Health Policies in Britain - Essay Example

Health Policies in Britain Introduction Almost everyone has been ill at one time in his or her life. The onset of sickness often is taken to mean that day to day routines are disrupted. In this regard, it means that people who fall ill often have problems performing their duties. However, there are differences in view of why some people fall ill more often than others, why there are differences between some groups of people in seeking medication, and most importantly, why these differences occur or exist in the first place (Goldthorpe 2010). With these deliberations, this paper will articulate on issues related to health inequalities. Specifically, the paper will be responding to the statement “addressing health inequalities requires interventions to change individual health behaviours”. Health inequality has been in existence for quite a long time across the world. Studies have indicated that these inequalities come in terms of social inequalities (Goldthorpe 2010). Poor people are more prone to diseases than rich people. Cases of illnesses are higher in poor households than in rich households. In the UK, health inequalities have been studied and well documented. Studies have indicated that there exists a difference in morbidity and mortality rates across the social spectrum (Gorsky 2008). Causes of healthcare inequalities and social determinants Health inequalities can be argued to be differences in health status or even distribution of health determinants between different social group’s spectrum (Dowler and Spencer 2007). It can also be argued to be as a result of increased differences in social inequalities that exist between those that are economically advantaged and the disadvantaged. Nonetheless, those differences should not be condemned unless their existence is proved to be avoidable or unfair. Nevertheless, it is now widely acknowledged that social inequalities are major causes of unfair health inequalities. Although some inequalities are natural biological oriented, some are manmade and can easily be controlled if not being avoided (Dowler and Spencer 2007). In England, it has been documented that people living in disadvantaged and poorest areas die at an average of seven years earlier than people living in richest areas (Gorsky 2008). Additionally, there is big a difference of average disability free expectancy between the poorest and richest areas. Another evidence of social inequality is in Scotland where men living in deprived environments die nearly on an average of eleven years earlier than men living in least deprived areas. On the same note, the socio-economic status of each social group is characterised by their geographical location and their features which among them include infrastructure of the location and the living conditions, race, and to some extent gender (Nettleton 2006). Poor people have difficulties in dealing with issues that increase the likelihood of falling ill. For example, it is apparent that poor people have difficulties getting jobs to sustain them, or even when they get one; it is not enough to sustain the family. This, therefore, has an implication that these people will have difficulties satisfying their basic needs which among them include good health (Smith 2003). Firstly, these people are unable to provide themselves with food, and if they have, the food is not a balanced diet. Some diseases are associated with poor eating habits which among them include lack of enough food and imbalanced diet. Therefore, it is apparent that the poor have higher chances of succumbing to such diseases. Additionally, Smith 2003 argued that some diseases are associated with poor living conditions, which in this case involve poor environmental conditions. Poor people leave in areas with poor sanitation and other environmentally polluted surroundings. In contrast, rich people are able to afford a balanced diet and leave in clean environments. Apart from living conditions, when people fall ill, there exists inequality in terms of how they receive treatment. Poor people have difficulties paying for their medical bills, as opposed to rich people who can easily afford to pay for their medical bills (Cummins, et al 2007). However, there have been efforts by the government to offer a quality and affordable health for everyone through the NHS. The NHS is mandated to provide health care service to the whole local population. However, as much as the government is committed towards offering affordable health care services to its people, there exists a concern about health care quality that people receives from the government. Firstly, the funds to run the NHS are received from the national tax collected from the public, meaning that the public has all rights to receive quality health care services from the government through the NHS (Marmot 2006). Although such a move by the government can be termed to be a good one, this is not enough, as there is a need to fight against health inequalities. To shade some light on this, it is true to argue that the NHS is only meant for the poor as the rich subscribe to various health insurance policies. They can easily afford to pay for these policies and obtain quality health care services (Marteau 2011). They go to private hospitals where they receive the services they want. Public hospitals are characterised by low quality health care services ranging from inadequate clinicians, inefficient facilities, poor management, misappropriation of funds, poor customer service, and political interference (Marmot 2006). With regard to this, it is true to argue that the government needs to initiate programs that can help reduce cases of illness and encourage, general individual behaviour. As much as the effort by the government to offer affordable and quality health care, it would be better if the government try to dig deep into the root cause of the problem. This should involve issues related to social inequality, which is later translated to healthcare inequality. Recent UK coalition government policies to reduce health inequalities The recent move by the UK government policies to reduce health inequalities can be termed as a move to liberate disadvantaged lot. This comes in the form of government giving the local authorities more responsibilities on matters pertaining provision of health of the public (Great Britain, Parliament, House of Commons and Health Committee 2008). However, it is necessary to focus on what this move brings to people and how it can help address individual health behaviours. For example, in the year 2006, the then improvement and development agency (IDeA) received some funding from the department of health to empower the local government to tackle health inequalities and advance the level of health (Bolton Muzio and Boyd-Quinn 2011). IDeA was successful in meeting its objectives. However, this can be argued to be unsuccessful endeavor by the government to handle the issue of health inequalities because this body closed its operations on December 2011. Although this was a good move by the government, creating temporally institutions to tackle issues of health inequalities does not solve the problem. All what is left is hopes that areas addressed by this body will not deteriorate again. In the year 2010, the UK parliament’s committee of public accounts confirmed that indeed there is a considerable gap in life expectancy between the general population and people living in deprived environments and that this gap has continued to widen (Greer 2009). The committee also confirmed that although the NHS spends an average of four percent of its funding on prevention measures, it was unclear on whether the NHS had made any contribution towards dealing with issues of inequalities. Another policy initiated by the government involved the department of health in 2004, where it set a target to reduce the gap that existed in life expectancy in local authorities especially in most deprived areas and the population as a whole by at least 10 percent by 2010 (Greer 2009). This was also to go hand in hand with improvement of life chances of children in the effort to tackle inequalities. Although these plans were underway, none of the agendas was met. However, the current coalition government has articulated some commitments to fight the vice of health inequalities. The public health policy stipulates that there is a need to change individual behaviour by a way of encouraging personal responsibility for matters pertaining health (Mackenbach 2010). The policy also calls for transfer of responsibility for public health to the local authorities. Other policies put in place by other departments other than the department of health that are also argued to have a significance impact on health outcomes include all policies relating to transport, the environment, economic security and education (Mackenbach 2010). One and the most notable efforts by the government involve the development of the white paper, which contains appealing strategies like ‘our healthy and our wellbeing”. An example such strategies is the tobacco control plan policy. This plan sets out measures of how tobacco control will be brought forward in the new public health system (Greer 2009). The intention of this plan is to look for means of driving down the prevalence of smoking. Such a move by the government can be argued to be of great significance in the effort to improve health of the people. The initiative by the government to reduce health care inequalities by giving the local authorities more responsibilities on matters pertaining provision of health of the public can produce a good result as far as individual health behaviours is concerned. There is potential in sharing good practice by connecting the NHS and grass-roots organisations. In fact, this is seen as a strategy of engaging local people in decision making process. When local people are involved and engaged in decision making processes, there is a high likelihood that issues pertaining their health and how to improve it will be addressed (Greer 2009). However, mandating local authorities to look into matters of health can be argued not to be enough. There is a need to formulate programs that support families in order to empower them socio-economically. These programs should also include routine education by public health professionals on various ways through which individuals can maintain good health. This may include education on substance and dug abuse, eating habits, and environmental hygiene (Gochman 1997). Measure of addressing healthcare inequality by focusing on individual health behaviours Diseases that affect disadvantaged people can be argued to be unnecessary. This is arguably true because most of them come as a result of the way the society organises its affairs. This is in terms of the society failing to meet fundamental human needs of autonomy, and human empowerment. But, in what ways can individual health behaviour be changed? This section will focus on the criteria through which health inequalities can be eliminated by changing individual health behaviour. Glanz, et al 2008 noted that human autonomy forms the basis of social development. Human autonomy enables individuals to access resources that assure better health. However, this should go hand in hand with social capital inclusion, which enables people to involve in issues like education, which is associated with economic, social and psychological benefits accrued from it (Glanz, et al 2008). This is where the concept of empowerment is generated. Good health is as a result of empowerment strategy, which involves key areas like economic and social development, which translate to health empowerment. As indicated earlier, human autonomy forms the basis of human development. Therefore, if the society endorses autonomy of its people, then, creating resources is as crucial as creating the autonomy, and these resources encourage social engagement (Baum and Ziersch 2003). Therefore, social engagement qualifies to be the first pathway that link autonomy to health. Besides, it is true to argue that apart from empowerment forming the basis of individual socio-economic development, which is translated to empowerment on health, there are social developments accrued from it in the wider society Glanz, et al 2008). The other set of pathways involves the extent to which risk factors for chronic diseases people are aware of. Studies have attempted to find out the relationship between these risk factors and social engagement. It is well documented that some risk factors have the direct link with social disadvantage. Perhaps, this variable is related to the living conditions of the disadvantaged. For example, studies have elucidated that smoking is linked with low social economic status (Christakis and Fowler 2008). It can, therefore, be argued that disadvantaged people tend to resort to smoking as a way of relieving their daily challenges. This is arguably true because these people undergo different hardships in their routines, and as a result, they deem it right to smoking as a way of alleviating their stressful moments (Christakis and Fowler 2008). They lack enough money to resort to other possible ways of relieving stress. This is as opposed to the rich, who when stressed, can easily take some wine, go for a vacation, or even pay for counseling services. With the poor, these are all day dreams. Therefore, addressing the issue of empowerment and autonomy can be argued to be a vital move in order to address the issue of risk factors for chronic diseases being associated with socio-economic status (Hunter 2009). Although there have been enough campaigns against smoking and its consequences, a lot needs to be done in terms of backing up these campaigns with mitigating practices, which involves actual empowerment of the people. In fact, studies have indicated that most of socially disadvantaged women have no or little capacity to control smoking behaviour as long as they are incapable of improving their living standards (Christakis and Fowler 2008). It is also worth noting that empowerment comes as a result of three classes of influence: individual endowments (human capital and what one has), external constraints (especially from the family, community, and systems of governance), and individual internal constrains (preferences). All these influences dictate the lives of people. With regard to individual endowment, the ability by individuals to adjust within a social hierarchy is essential in empowering them (Hunter 2009). However, endowment has to have a foundation on which it can develop on. For example, people tend adjust and climb the social ladder when they are given a playing field full of opportunities, freedom, and availability of resources. Therefore, individual endowment enables people to develop ideas and accumulate wealth. This means that these individuals will have opportunities to improve their living standards thus they can afford a balanced and adequate diet, clean surroundings, and above all, they can afford to pay for their hospital bills (Melissa, Julien and Nancy 2011). It is, therefore, true to argue that if the government can create a room for individual endowment to take place, the issue of health inequality would be a thing of the past. Focusing on external constraints, it is apparent that the family, community and all forms of influences associated with them has more to do with how individuals are empowered (Glanz, et al 2008). A child born to a lower social class family tends to adopt the living styles of the family and is more likely not to be empowered. It is also apparent that people who adopt a religion that holds certain beliefs that are against certain developmental matters would find it difficult to be empowered. On the same note, people living in a system of governance that fail to address fundamental issues would also find it difficult to be empowered (Russell and Burnett 2011). With these literatures, it can be argued that people under the influence of such factors would fail to liberate constrains that hinder them from attaining good health. It is, therefore, necessary for the government to address some of these issues, which jeopardizes the health of its population. Individual internal constrains are considered to be individual actions associated with their preferences (Glanz, et al 2008). This forms the basis of empowerment which is reflected in other areas of development. Some people have a notion that they are born poor, and they are more likely to die poor. Such a notion can hinder people from empowering themselves because it creates a motivation barrier whereby people fail to recognise the need to work. Such people tend to rely on donations, and they often complain of government negligence. However, such assertions does not imply that the government should not come in and help; nevertheless, they should understand that the government is there only to provide with infrastructure through with people can empower themselves. In fact, the first efforts for individual empowerment should come from individuals themselves (Walt 2008). It is also vital to note that unwelcoming life circumstances do not call for risky behaviour s, which are resorted to by many people who feel frustrated in life. As noted earlier, such behaviours like smoking to alleviate stress ends up causing adverse effects to the user, and worst of it, deaths. This should be awakening call for people with low self esteem, and who fail to kick out internal constraints to empower themselves. Conclusion Health inequalities can be argued to be differences in health status or even distribution of health determinants between different social groups spectrum. Studies have indicated that health inequalities come as a result of social inequalities. The socio-economic status of each social group is characterised by their geographical location and their features which among them include infrastructure of the location and the living conditions, race, and to some extent gender. Apart from living conditions, when people fall ill, there exists inequality in terms of how they receive treatment. However, the UK coalition government has initiated measures of reducing health inequalities, comes in the form of government giving the local authorities more responsibilities on matters pertaining provision of health of the public. In 2006, the then improvement and development agency (IDeA) received some funding from the department of health to empower the local government to tackle health inequalities and advance the level of health. Another policy initiated by the government through the department of health in 2004 to set a target to reduce the gap that existed in life expectancy in local authorities especially in most deprived areas and the population as a whole by at least 10 percent by 2010. In 2010, the UK parliament’s committee of public accounts confirmed that there was a considerable gap in life expectancy between the general population and people living in deprived environments and that this gap has continued to widen. The public health policy stipulates that there is a need to change individual behaviour by a way of encouraging personal responsibility for matters pertaining health. Health inequality can be eliminated by changing individual health behaviour. However, there is a need to empower people in order to access resources that assure better health. Addressing the issue of empowerment and autonomy can be argued to be a vital move in order to address the issue of risk factors for chronic diseases being associated with socio-economic status. Nevertheless, although the government has to endorse autonomy and empowerment of its people, it is crucial; for people first to empower themselves. Bibliography: Baum, F. E and Ziersch, A. M. 2003. Social capital. J Epidemiol Community Health, 57:320– 323. Bolton, C. S., Muzio, D. and Boyd-Quinn, C., 2011. Making Sense of Modern Medical Careers: The Case of the UK’s National Health Service. Sociology, 45, 4: 682–699. Christakis, A. N. and Fowler, H. J., 2008. The Collective Dynamics of Smoking in a Large Social Network. N Engl J Med, 358:2249-2258. Cummins, S. et al., 2007. Understanding and representing ‘place’ in health research: A relational approach. Social Science & Medicine, 65: 1825–1838. Dowler, E. and Spencer, N., 2007. Challenging health inequalities: from Acheson to 'Choosing Health'. Bristol: Policy Press. Glanz, K. et al., 2008. Health behaviour and health education: theory, research, and practice. San Francisco, CA: Jossey-Bass. Gochman, D. S., 1997. Relevance for professionals and issues for the future. New York [u.a.]: Plenum Press. Goldthorpe, H. J., 2010. Analysing Social Inequality: A Critique of Two Recent Contributions from Economics and Epidemiology. European Sociological Review, 26, 6: 731–744. Gorsky, m., 2008. The British National Health Service 1948–2008: A Review of the Historiography. Social History of Medicine, 21, 3: 437–460. Great Britain, Parliament, House of Commons, Health Committee, 2008. Health inequalities: written evidence. London: TSO. Greer, S., 2009. Devolution and divergence in UK health policies. BMJ, 338: 78-80. Hunter, J. D., 2009. The case against choice and competition. Health Economics, Policy and Law, 4: 489–501. Mackenbach, J. P., 2010. Has the English strategy to reduce health inequalities failed? Social Science & Medicine, 71: 1249-1253. Marmot, M., 2006. Health in an unequal world. Lancet, 368: 2081–2094. Marteau, T., 2011. Judging nudging: can nudging improve population health? BMJ, 342: 263- 265. Melissa. L. M., Julien, O. T. and Nancy E. R., 2011. Health across the Life Span in the United States and England. American Journal of Epidemiology Advance, 1: 1-7. Nettleton, S., 2006. The sociology of health and illness. Cambridge: Polity Press. Russell, J., G. T. and Burnett, A. J., 2011. “No decisions about us without us”? Individual healthcare rationing in a fiscal ice age. BMJ, 342: 1-5. Smith, D. G., 2003. Health inequalities: lifecourse approaches. Bristol: Policy Pr. Walt, G., 2008. ‘Doing’ health policy analysis: methodological and conceptual reflections and challenges. Health Policy and Planning, 23: 308–317. Read More