Sociological Explanations for Inequalities in Health Care - Case Study Example

Sociological explanations for inequalities in health care Today's world is confronted with disproportion, starting from budget inequalities, unequal development in countries, different approach to poor, systems, and the possibility for progression. All these give establishing different health care with different quality or inequalities in each country especially concerning the impact on social environment on people’s health and illness. All these exist because of unequal distribution of material and social resources in society, as a factor producing ill health and disease. Quality or inequality, especially dependent on social status on the individual or high social-economic status gives high quality health care, considering rich countries how devote and concerned about health care, as a base for progression and inverse. Countries with the shallowest gradient between the rich and the poor (e.g. Japan) have the best health indicators while those with steep gradients between the rich and the poor (e.g. the USA) have the worst health indicators. Observing low status ethic groups it came out that they face severe economic discriminations starting from access to loan and to basic of participation in economic life, such as healthcare and health insurance, adequate schooling and access to the legal system. This leads to the explicit outcomes of lower wages and participation in the informal sector of the economy with its increased exposure to health hazards at work and correlation with addiction and violent behavior. These political and economic inequalities are added to by a general disparagement and denigration of cultural values and health belief systems, and a stereotypical representation of ethnic groups as responsible for their own problems. The social pattern experiences of poorer health are based on class position concerning gander health issues and ethnicity. According to studies, it has been established a difference in health care system saying and that people at the bottom of the social system have a much higher mortality rate than those at the top applying to the majority disease, independently of lifestyle. People in lower classes suffer more from chronic disease and their children weight less at birth and they are shorter. There are also market inequalities in access to preventative services. National and international patterns of growing inequalities of wealth and income in the West mean that inequalities of health are also widening. The experience of poverty, homelessness and unemployment –socio-economic inequality – results in social exclusion, a lack of social networks and low levels of social support resulting in low self-esteem leading to greater vulnerability to disease and early death. From the end of World War II through to the late 1970s individuals in Western societies could expect the welfare state, but under the impact of neo-liberalism as achievement of working class and women’s movement didn’t gave the expected social goals, the concept of citizenship has been reconstructed as active citizenship in which the individuals are increasingly responsible for themselves, operating in privatized education, health and welfare markets. This gave a specific outcome of increasing inequality in health care , especially for women who are disadvantaged in the labor market through their working life and are more dependent on the state sector, especially in old age. One of the most important report that came out of the US in the twentieth century that demonstrates the links between poverty, inequality, and differential rates of disease and illness was the Black Report. Using the British Registrar-General’s classification of occupation on death certificates it showed that those in classes IV and V (partly skilled and unskilled) were sicker and died earlier than those in classes I and II (professional and managerial). The report systematically reviewed the evidence for this correlation and rejected explanations that suggested that it was a statistical artifact, that it was a consequence of natural selection, or that it was a product of lifestyle choice. Rather it argued that the distribution of disease down the social system was the product of structural aspects of inequality such as patterns of property ownership and poverty. In Western countries from over 75 per cent of the workforce in the early 1900s to less than 50 per cent by the early 1980s died earlier and suffer from more preventive disease and so the working class was blamed for that situation and for choosing health damaging lifestyle. The working class was unskilled, uneducated, and with low social status described that sector of society, where working conditions were physical exertion and repetition. In this perspective, language, as structural organization of conversation or as micro level of interaction on society, showed that it reinforces the gendered inequalities of power that exist, though since it is taken for granted, not in ways that are immediately obvious. These power relations between men and women are strained when the social distance is great. Gender has significant impact on health especially social distinguish as different social roll; women are sicker and men the earlier. Young men in particular are vulnerable as they attempt the transition into adulthood dying at twice the rate of young women from accidents, violence and suicide. Women appear to be sicker because they are more diagnosed as sick and because of the medicalization of their reproductive functions. The social role of mother and housekeeper means that women do a double shift of paid and unpaid work which impacts on their health. Gender differences in health are not as large as they were with more women in the workforce and the higher incidence of smoking in women, though there are still marked differences in the diagnoses of psychiatric illness among women. Men, in conforming to the idea of masculinity self-medicate with alcohol and drugs, do not report symptoms, and delay treatment. Consequently they die sooner of preventable diseases than women. Ultimately, for both men and women discrepancies in access to adequate healthcare is largely based on socioeconomic issues including income and full-time work status, with both groups of men and women with higher levels of income and full-time work receiving greater access to adequate healthcare. According to the World Health Organization in its Social Determinant of Health: The Solid Facts identified ten determinants of ill-health and diseases: social gradient or inequality , impact of stress-early life exposure to social insults such as poverty, homelessness and hunger, social exclusion the impact of work environment ,the impact of unemployment, the presence of social support, addiction induced by social circumstances, access to quality food and transport services. Health policy that concerned the social basis of illness and disease will do far more for the population’s health than biomedical interventions can do. Recent research known published in September 2000 as Reducing health inequality in Britain has come to a conclusion that better health care will be established if some of the key social policies of the Government will be rightly established. The researchers showed that some 7,500 deaths amongst people younger than 65 could be prevented if inequalities in wealth narrowed to their 1983 levels, some 2,500 deaths per year amongst those aged less than 65 would be prevented were full employment to be achieved, some 1,400 lives would be saved per year amongst those under 15 if child poverty were eradicated and 37% of 'excess' deaths would be prevented if the majority of lives saved from redistribution would be in poorer area. The key points of changes to society are a modest redistribution of wealth which refers to research that return the inequalities in mortality to their 1983 levels; achieving full employment refers to people may be temporarily between jobs, no one is in longer term receipt of unemployment benefit and eradicating child poverty-bringing one thirty of Britain children out of poverty. Though modest redistribution of wealth differences in wealth and income to be returned to the early 1980s level through policies with a mildly redistributive effect, we would expect the differences in life chances to be reduced. The effect of achieving this for Birmingham would be that about 17 of these 93 excess deaths would be avoided. The attainment is considered that equal society has been shown to have a positive effect on the health of entire populations. Trough achieving full employment includes improving health of worker and unemployment, 14 of the 93 excess deaths per year would have been prevented, avoiding unemployment and relating age, sex and social class. Trough eradicating child poverty, as vulnerable, exploit group would be saving the lives of 8 children per year and so the total of excess deaths prevented amongst all those aged less than 65 to 39, which is about 2 out of every 5 excess deaths prevented. The eradication of child poverty is only assessed on those aged 0-14 and so the results would be visible later ages. The most benefits from these would be seen at means because they suffer from grater inequality in mortality and the poorer people. Especially the mortality rate will be lower in the parts of the countries as north Britain and urban areas were the highest mortality rate and so there would be the grates benefit of all. Researches known as Social factors are key to ill health has showed that social factors are far more effective rather that genetics for huge variation of illness and life expectancy in the worlds. The conclusion is social injustice is killing people. Boy living in the deprived Glasgow suburb of Calton will live on average 28 years less than a boy born in nearby affluent Lenzie. Similarly, the average life expectancy in London's wealthy Hampstead was 11 years longer than in nearby St Pancras. The research also shows that a girl in the African country of Lesotho is, on average, likely to live 42 years less than a girl in Japan. In Sweden, the risk of a woman dying during pregnancy and childbirth is one in 17,400, but in Afghanistan the odds are one in eight. And so, in almost all countries poor socioeconomic status is equal to poor health, and so the differences were so marked that genetics and biology could not begin to explain them. Another research named “Long-term ill health, poverty, and ethnicity” published by Joseph Rowntree foundation in April, 2007, studied Pakistani, Bangladeshi, Ghanaian and white English working-age people living with long-term ill health. The study used quantitative and qualitative methods to examine why there are links between ill health and poverty, and why the consequences appear to be worse among minority ethnic groups This study explored the relationship between long-term health conditions and poverty across a diverse population..The result were following: health problems were often clustered, with individuals suffering from multiple conditions.; ill health was closely related to labor market outcomes, in particular lower participation in paid employment, but also low pay; those with long-term health conditions experienced a range of barriers to employment, despite having a strong work ethic: claiming disability benefits was perceived as a struggle and stressful, particularly among those with mental health problems.: difficulties making ends meet had a deleterious effect on health and on household well-being: attitudes to ill health, and the way it was experienced, varied with ethnicity, as well as age and gender. Ultimately, healthcare inequality in the United States is certainly an issue of race, as considerable disparities in levels of access to healthcare exist between ethnic minorities and whites, with ethnic minorities continuing to rank significantly lower than whites in levels of access to adequate healthcare. Here are also considerable racial disparities in access to insurance coverage, with ethnic minorities generally having less insurance coverage than non-ethnic minorities. For example, Hispanic Americans tend to have less insurance coverage than white Americans and receive less regular medical care. According to Trivedi et al., the level of insurance coverage is directly correlated with the level of access to healthcare including preventative and ambulatory care, and also states that race is a significant determinant in the level of quality of care, with ethnic minority groups receiving less intensive and lower quality care. Ethnic minorities receive less preventative care, are seen less by specialists, and have fewer expensive and technical procedures than non-ethnic minorities. The pathway through which social determinate influences on health care are: Social determinants contribute to health inequalities between social groups. This is because the effects of social determinants of health are not distributed equally or fairly across society. Social determinants can influence health both directly and indirectly. For example, damp housing can directly contribute to respiratory disorders, while educational disadvantage can limit access to employment, raising the risk of poverty and its adverse impact on health. Social determinants of health are interconnected. For example poverty is linked to poor housing, access to health services or diet, all of which are in turn linked to health. Social determinants operate at different levels. Structural issues, such as socioeconomic policies or income inequality, are often termed ‘upstream’ factors. Multiple causes for health inequalities are: socio-economic or material factors such as government social spending and the distribution of income and other resources in society which influence the social and built environment. Psychosocial factors such as stress, isolation, social relationships and social support. Behavioral or lifestyle factors, such as smoking, diet and exercise. These factors are inter-related and can all be influenced by the social conditions in which people live their lives. To advantage inequalities we shall work for health equity we can mange that though: Focusing on the most disadvantaged groups as poorest group; Narrowing health gaps: improving poorest by rising their health outcomes; Reducing the social gradient: reducing differences. Recent research by Pickett and Wilkinson (2007) for example, showed that in richer societies child well-being outcomes tended to be worse with higher levels of income inequality. It is suggest that in richer countries at least, improvements in child well-being may depend more on reductions in income inequality and levels of relative income poverty, than on further economic growth. In a health inequality impact assessment, Donald Acheson says that critical points for reducing health inequalities that accessory the health care assessment are: all polices that have influence on health should be evaluate in terms of their impact on health inequalities: high priority should be given to the health of families with children: further steps should be taken to reduce income inequalities and improve the living standard of poor householder. References: 1. Bartley, Mel. Health Inequality: An Introduction to Concepts, Theories and Methods. New York: Polity, 2004. 2. Bodenheimer, Thomas and Kevin Grumbach. Understanding Health Policy. Philadelphia: McGraw-Hill Medical, 2008. 3. Conrad, Peter. The Sociology of Health and Illness. New York: Worth Publishers, 2008. 4. Dowler, Elizabeth and Nick Spencer. Challenging Health Inequalities: From Acheson to “Choosing Health”. New York: Policy Press, 2007. 5. Health Inequalities. 2001. World Health Organization. Accessed December 7th, 2008 [http://www.who.int/health-systems-performance/docs/healthinequality_docs.htm] 6. Independent Inquiry into Inequalities in Health Report. 1998. Sir Donald Acheson. Accessed December 7th, 2008. [http://www.archive.official-documents.co.uk/document/doh/ih/ih.htm] 7. Long-term ill health, poverty, and ethnicity. 2007. Joseph Rowntree foundation. Accessed December 7th 2008. [https://www.jrf.org.uk/bookshop/eBooks/1995-health-ethnicity-poverty.pdf] 8. Ostlin, Piroska. Reducing Inequalities in Health: A European Perspective. New York: Taylor and Francis, 2007. 9. Pickett, Kate E. and Richard G. Wilkinson. “Child wellbeing and income inequality in rich societies: ecological cross sectional study”. British Medical Journal 16 November, 2007. 10. Smith, George Davey. Health Inequalities: Lifecourse Approaches. New York: Policy press, 2003. 11. Taylor, Loraine et al. Public Health Evidence: Tackling Health Inequalities. London: Oxford University Press, 2006. 12. Trivedi et al. “Relationship Between Quality of Care and Racial Disparities in Medicare Health Plans”. Journal of the American Medical Association, 2006; 296:1998-2004. Read More