Understanding of the Relationship Between Social Inequality and Health - Essay Example

Discuss your understanding of the relationship between social inequality and health, illustrating this with reference to poverty The linkages between health and poverty have just recently begun to be understood by scholars of the social sciences. Accordingly, the relationship between social inequality and health is important and can be explained by looking at a variety of important social cleavages, including class, race and income disparities. The social model of health explores both individuals and the social population in determining our conception of health. According to this theoretical paradigm, improved health can be improved by looking at the key environmental and social aspects of what constitutes positive health. This is a theoretical model that has recently gained credence due to its emphasis on the social determinants of health. Poverty can have dramatic health ramifications and social inequality between certain population groups can lead to significant health discrepancies. Thus, social forces influence healthcare delivery and nowhere is the relationship between social inequality and health more pronounced than in the United States where a racial gap in healthcare provision continues to exist. The following now turns to an exploration of the relationship between social inequality and health by looking at an underserved population beset by poverty and poor access to modern healthcare. In the United States, health insurance coverage ensures all can access that basic healthcare. Today, one in three Americans identify themselves as Hispanic, Native American, Asian American, African- American or Pacific Islander. Accordingly, it is predicted that by 2050, more than half of the American population will be self-identified minorities. Over the last 50 years, the United States has made efforts to ensure the improvement of healthcare access for all Americans. In the early 1960s, the United States established policies aimed at expanding the access to healthcare for all citizens. These programs did result in expanding access to healthcare for low-income families, people with disabilities and the poor through Medicare, Medicaid and the 1964 Civil Rights Act. Despite these positive changes, disparities in healthcare continue to exist for minority populations in the United States. Accordingly, minorities families in the United States continue to wrestle with high levels of poverty, unemployment and healthcare challenges. For a country that came into existence on the premise of universal equality, the United States has, from a health-perspective, ignored some of the very principals under which it was founded (Gans, 1995). More than 20 years ago, the United States Department of Health and Human Services released a milestone report on racial health disparities in the United States entitled, “Secretary’s Task Force Report on Black and Minority Health.” Revealing significant gaps in the health status among Americans of diverse racial and ethnic groups, this report was the first of its kind. This was also the first national report to document the health disparities of racial populations in the United States. Despite attempts at addressing these issues, health issues among minority populations continue to persist (DHSS Report of the Secretarys Task Force on Black and Minority Health, 1986). Today, a number of studies have shown that minority populations have higher death rates and rates of diseases such as cancer, HIV/AIDS, and cardiovascular disorders. These studies represent the social model of health and data collected from independent studies over the years have concluded that African-Americans have the worst health outcomes when compared to other minority populations in America. For example, African-Americans have the higher cancer rates and the survival rate for African-American women with breast cancer is half that of white females. Such disparities are generally ignored by the U.S. healthcare system because the system does not fully address the environmental causal factors which result in health inequalities. Not addressing the factors which lead to health disparities furthers the bridge between the minority and the majority population in relation to health statuses (Fiscella and Williams, 2004). There has been increasing interest in racial and ethnic disparities and the use of preventive health services to counteract these disparities. Since the Healthy People 2010 Initiative, there have been many attempts to develop interventions that decrease health inequities. Some of these interventions include cultural competency programs, community-based outreach for minority populations, and advance targeted screenings. In an important study conducted by the Kaiser Family Foundation in 1999 entitled Race, Ethnicity and Medical Care: A Survey of Public Perceptions and Experiences, researchers assessed people’s perceptions about racial biases in the US healthcare system. Accordingly, this was the first national research study to study these trend. The aim of this studies was an attempt to understand the differences that occur in the health system by virtue of race (Kaiser Family Foundation, 1999; Gans, 1995). The Federal Healthy People 2010 Initiative, led by the U.S. Department of Health and Human Services, has set important health improvement goals for the United States. These include goals to eliminate health disparities among ethnic minority populations. The Healthy People 2010 Initiative has been instrumental in increasing awareness about health inequities across the United States. As a result, various attempts have been made to develop interventions that have been designed to decrease the occurrence of health inequalities in healthcare. These interventions include cultural competency initiatives, health literacy programs aimed at enhancing patient-provider communications, and group-specific outreach activities (Fiscella, et al., 2004). Concluding Remarks The United States has the most advanced medical care in the world. However, medical care in this country is very expensive and unevenly distributed. African-Americans in the United States continue to face a variety of health-related challenges including high rates of general mortality, infant mortality, cancer, hypertension and HIV and AIDS, among others. While personal bias and racism can influence health inequities, research has shown that societal and institutional racism has also accounted for some of these disparities (Maynard et al., 1986). Without the social model of health, one would not be able to understand the particular health challenges facing specific groups such as African-Americans. The linkages between health and poverty have just recently begun to be’ understood and taken seriously by scholars as well as by medical practitioners throughout the world. The relationship between social inequality and health remains important and can be explained by looking at a variety of important social cleavages, including class, race and poverty. As this essay has emphatically demonstrated, poverty can have dramatic health ramifications and social inequality continues to lead to significant health discrepancies (see Fiscella and Williams, 2004). How you might apply these insights into professional practice? As mentioned above, the relationship between social inequality and health is starting to be understood and the social model of healthcare provides much insight into the interdependent factors which can account for healthcare discrepancies in particular societies such as the United States or the UK. Seeking to explore how the insights above can be applied into professional practice, the following will discuss challenging social attitudes, working with individuals, working with groups and social inequality and health in service provision. Insights about the relationship between health discrepancies and social inequality can be applied to professional practice if healthcare practitioners seek to change social attitudes and challenge stereotypes. Thus, insight derived from the American healthcare system about poverty and racial discrepancies in healthcare can be applied in the United States as well as in the United Kingdom. Challenging social attitudes about the relationship between poverty and health can do much to combat stereotypes about certain populations which face important health challenges. Some may feel that immigrant communities in the UK have higher incidents of health issues such as high birth rates or high infant mortality. Take Tower Hamlets for example. This community is home to numerous ethnic groups and today boasts one of the largest concentrations of Bangladeshis in United Kingdom. The 2001 UK census listed the Bangladeshi community in Towers Hamlets at more than 65,000, establishing the largest non-white cultural community in the borough. Importantly, health challenges that afflict this community are often stereotypically tied to the immigrant Bangladeshi community. Challenging attitudes means understanding the social forces which may contribute to inequalities in healthcare and the ways in which race, poverty and class intersect to produce health disparities in the UK (Tomlinson, 2002). Professional practitioners can also implement change by working with individuals as well as working with groups to understand that health discrepancies are real and are tied to social forces that promote social inequality. Thus, working with individuals can mean reaching out to certain underserved populations such as the poor, the working class and visible minorities and immigrants. Working with individuals may imply paying closer attention to the needs of underserved population groups while ensuring that healthcare delivery is comprehensive and based upon the concept of equality for all. Only by working with the poor, visible minority groups, amongst other underserved communities, can a healthcare practitioner truly understand the needs of a particular underserved community. Individual health challenges and disparities based upon race, class and ethnicity must be tackled from the grassroots up and by working with specific understudied groups can healthcare delivery truly be improved upon. By targeting specific groups, the insights derived from an analysis of healthcare inequality can greatly improve the access of specific groups to the benefits of modern healthcare. Looking at the example of racial discrepancies in the United States once again, health professionals can seek to understand and address healthcare inequality by reaching out to specific communities and engaging in change on the ground with specific target groups. Thus, visible minorities or immigrant groups may be sought out as important communities with which to work to improve the social health of the communities studied. Furthermore, a healthcare practitioner may be able to address the healthcare challenges of these communities through a hands-on, proactive approach to working with both groups and individuals within target communities. Only through a proactive approach can the relationship between social inequality and health be explained by looking at a variety of important social cleavages, including class, race and income disparities. Insights derived regarding the various social cleavages which impact healthcare can also be implemented by the healthcare professional through an analysis of service provision and the ways in which provision is unequally distributed. As mentioned earlier, unequal access to healthcare is one of the most important factors which relates to healthcare disparities. Service provision can thus be targeted towards specific underserved communities with an eye to increasing the ways in which these particular communities are served by healthcare professionals. Thus, targeting underserved communities such as blacks, Indians or immigrants in the UK can do much to address inequalities in access and health delivery. The provision of healthcare is dependent upon adequate delivery and groups who do not have access to basic healthcare are certain to exhibit health-related ramifications. Accordingly, service provision is a basic goal of practitioners and which remains essential if one hopes to address inequality in healthcare. Understanding that inequalities in healthcare do exist is the first step in seeking to address them. Discrepancies in healthcare are real, do exist and have a variety of social ramifications. Accordingly, a comprehensive approach aimed at addressing inequality in health should aim to challenge social attitudes in order to bring about change. This is important and involves first and foremost an appreciation for the inequalities which do exist within healthcare. Importantly, healthcare practitioners can address these discrepancies by working with individuals as well as by working with groups top provide a grassroots response to the particular health-related challenges afflicting key, target communities. While in the United States these communities may be African-Americans, in the UK they may be non-white groups such blacks, Bangladeshis or Indians. Finally, service provision is the final, most important step in addressing the ways in which inequalities within health which are tied to the social cleavages such as poverty, race and class. Healthcare providers cannot reach target communities unless the facilities exist to provide adequate care. Accordingly, healthcare providers can seek to address the important inequalities that exist within healthcare by ensuring that groups are targeted and that healthcare is provided. While the linkages between health and poverty have just recently begun to be understood by scholars, practitioners play an important role in the frontline of healthcare delivery and can do much to alleviate the health discrepancies which are real and continue to exist. References Fiscella, Kevin and Williams, David R. 2004. Health Disparities Based on Socioeconomic Inequities: Implications for Urban Health Care. Academic Medicine 79(12):1139-1147. Gans, Herbert. 1995. The War Against the Poor: The Underclass and Poverty Policy. New York: BasicBooks. Kaiser Family Foundation. 1999. Race, Ethnicity and Medical Care: A Survey of Public Perceptions and Experiences. Menlo Park, CA: The Henry J. Kaiser Family Foundation. Kaiser Family Foundation. 2007. Key Facts: Race, Ethnicity and Medical Care, Update. Menlo Park, CA: The Henry J. Kaiser Family Foundation. Smedley, Brian D., Adrienne Y. Stith, and Alan R. Nelson (editors). 2003. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: The National Academies Press. Tomlinson, S. 1992, ‘Disadvantaging the Disadvantaged: Bangladeshis and Education in Tower Hamlets’, British Journal of Sociology of Education, 13.4: 437-446. U.S. Department of Health and Human Services. 2010. Healthy People 2010. Washington, DC. U.S. Department of Health and Human Services. 1986. Report of the Secretarys Task Force on Black and Minority Health. Washington, DC: U.S. Department of Health and Human Services (1):63-86. References Health Insurance Reform. (2009). The White House. Last Accessed August 14 2009 http://www.whitehouse.gov/realitycheck/ Smedley, B. D., A. Y. Stith, & A. R. Nelson (editors). 2003. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. 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