Health Inequalities in the UK - Essay Example

Health Inequalities in the United Kingdom Introduction Despite progress in various socio-economic and health related aspects over the past five decades in the United Kingdom or UK, the benefits and improvements are not being enjoyed by every strata and group of the society, thus leading to inequality in various aspects of life including health. Health inequality is a major public health concern not only in developing counties but also in developed country like UK. According to the WHO (2010), health inequality is defined as "differences in health status or in the distribution of health determinants between different population groups and communities" like "differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes." Throughout the world, there are gross inequalities of health between countries and between various groups within the same country. For example, in Japan, the life expectancy is 81.9 years while in Sierra, it is 34 years. In this essay, health inequality in UK, which is a developed country will be explored to ascertain the magnitude of the problem, evaluate the causes for it and study the various interventions undertaken by the government to tackle it. Health inequalities within UK Of the health inequalities within the population of UK, the most noticeable is the difference in the life expectancy between the rich and the poor (House of Commons Health Committee or HC, 2009). According to the 2006 statistics, individuals born in Chelsea and Kensington have a life expectancy of 87.8 years while those born in Glasgow city have a life expectancy of only 77.1 years. Despite aggressive measures by the government and effort by the people, health inequalities in UK continue to persist. One of the main reasons for this that while there is improvements in the health status of the poorer population, the richer continue to get better and keep the gap open. The gap is in fact increasing. According to HC (2009), "the gap in men’s life expectancy in the period 2005–07 was 4% wider than the baseline period, while for women, this gap was 11% wider." Also, "from 2005–07, infant mortality in routine and manual groups was 16% higher than in the population as a whole, compared to 13% in the baseline period." The HC (2009) has also reported health inequalities in some major causes of mortality like coronary artery disease and stroke. Similar differences have been noted for infant mortality too. Apart from socio-economic strata, health inequalities have been reported even between various ethnic groups. Individuals from Bangladeshi and Pakistani groups have poorer health and long-term illnesses when compared to other groups. The best health outcomes have been reported in Chinese groups. Also, while people of South Asian origin have higher rates of hypertension, ethnic minority groups have higher prevalence of diabetes and young Black Caribbean men have higher rates of psychoses (HC, 2009). Another factor which influences health inequalities is gender. For example, men are more likely to be affected by suicidal tendencies, cancer and obesity (HC, 2009). Also, people with impairment of physical and mental aspects are more likely to have poorer health outcomes when compared to those with intact mental and physical aspects (HC, 2009). Figure.1. Life expectancy at birth for men & women in social class I (professional), social class V (unskilled manual) and all, 1972–2005, England & Wales Figure. 2. The widening mortality gap between social classes Figure.3. Age-standardised death rates for CHD and stroke, adults aged 15 to 64, 1993 to 2003, England and Wales Figure.4. Age-standardised limiting long-term illness: by ethnic group and sex, April 2001, England and Wales Causes and determinants of health inequalities According to the WHO (2003), health "is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." It is determined by an interplay of several factors which are known as health determinants. The main determinants of health are social factors, environmental factors, physical environment and; various behaviours and characteristics of the individual. While some of these determinants are in the control of the individual, many factors are beyond the scope of direct control of the individual. These factors contribute to health inequalities in a society. Some such factors include social status and income, education status, physical environment of the individual at home and work place, "social support networks", individual genetics, accessibility to various health services and gender (WHO, 2010). Higher the income, higher is the health status of an individual. Thus, poverty is a major contributor for health inequality. Individuals with lower education levels have poorer health status, lower levels of self esteem and decreased self confidence when compared to those with higher education status. Physical environment constitutes of clean and safe air, water, environment and food at home and workplace. Those who have better support form friends, family member and various community groups enjoy better health than those who do not have established social networks. Genetics often influences health -related behaviours like smoking, alcohol, coping skills and balanced intake of food and thus indirectly influences health of an individual (WHO, 2010). Public health researchers have identified social determinants as the main cause for health inequalities in many parts of the world including UK. Of these, the most important is poverty. In fact, tackling poverty is the main issue raised by the Millennium Development Goals which include reduction in child mortality (Marmot, 2005). Thus health inequality is a complex interplay between socio-economic status, genes, antenatal factors, lifestyle behaviours like smoking, exercise, diet and stress and inter-generational causes of health related behaviours (HC, 2009). Important lifestyle factors which influence health are nutrition, exercise, weight, smoking, consumption of alcohol, stress, sexual behaviour and drug abuse. Specific initiatives against health inequalities in the UK Health inequalities usually start very early in life and get carried on not only until oldage but also to subsequent generations. Thus tackling health inequalities is one of the top priorities of the government of UK. The major reports which influenced various interventions pertaining to health inequalities are Acheson report of 1998 and HAZ report of 1998. Various policies which have been implemented to tackle health inequalities include Sure Start of 1999, Targets of 2000, Cross cutting review of 2003, Spearhead areas of 2004, National support team of 2006 and Health inequalities intervention tool kit of 2006. The first policy introduced was Health Action Zones launched in 1998 with objectives to "identify and address the public health needs of the local area; increase the effectiveness, efficiency and responsiveness of services; and develop partnerships for improving people’s health and relevant services" (HC, 2009). Most of the initial policies and programmes stressed on improvement of health by promotion of various health related aspects like lifestyle behaviours, employment, education, housing and tacking substance abuse. However, this programme was terminated in the year 2003 due to poor resource, insufficient support and lack of clear direction. Currently, National Health Service has a major role in curbing health inequalities through different parts of system like "primary care teams, Strategic Health Authorities and Primary Care Trusts, Secondary care and specialist services and Early years NHS services" (HC, 2009). Other approaches to tacking health inequalities implemented by the government of UK are appropriate school meals in schools, food labelling, health promotion in schools and educational institutions, improvements in built environments and control of intake of tobacco. The government of UK has prioritised tackling health inequalities and has introduced “the most comprehensive programme ever seen in this country to address health inequalities”. For this purpose, Public Service Agreement was implemented in the year 2003, the target of which is "By 2010 to reduce inequalities in health outcomes by 10 per cent as measured by infant mortality and life expectancy at birth" (HC, 2009). Despite aggressive measures by the government and effort by the people, health inequalities in UK continue to persist. One of the main reasons for this is that while there is improvements in the health status of the poorer population, the richer continue to get better and keep the gap open. Conclusion Health inequality is a major public health challenge all over the world including developed countries like United Kingdom. It is mainly caused due to a complex interplay of several factors which affect the outcomes of health. Of these, the most important cause is poverty. Though it is complex and difficult to measure health inequality, life expectancy and infant mortality rates have been used as guiding indicators to ascertain health inequality by public health researchers. The government of UK has employed several strategies to tackle health inequality, the most important of which are Millennium Development Goals, Surestart and national Health Service contribution. Despite such aggressive measures by the government since many years, health inequality continues to reign. References Department of Health. (2009). Health Inequalities [online] http://www.dh.gov.uk/en/Publichealth/Healthinequalities/index.htm [Accessed 2nd January 2010] House of Commons Health Committee. (2009). Health Inequalities [online] http://www.parliament.the-stationery-office.co.uk/pa/cm200809/cmselect/cmhealth/286/286.pdf [Accessed 2nd January 2010] Marmot. M. (2005). Social determinants of health inequalities. Lancet, 365, 1099- 1104. WHO. (2010). Health Impact Assessment [online] http://www.who.int/hia/about/glos/en/index1.html [Accessed 2nd January 2010] WHO. (2010). Determinants of Health [online] http://www.who.int/hia/evidence/doh/en/ [Accessed 2nd January 2010] WHO. (2003). WHO definition of Health [online] http://www.who.int/about/definition/en/print.html [Accessed 2nd January 2010] Read More