Inequalities in Health and Social Care - Report Example

Inequalities in Health and Social care Health inequities or inequalities are the inequalities in health between people between countries and within countries that are avoidable. Such inequities might arise from inequalities between and within different societies. Economic, as well as social conditions and their effects on lives of the people, determine their risks of illness, as well as the actions taken in preventing them from becoming ill. Some examples of health inequalities between various countries include the infant mortality rates that are 3 per 1000 live births in China and over 130 per 1000 live births in Kenya, and the lifetime risks of the maternal deaths during after pregnancy is 2 in 18,300 in Sweden, but it is 2 in 9, in Afghanistan (Amir, Z. Scully, J. & Borrill, C. 2004). The poorest of the poor worldwide are known to have the worst health. Research has shown that in general, the lower the socioeconomic status of an individual, the worse his or her health. Generally, in health, there is a social gradient running from the top down the ladder of the social economic spectrum. It is a world phenomenon, often seen in high, middle, and low income countries. The existence of social gradient or social inequalities in health implies that health inequalities affect everyone. The social determinants of health entail the circumstances through which people are born, live, age, work, grow up and the system adopted to deal with illness (Asplin, BR. Rhodes KV. & Levy, H. 2005). All these circumstances are then shaped by a whole set of forces including social policies, politics and economics. This paper is a report on inequalities in health and social care which provides explanations for difficulties of measurement while focusing upon two social variables (gender and ethnicity). It cuts across the theoretical argument for the existence of their inequalities while analyzing the findings of sociological research into inequality in cancer care provision, in gender and ethnicity. The report, as well discusses the problems in the measurement of inequality in gender and ethnicity while taking into consideration the practical problems associated with creating valid data in cancer health care provisions. Additionally, the report would discuss the sociological explanations that explain the inequalities in health which entail the Materialist, Social Selection and Cultural/Behavioral. The Marxist, Pluralist and Structuralism explanations of power, for the competing groups will take a center stage in this report. Cervical, breast and the endometrial cancers are the global paradigms for health disparities. The paucity of used and well-designed cancer registries tend to obstruct accurate planning and assessment for allocation of resources in the international agency. Increasing rates of smoking and obesity among resource poor nations leads to increases in the cancer incidences of cancers (Ayanian, JZ. Weissman, JS. & Zaslavsky AM. 2000). Women who reside in the developing world present in later stages of cancer disease and tend to have fewer choices for treatment relative to those in developed countries. Poor health in countries and between different countries is largely due to unequal distributions in goods and services, power, and income, which result from poor social policies, dirty politics and the unfair economic arrangements. It is the actual downstream effect of the social policies such as clean water, shelter, literacy, nutritious food, sanitation, meaningful work, and health care that act in a synergistic way alongside genetics in determining the life expectancy of populations. With respect to financial and access, the systems of health care themselves are social determinants of the individual health. Research shows that currently only about 7% of the global spending for cancer goes towards the developing nations. Evidences for existence of inequalities in cancer care provision. The survival of cancer patients varies depending on the socioeconomic group. Studies documented by 1995 displayed out this association as a resilient and universal to the vast ways for determining the socioeconomic status (Ayanian, JZ. & Kohler BA.2002). The health distribution is determined by different community, nation factors, and individuals. Broad evidence has been established in the existence of health inequalities in the provision of the health care internationally. Accessibility to the supply of health care is one side issue of supply that shows out the level of services that a socio or health care system gives to an individual. A number of studies have reported inequalities in health care distribution by gender, ethnicity and social class (Bradley CJ. Gardiner J. & Given CW. 2005). A recent study on the socioeconomic inequalities in the United Kingdom established evidences of the existence of the inequalities in health care provision (Berry, DA. Cronin KA. & Plevritis SK. 2005). In the beginning of the twentieth century, the government of Britain established occupation queries in the census of denial. This gave room for researchers to look into the outcomes of health by social class (Campbell, D. & Khan, A. 2006). For instance, the denial occupational mortality supplement reported that the individuals who were unskilled are 2.8 times exposed to death compared to the professional group of individuals. This study reported that the unskilled persons die before the age of 60 due to lack of cancer care provision. Children from the unskilled families were twice likely to experience death unlike those in the professional class. Social inequalities do exist in every age especially for cancer care provision (Hussey, PS. & Anderson GF. 2004). A study that was published after the first comprehensive IARC on cancer cases and social inequalities reported that massive social inequalities existed in cancer mortality and incidences within the Western countries (Grann, VR. & Jacobson, JS. 2006). This study reported a higher risk in people who were socially disadvantaged for cancer of cervical cancer. An analysis of death on the less uneducated population found that the contribution of cancer for death due to inequalities was 30% on the whole. Another study has shown out different inequality patterns in the provision of cancer care across European countries. In this study, cervical cancer displayed the largest inequality index, where as stomach cancers and alcohol related cancers accounted for a great magnitude of social inequalities in the provision of cancer care among these countries. A study made on cancer cases in women estimates that 20% of these incidences occur in women from the groups that have low education. In this study, low education and inequality in cancer care provision was linked to higher risks of breast cancer, cervical cancer, stomach cancer, ovarian cancer, and kidney cancers respectively (Grann, VR. Jacobson JS. 2003). Another study on this data made a comparison of the associated overall gradient to socioeconomic indicators on the position of the economy in the late and early adulthood by sing the RIIs (relative index of inequalities) (McDavid, K. Tucker TC. & Coleman MP. 2003). This study gave an allowance for the assessment of the risk of case in regard to all the risk factors. This confirmed the previously done the research on inequalities in cancer care provision, in European countries. Apart from this, this study also reported results that were particularly amusing. The first result was that for men indicators on socioeconomic individual position had a strong effect on the risk of cancer. Deprivation index that was area-based was also reported. The second result was that, in women, the risk for cancer was linked to housing characteristics and education. In this regard, women who were less educated had protection because their total cancer risk showed out the breast, cervical, and lung cancer. In adulthood, the disadvantage material dimension had a correlation with higher risk of cervical, breast, and lung cancer (National Cancer Institute. 2006). Material indicators capture the social gradient in women who smoke. This is so because smoking on its own displays an economic difficulty and the stress that are related. A research made on an inverse association of social deprivation and cancer incidences was recorded in some sites of cancer like the breast cancer. Risk factors that are reproductive like lower parity, low breast feeding rates, use of the hormone therapy of replacement, age at pregnancy, and high breast cancer incidences do exist in the socioeconomic groups that are deprived. Analysis of data from the registries of English cancer in the 2000-2004 periods made an estimation that since all individuals in the socioeconomic group had the similar interest to the group that had little deprivation. In this respect, the number of cases decreases to about 40% for lung cancer, 26% for the breast cancer and 54% for the cervical cancer (Wryson, CG. 2008). In this study, the political, socials and economic factors were established as the root for many health inequalities. Both proximal and distal inequalities were evidenced in the downstream and upstream policies from the economic strategies in the nation to the local health programs of prevention. Further research has shown out that, in countries that are still developing, cases of cancer are increased due to the inequality of cancer care provision. A different study showed out that age remained the vital risk factor for cervical cancer across all the ethnicity. However, to this date there is not any clearance on the factors that cause the level of incidences to vary with the ethnicity. Inequalities related to the ethnicity in cervical cancer. Studies made on African, Caribbean men reports that women are three times at a greater risk of obtaining a diagnosis with cervical cancer than the white women in United Kingdom (UK Department of Health and Human Services. 2005). This study also presented a younger age diagnosis than the White women. Approximately, African Caribbean women present 67 years whereas the white me present 73 years (Wryson, CG. 2008). Even though there is an increased risk for cervical cancer and breast cancer for women who are black there is a poor awareness of the existence of cervical cancer among these groups than the white people. In a study made recently, only 37% of the black women had got a chance to hear about cervical cancer compared to 64% of the white women (The cervical Cancer Charity. 2009). In this study, White women displayed a massive awareness of the symptoms and signs of cervical cancer in comparison to the Black individuals. African, Caribbean individuals identified cervical cancer correctly as a type of cancer that mostly affects women. This research established that 15% of women in the Africa Caribbean category new of the cervical cancer risk of development. It is of considerable concern that the African Caribbean women who face an enormous risk of cervical cancer have little information about the disease compared to White women who are aware about the disease. Anyone could automatically presume that persons like the African, Caribbean women require a higher level of cervical cancer awareness (Yoav Ben-Shlomo, et al. 2008). This has clearly suggested a level of awareness inequality and that information or messages about cervical cancer are not reaching this group of vulnerable individuals. Inequality related to gender in cervical cancer. Cervical cancer only affects women, and there are different types of inequalities that are associated with gender in health care provision. In health, inequality in gender come from a traditional society in which traditional medical practices and health status definitions all have a reflection to the social status of women that are normally subordinate. These inequalities in health are displayed in traditional medical practices that characterize cervical cancer to lapses in women behaviours. Women and girls have differing accessibility to modern health care utility including general health care, maternal care, services of safe abortion, and family planning services (Haralambos, M. & Holborn, M. 2008). Apart from this, there is remarkably little knowledge of how women deal with cancer and about their support needs. It is also evidenced from the review that the social aspects of cancer treatment and diagnosis affect women and men differently. In this regard, there exists a gender difference in terms of social factors and psychological responses that could in one way or another impact on the post-diagnosis progress. These differences include differences in the behaviours of seeking health, differences in the social network access, and differences in the emotional support levels between women and men. These inequalities are due to childbearing roles of women that lead to excessive child bearing, Preference of sex that is shown in female children discrimination against general and health care, workloads of women that expose them to hazards of health and limits them time in acquiring cervical cancer health care, early marriages that make women be exposed to excessive childbearing, lack of women autonomy that makes them lack the ability or power to making a decision and have an access to income that is independent. Problems in the measurement of inequality. For decades, many approaches used in measuring health inequalities in cancer care provision have had a number of problems. Most of the approaches that have been used do not take into consideration the socioeconomic inequalities within the population. In this regard, these measurements have suffered from the redistribution health problem. Despite the issues of conceptualization, the procedures of estimation normally have methodological problems that are put a hidden statistical procedure that is sophisticated. These measurement procedures have, therefore, given out confusing explanations. The WHO (2008), for example, has individual differences in measuring the inequalities of health. This inequality is expressed in survival time unit that is raised to 2.5. Apart from the interpretation difficulty, the individual index is not identified as a relative measure (WHO. 2008). Another problem is the specialized literature negligence. The WHO (2008) gives out a generalized Gini coefficient while ignoring the adequacy concerns and procedure validity for purposes of having the health inequality measured. Explanations for the existence of inequalities. Pluralism is a view that decision making and politics making are located in government framework and nongovernmental organizations utilize their resources to influence the government (National Institute for Health and Clinical Excellence. 2004). The major argument of classical pluralism is the influence and power distribution in the political process. Individuals groups attempt to increase their interest. Conflict lines are numerous and do shift as power continuously bargains in the competing groups. In this case, inequalities may exist and may be evenly be distributed by resource distributions in a given population of individuals (Sullivan, A. Elliot, S. 2007). A change in this case is slow because groups have interests that are different and may destroy the existing legislation in case they are not in agreement (Schoen, C. & Osborn, R. 2007). In this regard, pluralists insist that power is not a physical entity, but moves from sources that are different. A person is said to be powerful because he or she can take control of various resources. Pluralists insist on the differences in actual and potential power. To them, actual power is the ability to convince an individual to do something and is the causation view of power. Potential power, on the other hand, a chance of changing resources into real power. Money is only but a bill stack until when it is put into useful work. This explanation of power emphasizes that nothing concerning power should be ignored in any community. The key question that comes up in this explanation is whoever will run a community and if any group will certainly do it. In seeking answers to these questions, pluralists had to study some particular outcome. This was so because pluralists had believed that the behavior of humans is substantially governed by inertia. Involvement in activities that are overt is a valid leadership marker and not a reputation that is comprehensible (Vercelli, M. & Capocaccia, R. 2000). Additionally pluralists also believed that at there is no any point of time where a group of individuals must ensure keeping its values but instead there are many issues that make this be impossible (Rabjabu K, et al. 2007). There are some costs that are involved when one takes an action. These costs are not only expenditure of effort and time but also losing. In health, this explanation gives out evidence on the existence of health inequalities in the provision of health and social care to patients with cervical cancer. For instance, the argument about behavior is one aspect that brings out inequalities in the provision of health care. The argument by pluralists that behavior of humans is extremely governed by inertia is one aspect that supports the existence of health inequalities in many countries. When a countries’ political system is made up pluralists, then existence of health inequalities would not questionable. The three pluralist tenets include: Potential power and resources that are scattered widely throughout the society; at any particular period of time the potential power is more than the actual power, and at least there exist some resources to each individual. Structuralist, on the other hand, explains that the distribution of power has a nature that is permanent. This rationale argues out that power may be connected to a number of issues that vary in duration (Kogevinas, M. 2006). Unlike the pluralist, structuralist emphasizes on the roles of leadership. Studying this explanation determines the extent to which power structure is present in the society. Inequalities in social and health care can be increased in persons who survive a cancer diagnosis. The treatment and cancer experience, especially in adolescence and childhood may have a consequence that is long term. This can lead to disruption of attainment of education and social functions in academic subjects thus increasing the risk of the disparities of health. Existed of cervical cancer is still on the increase in most countries (National Audit Office. 2005). Several factors including provision of cancer health and social care; increment of early diagnosis, and cancer therapy improvement, are the support that are needed for evaluation and development of interventions that are geared towards improving social outcomes of cervical cancer. References Amir, Z., Scully, J., & Borrill, C., 2004. The professional role of breast cancer nurses in multi-disciplinary breast cancer care teams. Eur J Oncol Nurs. 8(4):306-14. Asplin, BR., Rhodes KV., & Levy, H., 2005. 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Retrieved on 15th June 2012 from http:/ / www.who.int/ social_determinants/ thecommission/ finalreport/ en/ index.html Wryson, CG., 2008. The risk of cervical cancer amongst African Caribbean women in the United Kingdom: The PROCESS cohort study. European Urology. 53 99-105. Vercelli, M., & Capocaccia, R., 2000. Relative survival in elderly European cancer patients: evidence for health care inequalities. New York: Jack and sons publishers. Read More