health and Social Security (1980). Inequalities in health: The Black Report. London: HMSO. Eames, M, Ben-Shlomo, Y and Marmot, M 1993. ‘Social deprivation and premature mortality: Regional comparison across England’. British Medical Journal. Vol. 307. pp. 1097-1102. Graham, H 2000. Understanding Health Inequalities. London: Open University Press. pp. 117. Isaacs, J, Stephen, L and Schroeder, S 2004. Class - The Ignored Determinant of the Nation's Health. New England Journal of Medicine. Vol. 351 (11). pp 1137-1142. Mackenbach, J and Kunst, A 1997. Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe. Social Science & Medicine. Vol. 44. pp. 757-771 McLoone, P and Boddy, F 1994. Deprivation and mortality in Scotland, 1981 and 1991. 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