Health Inequalities Persist - Essay Example

Healthcare-inequalities Healthcare inequalities can be described as the of disequilibrium in access to healthcare facilities by different communities resulting in poorer health, reduced quality of life and early deaths for the less privileged in society. Many researchers view social position as the fundamental cause of inequalities in health. The social class structures have been identified as the main causes of such disparities in the access to health care services. However, to a certain extent, other factors such as gender and ethnicity have also been cited as causes of health inequalities. In an attempt to understand clearly the concept of health inequalities, it is imperative to explain the concept of class structure vis-à-vis the access to health services. In virtually all societies some people are regarded as more important than the others, more worthy of respect or more useful than others either within the society as a whole or in certain situations. This position relative to that of other people in the Group is called ‘status or class’ and may be based on many factors such as wealth, heredity, possessions, sex education, skin colour, job or age. Thus according to Gerard O’Donnell (1994:370), class is defined as: a broad category of people within a society who have similar social and economic status. Although primarily based on economic factors, such as ownership or occupation, class also encompasses attributes such as lifestyles and attitudes. In this context, status is a person’s social position as defined by others and the person with a high status is regarded as more worthy of respect, accorded more esteem and has more prestige within that social group. Usually people who occupy high class positions are generally richer than those who occupy lower classes and they have more wealth through earnings or investment. In this regard, a wealthy person enjoys access to better life chances such as heath care, education and shelter. Research has shown that the notion of class or status in society has a bearing especially on access to health care facilities. This notion was illustrated by a report, Inequalities in Health, sponsored by the Department of Health and Social Security in 1980, commonly referred to as the Black Report. It found a close link between class and life expectance. The report commented: ‘the class gradient can be observed for most causes of death and the lower the person’s social class, the more likely they are to suffer an illness that they have had for a considerable time.’ The report concluded that the lack of improvement, in some cases deterioration of the health experience of the unskilled and semi skilled manual classes throughout the 1960s was striking. Inequalities in health are mainly caused by imbalances in the distribution of wealth and they are persistent. A study entitled, Inequalities in Health in the Northern Region by the Northern Regional Health Authority/Bristol University (1986), found a direct link between the high death and illness rates in the region and poverty. A major survey in one local Health Practice in Stockton on Tees in 1986 suggested that the ‘deprived’ group had three times more mental illness, 60 per cent more hospital admissions and 75 per cent more casualties than the ‘control’ group. A Health Education Council report entitled The Health Divide (1987) claimed that class differences in health had continually widened over a period of time. The trend highlighted above with regards to access to health care shows that the concept of inequalities in health is not a new social phenomenon altogether but has been persistent over the years as a result of especially differences in the distribution of wealth The Acheson Independent Inquiry into Inequalities in health (1998), also helped generate extensive debate on inequalities in health. Its findings also pointed that the difference in wealth greatly contributed to the inequalities in health with the disadvantaged societies at the receiving end. In a News article entitled, Johnson to tackle health inequalities, Healthcare republic News.html, 23 October 2007, it is reported that the issue of inequalities in health is of prime concern and is given priority by government. It says, ‘the health gap between rich and poor remains wide and in some areas is getting wider with 13,700 patients die prematurely because they do not get the systematic high quality service they deserve.’ The report emphasizes on the widening gap between the rich and the poor showing that patients in deprived areas have worse health outcomes. Comparing with the past, the report observes that people in the United Kingdom are better off than in the past across a range of measures but the benefits are still not spread equally. ‘Household income and educational attainment have improved overally but the gaps remain large. Nevertheless, a significant minority of people is affected by a lack of material resources and the inequality in the health of the population has widened,’ it observes. Commenting on a government report, Andrew Sparrow, senior political correspondent of guardian.co.uk, March 13 2008 in an article entitled, ‘Health inequality has got worse under Labour,’ said ‘health inequality as measured by life expectancy and infant mortality has got worse since Labour came to power…babies born to poor families now have a 17% higher than average chance of dying, compared to a 13% higher than average chance 10 years ago.’ Sparrow also notes that whilst the health sector is getting better, life expectancy for all social groups going up, the infant mortality figures are going down. Thus, health is generally said to be heading in the right direction. However, life expectancy is improving faster for the better off people while those from poorer backgrounds lag behind. Statistics obtained from the report show that in 2004-06, infant mortality among manual workers was 5.6 deaths per 1,000 live births. That was 17% higher than the national average of 4.8 deaths per 1,000 live births. In another article in The Guardian, 19 March 2008, Mary OHara writes that the government has had a decade to tackle health inequalities, but still they persist. ‘The expanding wealth gulf between the most well off and the poorest in our society has been criticised for the inequalities in health’ she said. She goes on further to say that the issue of health inequality is a complex issue where a multitude of factors from entrenched poverty and low educational attainment to long term unemployment have a role to play. Basically, the concept of class is cited as the cause of health inequalities in many studies. However, to a certain extent the concepts of gender and ethnicity also have a bearing on the issue of health inequalities. Haralambos M. (1991:531) attributes gender to the masculine and feminine behavior of the society where both male and female role expectations in society are spelled out. In most cases, patriarchal societies are male dominated, and the result is that women are often relegated to lower positions in society. In this case, gender inequality is evident and in some cases may translate into inequality in health as well. Ethnicity on the other hand entails the religious group of belonging and in racially segregated societies, may cause inability to equal access to health care facilities. Oliver James (1998) gives insight into how the issue of gender can cause inequalities. Since 1950s, mothers in Britain could go to work just like their male counterparts but this has been debatable in other sections of the society. Oliver James said, ‘the contribution of new patterns of employment of this conflagration especially on the new trend for working mothers of small children is controversial and debatable.’ According to James, mothers for small children are depressed by strain of working and the burden of looking after children. In some instances the notion of mothers working has helped create a sense of identity and has also contributed to ill feeling by man causing an increase in divorce statistics. This scenario can also cause inequalities in access to health as women would be more often looked down upon in a patriarchal society. However, despite cases of inequalities in access to health, the government has prioritised the need to tackle causes and consequences of health inequalities as part of its commitment to deliver economic prosperity and social justice. The national strategy report published by the Department of Health called Tackling Health Inequalities; Programme for Action (2003) outlines the government’s major concern on health inequalities. It sets out plans to tackle health inequalities and establishes foundation required to achieve the challenging national target for 2010 to reduce the gap in infant mortality across social groups, and raise life expectancy in the most disadvantaged. Introducing the report, the Prime Minister said: A whole series of cross-departmental action will address the root causes of poor health and inequalities …the government’s aim is to reduce health inequalities by tackling the wider determinants of health inequalities such as poverty, poor educational outcomes, worklessness, poor housing and the problems of disadvantaged neighborhoods. The remarks seek to reaffirm the government’s commitment on trying to reverse the problem of inequalities to health. The report also notes that inequalities are stubborn, persistent and difficult to change. ‘Inequalities are widening and will continue to do so unless otherwise lasting solutions are put in place,’ it said. The programme targets to achieve mainly two goals, the national health inequalities target and the underlying causes of health inequalities. This programme sets the agenda that includes all government departments, regional and local bodies. In conclusion, it can be noted that healthy inequalities are mainly caused by social position factors such as class where the haves enjoy quality access to health care facilities at the expense of the have-nots. However, the government has also played a role of putting measures to curb the persistent trend in healthcare inequalities. 1. Gerard O’Donnell, Mastering Sociology, 3rd Edition, Macmillan Master Series, 1994 2. Tackling health inequalities: A programme for action, 2003. http://www.doh.gov.uk/healthinequalities/programmesforaction 3. Health Care Republic http://www.healthcarerepublic.news.html 4. The Guardian 13 March 2008 http:www.guardian.co.uk/politics/2008/mar/13/health.health 5. Oliver James, Britain on the Couch: Why we’re unhappy compared with 1950 despite being richer-A treatment for the low serotonin society, Arrow Books Limited, 1998. 6. M Haralambos & M. Holborn, Sociology: Themes and perspectives, 3rd Edition, Collins Educational, 1991. 7. Sir Donald Acheson, Independent inquiry into health inequalities, 1998. http://www.doh.gov.uk/greespace/living/ 8. http//www.statistics.gov.uk/focuson/socialinequalities/ 9. http://www.radstats.org.uk/no74/article4 10. Health and Social Care Act 2001 http://www.hmso.gov.uk/acts/acts200120010015.htm 11. Healthcare Republic http://www.healthcare republic.com/news 12. http://www.chp.creighton.edu/events/ces.htm Read More