Health and Illness in Britain Society - Essay Example

Health and Illness in society – focus on Diabetes in Britain In UK, the health of people has improved notably over the past 140 years. The data for 1841 shows that life expectancy at birth was 40.2 years and 42.2 years for men and women respectively. In 1948 this was 66.4 years and 71.2 years respectively. In 2000, values were 75.6 years for men and 80.3 years for women (Office of Health Economics, 2006).Despite all these improvement, health of different groups differed significantly. According to English statistics, the higher an individual’s social status, the longer the individual is likely to live. Health conditions of the poor and the rich differed notably in the UK(Office of National Statistics, 2007).Many socio-economic aspects can explain health inequalities. Not only poor people live less long than the rich people, but also they have more years of poor health. There is also inequality in access to health. The young and able-bodied people receive better treatment than theold and disabled people (BBC News, 2009).In UK one of most important health challenges existing today is diabetes.By 2011 the number of people affected by the problem of diabetes islikely to reach to 5 million (Diabetes and the disadvantaged: reducing health inequalities in the UK, 2006, p. 5). Almost half of these people are from disadvantaged community, who do not have adequate access to the appropriate care. Findings on general health problems in UK: Life expectancy at birth for men and women in all the social classes has increased from 1972-2006. Over the years mortality gap has been widened amongst social classes (Office of National Statistics, 2007).Death proportions for both the men and women have increased overtime. This is also true for children and adults. Improved living conditions, availability of healthcare and other factors have caused the infant mortality rate to fall significantly (Health Inequalities in the UK, 2009, 14). Years of healthy life expectancy (LE) and poor health by deprivation level: (Source – Health Inequalities in the UK, 2009) One can define health inequalities in two different ways. One is absolute and the other is relative. By subtracting one figure or rate from another, we get absolute inequalities and by dividing one number or rate by another, we get relative inequalities.Socio-economic class is the only cause of measuring health inequalities in England.There are many other dimensions of measuring health inequalities, which are also very important (Ihsan& Ahmad, 1993). There are differences of health among ethnic groups. In 2001 Chinese men and women in England and Wales reported the lowest frequencies of both poor health and restricting long-term ailment, while Pakistani and Bangladeshi men and women recounted the highest rates. South Asian and Black Caribbean people are reported to have high rates of hypertension, while only South Asian people are reported to have high rates of heart disease. Young Caribbean men are reported to suffer from severe mental disorders (Health Inequalities in the UK, 2009, p. 18). Causes of these health problems: Although health inequalities are measured in term of socio-economic class, ‘Human Capital’is also expected to affect health inequalities (Grossman, 2000, pp. 367-408).Lifestyle factors, such as smoking, consumption of alcohol, adequate nutrition, sufficient exercise, weight, usages of drugs, sexual behaviour, mental and physical stress, affect health inequalities. These are sometimes called the “proximate” causes of health inequalities (Bromley, 2003). Socio-economic factors are also responsible for heath differences. Income, educational attainment, employment status, socio-economic group are the causes that affect health inequalities. The poorest section of the society is less likely to adopt beneficial health services. There are different reasons behind these findings. Firstly, some groups of society may not get the information about healthy behaviours. Secondly, there may of lack of material resources that are needed to live healthily. Their living environment may also be the obstacle for them to live a healthy life. Finally, people facing problems with income, employment, personal safety are also supposed to have bad health status(Health Inequalities in the UK, 2009). Socio-economic situations are also likely to have a negative effect on health behaviour because future health is not a high priority for people facingmuch more immediate and serious problems, like crime and unemployment.Due to the presence of income inequalities, the poor dies before the rich. This is because poor people are not capable of spending more for those diseases which require huge level monetary expanses, such as chronic diseases, cancer, coronary diseases. On the contrary, rich people are much more capable of spending on these diseases (Wilkinson, 1996). Over the last ten years health inequalities between social classes have increased in Britain although the health of all groups in Britain is improving. The health of poor people is improving less quickly than that of the rich people. The main reason for this kind of finding is that health services are much costlier now than in the past. As the gap between the rich and the poor people are more widened in UK, hence it becomes verydifficult for the poor people to spend huge amount of money health problems. Because of this health inequalities have increased by 4 per cent and 11 per cent amongst men and women respectively. Health inequalities are not only found in people of different socio-economic groups, they are found to be present between different genders and different ethnic groups also. The elderly people and people affected with mental health problems or from learning disabilities have worse health compared to the rest of the population. The factors responsible for health inequalities are multifaceted. These include smoking, nutrition, exercise,and many more lifestyle factors. Also major determinants like poverty, housing, education etc. are also affecting Health Inequalities in the UK (Health Inequalities in the UK, 2009, p. 26). Findings on diabetes: The most disadvantaged section of the society in the UK is 2.5 times more inclined to incur diabetes.The presence of diabetes in women of North East England is 45 per cent higher than the national average.Almost 80 percent of the people affected with Type 2 diabetes are suffering from excessive body weight (Diabetes and the disadvantaged: reducing health inequalities in the UK, 2006, p. 5) 1.3 million people aged over 65, are suffering from diabetes.One in five people having severe mental illness are suffering from diabetes.Complex effects of diabetes such as kidney damage, stroke and heart disease are more likely to affect people in the lower socio-economic group.People belonging tounderprivileged or ethnic groups are more likely to be affected by diabetic problems.People with lower educational level are more likely to have heart disease, poor diabetes control and retinopathy.Deprivation is strongly related to higher levels of obesity, unwholesome diet, physical idleness, reduced blood pressure control etc. All these factors are responsible for diabetic problems (Diabetes and the disadvantaged: reducing health inequalities in the UK, 2006, p. 5). Smoking and high blood pressure cause 50 per cent of poor health.People in lower socio-economic groups are 50 per cent more addicted to smoking than the people in the higher socio-economic groups.Women of lower socio-economic group are 50 per cent more likely to suffer from problems of overweight (Diabetes and the disadvantaged: reducing health inequalities in the UK, 2006, p. 5). It is very difficult to argue whether gender discrepancies affect the occurrence of diabetes or the prevalence of diabetes reflects gender differences as one of the risk factor for diabetes.Type II diabetes is found to be affecting men more likely than the women. But in the case of the type I diabetes men are almost as likely as women to be affected by this problem (Goldman & Hatch, 2000, p. 820). Causes of diabetes: Problem of diabetes is likely to rise steeply with age. In the UK, in current time there are 11.4 million people whose age is over 65 years. In 2011, it is estimated to rise to 12.2 million. In 2031,it is expected to rise to more than 15.2 million.The occurrence of diabetes increases sharply with age. It reaches around 5 per cent at 65 years and 20 per cent in the over 86s (Diabetes and the disadvantages: reducing health inequalities in the UK, 2006, p. 11). Older people have been described as being under researched, under-valued, under diagnosed and sometimes over-medicated. There is also problem of delayed diagnosis. Sometimes the younger patients get more care than the older people.As diabetes is a progressive condition, the complications develop largely for the older people. They are more probable to get admitted to hospital suffering from foot ulcer compared to other complications of diabetes (Diabetes and the disadvantaged: reducing health inequalities in the UK, 2006, p. 12). People living in nursing and residential homes are more likely to be affected from diabetes. This is because the staffs are untrained and the dietary supplies are unsuitable for their daily energy requirement.Gender differences are also likely to affect the occurrence of diabetes. Women suffering from socio-economic deprivation, mainly in the traditional societies, are likely to be more affected by the diabetic problems. Differences in smoking rates, the occurrence of obesity and differences in food choices cause more marked prevalence of diabetes for women (Diabetes and the disadvantaged: reducing health inequalities in the UK, 2006, p. 12). In the UK, the young generation is more likely to be affected from diabetic problems. In fact this amount is increasing rapidly in UK. Due to prevalence of ‘youth culture’, there has been massive increase in junk food intake, smoking, excess alcohol and self–neglect. All these factors caused the young people of UK to suffer from the problem of diabetes (Diabetes and the disadvantaged: reducing health inequalities in the UK, 2006, pp. 12-13). The growing problem in the UK is homelessness. Many of these people are suffering from problems of unemployment, mental illness, family failure and substance abuse. These socio-economic and economic problems are causing the homeless people to suffer from diabetes. Again these homeless people are forced to live in unhygienic places or are bound to take inadequate foods that ultimately cause them to suffer from diabetes (Goyder, Simmons & Gillett, 2010). Prisoners are likely to be more affected by diabetes. In UK, 10 percent of the total prisoners are black. It is already known that the prevalence of diabetes is much more likely for the black people. Again these prisoners largely come from the lower socio-economic groups and they have the lower level of education. All these reasons are causing the prisoners to suffer from the problem of diabetes. Again half of the prisoners are heavy alcohol users, which is the major reason of having diabetes. Lacks of education among the staffs of prisons as well as the ignorance of prison officers are diabetic problems are increasing rapidly among the prisoners. Also the lack of managements to take proper measures to stop the diabetic problems is causing the prisoners to suffer. Refugee families and asylum seekers are living in the unhealthy and naïve environment and suffering from social stigma, domestic violence and psychological trauma. They are not able to give proper education to their children and do not take adequate food or do not earn adequate money to be spent on treatment (Diabetes and the disadvantaged: reducing health inequalities in the UK, 2006, pp. 14-15). In UK, the presence of diabetes also depends upon the racial differences. Some races, which are living in UK but originally came from some other parts of the world, are affected by this disease more often than local communities. For example, the people who came from south Asia and are living now in UK are 6 times more likely to suffer from the problem of diabetes than those people who are living in the UK having white European living backgrounds (Fleming &Gillibrand, 2009, p. 146).The main causes for this type of findings are the hereditary and stress. A person who belongs to a family history of suffering from diabetesis most likely to be affected from the disease. 20 percent of the South Asian people and 17 percent of the African – Caribbean community are suffering from the problem of diabetes (Fleming &Gillibrand, 2009, p. 148). Even within a specific race or community the prevalence of diabetes is found to be differently affecting the different social groups or classes. People of the lower class are suffering from diabetes more than those of the higher social class. This is due to educational differences, differences in awareness and differences in lifestyles that the lower-class people live (Bromley, 2003). Critical evaluation of various reasons of continuing health inequalities in Britain: There are various reasons for continuous growth of health inequalities in Britain in modern times. Among those reasons natural or social selection, behavioural and cultural reasons, racism and psycho-social reasons are most important. Social selection plays a notable role in increasing health inequalities in UK. Natural or social selection deals with the fact that the people with poor health will suffer from possessing lower social class, while the healthy people will enjoy higher social advancements. This has made people having poor health conditions to suffer more from different diseases, such as schizophrenia, diabetes and other diseases for a longer time and across generations. There are various coordinated reasons behind the prevalence of continuing health inequalities in UK which are called artefact. These include ‘occupation, property ownership, educational status and access to social resources’. In this regard it can be said that the degree of health inequality will in fact depend on the process of measurement of class and health indicators. If class is defined in such a way to make a distinction between the poor and well healthy people, then the existence and growth of health inequalities are inevitable. In regard to the cultural reasons it has been suggested that the people living in lower social class are less concerned about their health and they are tempted to eat unhealthier and fatty foods, do less exercise, smoke and drink more. On the contrary people of middle or higher social class are always concerned about their health status and hence they consume healthy foods and exercise more. In regard to the material conditions people of lower social class live in poor health conditions with poor housing conditions and poverty with lack of proper health education and resources to improve their health status. Poverty has been the major problem for the growinh health inequalities in the country. But this condition is not sufficient for explaining the growing health inequalities in Britain. Some of the diseases, such as diabetes, are more prevalent in Britain. And these diseases affect the poor people most because these diseases require enough money for its treatments. Another important determinant of growing health inequalities in Britain is the divergences in possession of social capital. people living in social communities or groups or areas where the prevalence of certain types of diseases are most likely, are expected to suffer from these diseases more compared to the people living outside those communities or groups or areas. Social contact plays an important role in this case. In UK there are lots of places where people are living with little or no contact or communication with their relatives or neighbours. This social isolation causes these people to suffer from mental and physical diseases. It has been found through researches that housewives and unemployed people suffer more from poor health condition compared to employed people, because of having lower social capital (Maguire, n.d.). Policies taken to tackle health inequalities and the drawbacks: The National Health Service (NHS), healthcare systems in the UK, financed entirely by the government. These systems provide a wide range of health care services to the citizens of UK for free.The government of UK has created the Health Action Zones (HAZs) (Health Action Zones: Learning to make a difference, 1994) in the late 1990s to provide proper education, health services to the patients and the users in order to reduce health inequalities in these areas. Primary Care Trusts (PCT) and Strategic Health Authorities (SHAs) are responsible for undertaking public health initiatives, providing local leadership and improving access to health services.The Healthy Schools initiative was taken to improve the awareness among the students and the parents. The Expert Patient programme (Hardy, 2004) was taken to give proper training to those expert patients of chronic diseases. These patients have more knowledge about their nature of illness as well as the remedial measures.The UK government has taken several policies to tackle health inequalities. These policies have covered a wide range of socio-economic as well as purely economic aspects. There are also few problems that these policies have faced (Health Inequalities, 2009). This task of tackling Health Inequalities in the UK is very much difficult because of the following reasons: 1. There has been lack of evidence regarding the effectiveness of the policies taken to reduce health inequalities. Primary Care Trusts are responsible for using NHS funds to reduce health inequalities. Lack of evidence has forced them to face difficulties in making decisions regarding the effectiveness of these policies taken. There has been proper evidence regarding prevention of coronary heart disease and reduction in smoking habit of the people. All the other socio-economic aspects were more or less same or there has been a lack of proper information (Stafford & Marmot, 2003). 2. The main reason for this lack of evidence is the inadequate evaluation. There has been no research evidence on the effectiveness on the Healthy Schools initiative. The Expert Patient Programme was initiated without any plan to evaluate its effectiveness. Even though funding has been given by the government for the evaluation purposes, it was inadequate (Health Inequalities, 2009). 3. Sometimes government has found it difficult to evaluate complex interventions (Roberts, Patticrew& Macintyre, 2008). Among multiple factors affecting health. According to Professor Sally Macintyre, there have been few outcomes out of the outcomes found after the evaluation that are actually related directly to health issues. For instance, the Extended Schools programme has affected inspection results and attendance levels, rather than the health outcomes (Health Inequalities, 2009). 4. The evaluation procedures have not been up to the mark because of poor designing and introduction of interventions. The HAZ policy has been suffered from the problems of including too many outcomes that are sometimes not directly related to the health dimensions (Goyder, Simmons & Gillett, 2010). Policies taken to effectively tackle problems on Diabetes and the drawbacks: Both SIGN and NICE have taken measures to reduce obesity and overweight and also to promote healthy lifestyle options.The British Department of Health has published appropriate policies and consultation documents that deal with screening and intervention programmes for diabetes and cardiovascular risk. These policies are mainly used for the deprived and rural backward communities so that they can manage and take care of their own health. By increasingly using tools and techniques from social marketing, health-promotion programmes have been favourable to reduce diabetic problems (Diabetes and the disadvantaged: reducing health inequalities in the UK, 2006). There have been individual level interactions to reduce this problem.For the older people, proper researches, proper diagnosis, proper treatments have been initiated.For the homeless people and people living in residential and nursing homes many steps has been taken, such as urgent improvements in the living condition ns of these areas, making them aware to control diabetes etc.Again for the young generation and for the prisoners there have been many awareness programmes been taken (Diabetes and the disadvantaged: reducing health inequalities in the UK, 2006). Many of the policies to reduce diabetic problems could not be effective because several reasons. Due to lack of information to the patients this problem could not get reduced. The young generations are living an extremely unhealthy lifestyle.The black community and the deprived community are getting larger and larger (Diabetes and the disadvantaged: reducing health inequalities in the UK, 2006). Conclusion: The policies taken to reduce the health issues and illness as well as diabetes have not been fully effective. The effectiveness of any policy depends on the long run. So we need to take sufficient time to judge those policies.One needs to exclude all the interventions that are detrimental to the reduction of diabetic problems.It is important to increase awareness among the citizens of UK for control of this disease. 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