Notion of Community and Its Relation to Social Context of Health - Case Study Example

Social Context of Health – Locality Project Introduction Studying the social context of health develops a sociological perspective which may be applied to health care practice and develop an understanding of health care policy and its impact on the provision of health care services. Its central theme and philosophy provides foresight into the nature of sociological enquiry and considers the relevance of sociology and health policy to health care. Integral to the context is the exploration of key sociological issues which influence health and health care such as poverty, gender, social class, ethnicity and race. (Blane 1996; Keith 1998) It also tells the impact of poverty on health status and peoples’ experiences of health care and its effect on the accessibility of health services. Certain aspects of psychology and peoples’ beliefs come in regarding about health and illness and how these affect health-related behaviour as well as attitude towards seeking treatment and care for acute and chronic illnesses. (Clarke 2001) Peoples’ sociology about mental illness comes into play as a result of social issues and pressures in life rather than being caused by biogenetic or psychological influences as explained in “Social Context of Health and Health Care”. Under this context intellectual impairment, violence and abuse also affect the health of individuals and communities. Refugees and asylum have implications for health and health care too. Age and ageism also plays a vital role in the community for health and safety since social policy and attitudes affect older peoples’ experiences of health and health care. (Kerry 2007; Paul 2005) Notion of Community and its Relation to Social Context of Health A community is a social group of organisms sharing an environment, normally with shared interests. In human communities, intent, belief, resources, preferences, needs, risks and a number of other conditions may be present and common, affecting the identity of the participants and their degree of cohesiveness. (“Community”, Encyclopedia Wikipedia) It is related to the social aspect which is the society and psychology through the sense of community which is made up of (Blane 1996; “Community Plan”) Membership Influence Integration and fulfillment of needs Shared emotional connection It combines the cultural, ethnic and racial forces along with religious and individual aspects. All these factors have an effect on the social context of health of the individuals living in that community. Therefore it is important that there is a better place for living safely reducing crime, making people feel safer and creating a more secure and cleaner environment. It should be a better place for creating and sharing prosperity that brings investment into the borough and ensures that all residents and businesses are in a position to benefit from, and contribute to, growing economic prosperity. It also should be a better place for learning, achievement and leisure raising educational aspirations, expectations and achievement, providing the widest range of arts and leisure opportunities for all and celebrating the cultural rich diversity of the communities. (Costello 2003) Rational For Choosing Housing in Tower Hamlet The locality chosen for this research work is the London Borough Tower Hamlets. The London Borough of Tower Hamlets is a London borough to the east of the City of London, England and north of the River Thames in East London. It includes much of the redeveloped Docklands region of London, including West India Docks and Canary Wharf. Many of the tallest buildings in London are located on the Isle of Dogs in the south of the borough. According to the Daniel Dorling and Bethan Thomas (2001) in “People and Places: A 2001 Census Atlas of the UK” the population for the borough was 196,106. Percentage of resident population in ethnic groups: Tower Hamlets England White 51.4 90.9 Asian or Asian British 36.6 4.6 Indian 1.5 2.1 Pakistani 0.8 1.4 Bangladeshi 33.4 0.6 Other Asian 0.9 0.5 Black or Black British 6.5 2.1 Caribbean 2.7 1.1 African 3.4 1.0 Chinese or Other Ethnic Group 3.0 0.9 This vast cultural diversity is an ideal location for the study at hand since cultural diversity is one of the vital factors analyzing the health of the residents. According to “London Borough of Tower Hamlets” various other factors including the migration factor, poverty, un-employment and various others gives this locality a perfect setting for the research since health hazards are reported the most in areas with high diversity. Tower Hamlets uniqueness lies in this very fact that people from all walks of life live in them. The rich, poor, deprived, social, people from different ethnicities and different religions can all be found. The study undertaken is such that it analyses the differences in health standards in these very different diverse sects and how these social factors affect these health factors. Therefore the Tower Hamlets is one of the best setting to undertake this research. Data Collection and Methodology For the research at hand, extensive research was required and was done to get the most accurate results. The data was collected both from primary and secondary sources available. For the primary research, real estate agents, residents, doctors and patients were interviewed for their point of view about the general social context of health in the locality. Secondary research was done from articles and news readily available on the internet and from previous researches. For a more detailed source review, refer to the appendix. Findings Owning & Renting The people can own as well as rent out the place where they live. The impact of this on their health can bring about a positive or a negative depending in what situation they are. For example an owner living with a humble tenant will have a better life than the one living that creates trouble and is noisy. (“Services”) A study done (Xleinman 1999) tells us that between 1986 and 1995, the median house price rose by 27.5% in Newham, 21.1% in Tower Hamlets, and by 40.2% in Southwark. This compares with a rise in the median house price in Greater London of 32.1% over this period. Relativities hence changed little over this period: median values in Tower Hamlets were by 1995 slightly below rather than slightly above the London average. The rise in rents and the ability of the people to cope up with it is also a source of stress as people need to work harder to earn more. People living under rented homes feel more threatened from the outside world because of the insecurity they feel that they may have to abandon their home in future. A person living in the Bethnal Green North or South of the tower hamlets area might have to shift to a lower rent area of Whitechapel to afford the cost of the house. This shifting of area can be bad for the image or the perception of the people in the eyes of others causing stress and fatigue. The insecurity to leave a home one day plays on the minds of the tenants and causes stress related diseases like anxiety attacks or depression. In some cases people even start smoking to relieve of this tension. Homelessness The housing system in the Tower Hamlets has been highly inconsistent due to the over population in the area. New people are inducted into the boroughs daily (after a complete check in procedure) causing the people who deserve bigger homes to remain a part of their old smaller homes. If there are not enough places for people to live, then someone has to go without. Because housing is mainly allocated by the market, those who are excluded will generally be the poorest people. The overcrowding and rise in rent rates are some of the reasons for homelessness. Homelessness is often attributed to the characteristics of the homeless person, such as alcoholism and psychiatric illness; or to the social situation of homeless people, such as unemployment and marital breakdown. The “An Introduction to Social Policy” says that the central issues are the problems of poverty and exclusion. In some extreme cases the people become so distressed that violence can also spark up against the management for not providing adequate housing facilities. Over Crowding Overcrowding in homes causes ill-health because it makes disease transmission easier and because the lack of private space causes stress. Overcrowding is related to socioeconomic level, and the poor often have little choice but to live in cramped conditions. The survey of English housing estimates that there are more than 17,000 overcrowded households in London. In Tower Hamlets, there are approximately 8,000 overcrowded households. The “Parliamentary Debate 29 Oct 2003 - Overcrowded Housing” enlightened the people that this the most severe level of overcrowding in the country, and is accompanied—unsurprisingly, as there is a direct link between the two—by the highest density of poverty in the country. The vast majority of those overcrowded households are young families with two or three children waiting for a family-sized home to become available. In Tower Hamlets, the most overcrowded London borough, 64% of Bangladeshi households live in overcrowded conditions. The people in overcrowded homes feel respiratory problems since there is lesser air for them to breathe. Another major threat to their lives that a disease caught by one member of the family can spread to other members very quickly since these family members live in one or two room homes. Tuberculosis, Meningitis, Helicobacter Pylori and Mental Disorders are some other health problems that are common in overcrowded areas. The concept of plagues and epidemics is very common in areas with overcrowded homes due to the transmittal of germs and diseases in high population density area. Deprivation The Breadline Britain surveys, identifying what people thought of as essential, came up with answers like a damp free home, heating, indoor toilet, the use of a bath, home decoration, having enough beds and refrigeration - the last two depending on space. Social segregation by housing officers has contributed to this process in the past, but it equally happens in the private sector where there this has not happened. However, deprivation is not only concentrated. Most poor people do not live in poor areas; and most of the people who live in these areas are not poor. (“An Introduction to Social Policy”) “The Tower Hamlets Health Profile 2007” Bow East, Bromley-by-Bow, St Dunstans and Stepney Green, Limehouse and Shadwell are some of the most income deprived parts of the borough. These areas are shown as dark blue in the chart above. Children from deprived backgrounds have a poorer start in life on many levels, but without good mental health they may not have a chance to develop emotionally and reach their full potential in life. People who feel deprived may face mental disorders and cases of alcoholism and smoking are often reported due to their unacceptability by others. Mortality from suicide and undetermined causes shows a clear correlation with deprivation, especially in the younger age groups. Suicide, Depressive Illness, Schizophrenia and Anxiety are some major diseases that deprived people have to come terms with. Social Exclusion The worst estates have become a central focus of policies dealing with social exclusion. Their problems are the problems of poverty. People who are poor live differently as they are stuck at home more, they cannot afford enough heat to avoid damp. Rich people without young children would not have the same problems. Examples of problems in poor areas in the Tower Hamlets like the Limehouse or the Bow East area include vandalism, rubbish, lack of community facilities, empty housing which is left empty because the area is unattractive is a result of social exclusion. (“An Introduction to Social Policy”) “The Tower Hamlets Health Profile 2007” Social exclusion can also be caused by the race the people belong to. The ethnicity in the Tower Hamlets comprises of different nationalities. The affect of this on people’s health is shown in the chart above. The chart highlights the conditions of the people belonging to different sects. Poorer children at an early age face the problem social exclusion the most since they want to be a part of the rich and the famous which is more fun to them. Early suicides, stunted mental growth and poor development of the whole body system, teen pregnancies are sometimes based on the social exclusion factor. Adults too face this problem which they try to solve through alcoholism and drug abuse. Health Issues Facts Life expectancy in men and women in Tower Hamlets is lower than in England as a whole, (2.0 and 1.2 years shorter). The death rates from major causes in Tower Hamlets are higher than the England average. For example, smoking related mortality is higher. Smoking accounts for over 1 in 5 of all deaths. The percentage of people with recorded diabetes is higher than the England average. This is consistent with the ethnic diversity of the population. Estimates suggest levels of binge drinking are below the average for England. The rate of hospital admissions for alcohol specific conditions is higher than the rate in England as a whole. Almost 1 in 2 children live in households dependent on means-tested benefits, compared with 1 in 5 in England as a whole. Tower Hamlets has a high level of deprivation, with the majority of small areas falling within the most deprived fifth of areas in England. Within the borough, areas in the centre and north east are the most deprived. Life expectancy in the most deprived areas for males and females is 73.7 and 78.7 years, 2.7 and 1.8 years less than the least deprived areas. In Tower Hamlets, over 1 in 4 of the population in the Bangladeshi ethnic group is in a routine and manual occupation compared to 1 in 5 of the borough as a whole. A local priority is to reduce the gap in life expectancy with England by tackling cardiovascular disease cancer, diabetes, smoking and obesity. (“The Tower Hamlets Health Profile 2007”) Tower Hamlets borough, a historically deprived haven for immigrants and refugees and features the massively funded Docklands development: the Canary Wharf office project, the Docklands Light Railway, the Limehouse highway, and the Jubilee line extension to the mass transit London underground. But, say community planning activists, though Docklands attracts more than 70,000 daily commuters to work in area offices there are few neighborhood or service oriented projects for isolated low income residents and newcomers from Bangladesh, Viet-Nam and Somalia. According to “Europes new melting pot cities”, the Tower Hamlets provides a stark case study of what can happen when the needs of local people are subordinated to market forces. It contains about 3.8 million square feet of unused office space in Docklands, much of it speculatively built with the support of the London Docklands Development Corporation (LDDC), a quasi governmental organization. At the same time, domestic overcrowding is the worst in London and unemployment is the second highest in the capital. The great majority of the jobs in Docklands have been of little or no benefit to the people of the Borough. Race Equality in the Context of Health As mentioned is “The Race Equality Scheme”, the Tower Hamlets is the sixth most deprived borough in England with 30% of households being recoded as overcrowded. Unemployment is 13.6% compared to an inner London average of 9.6%. Health profile of Tower Hamlets is also not very promising. The area has higher mortality rates for under 65s. The prevalence of CHD and diabetes are three times higher than England and Wales as a whole. Tuberculosis rates are five times higher in Tower Hamlets then they are for England and Wales as a whole. The demand for mental health services is higher amongst immigrant communities and asylum seekers. The PCT acknowledges the fact that health inequalities do exist among the population it serves. It also recognises that the equitable, patient-centred and culturally appropriate service delivery is a real challenge in this area. What the Tower hamlet Council is Doing to Alleviate Social Issues Health and Medical Advice Tower Hamlets Primary Care Trust was formed in 2001 and it serves the area of London Borough of Tower Hamlets delivering health care in its role to: (“Services”) to improve health to reduce inequalities and to modernise the services in Tower Hamlets The GP surgery should be contacted for medical advice in the first instance. The GP or practice nurse will be able to treat or refer the resident to a range of health services, designed to meet health needs. The service provides information and advice about local practices, sends out lists of GPs in the local area and assigns patients to a GPs list when they cannot find a GP who will accept them. (Ackers 1996; Béphage 2000) Environmental Health Tower Hamlets Council health and safety team provide the following services to residents and businesses in the borough: (Clarke 2001; “Services”) Health and safety enforcement – Health and safety enforcement of laws in retail, warehouses, offices, leisure centres etc. Investigating accidents involving employees and members of the public. Communicable disease control – Control the spread of infection from food and non-food sources e.g. salmonellas, legionella, investigate food poisoning outbreaks. Licensing – Covering public safety, security and well being at events in the borough. Massage and special treatments – Covering inspections of treatments hair salons, beauty parlours, nail parlours etc. Pet shops– To ensure that animal welfare is maintained during the sale of animals. Conclusion The Tower Hamlet with its vast area with people belonging to different walks of life living together makes up one of the biggest communities in the world. When a community is as big as this, proper management and facilitation to the people is one of the biggest problems. However along with this comes into various issues that need to tactfully solve to bring about favourable results. Social factors such as these mentioned below cause problems for the people living it the community. (Kerry 2007; Paul 2005; Terry 2006) Socio-economic status Minority Status Gender Work Social Isolation Culture Gender Ethnicity Social Position Poverty Inequalities Religious Beliefs Families Migration The problems that diversity brings about have the greatest effect on the health of the people. Health here does not always mean in the form of visible illness. Mental and psychological sickness which is not apparent also comes into this. Tension and stress are all part of the health issues that the Council of the Tower Hamlets have to continually face. Through years and years of experience, the council is doing fairly well in managing these problems. The council has various divisions that handle the health issues of the residents. As they say “prevention is better than cure”, this council applies this quote and tries to prevent stressful occasions for the residents. Toll free numbers are available to the residents to call up in case of any emergency. Trauma centres, mental disorder centres, health care centres, social services, medical advice and more is available to the residents for a better and healthier life. Works Cited Page 1. Ackers L, Abbott P. (1996) Social Policy for Nurses and the Caring Professions. Buckingham: OUP 2. Allsop J. (1995) Health Policy and the NHS. 2nd edition. London: Longman 3. "An Introduction to Social Policy" [Internet], Available at , Accessed on July 10, 2007 4. Barry AM, Yuilll C. (2002) Understanding Health. A Sociological Introduction. London: Sage 5. Béphage G (2000) Social and Behavioural Sciences for Nurses. An Integrated Approach. London: Churchill Livingstone. 6. Blane D, Brunner E, Wilkinson R, editors. (1996) Health and Social Organisation. London: Routledge 7. Bond J, Bond S. (1994) Sociology and Health Care. 2nd edition. London: Churchill Livingstone 8. Clarke A (2001) The Sociology of Healthcare. Essex: Prentice Hall. 9. “Community” [Internet], Encyclopedia Wikipedia, Available at , Accessed on July 9, 2007. 10. “Community Plan” [Internet], Tower Hamlets Council Available at Read More