Inequalities in Healthcare - Literature review Example

Inequalities in healthcare Supervisor] Inequalities in healthcare Introduction Health inequality can be thought of as the difference that exists between different ethnic, social and gender groups regarding their health status (WHO, 2013). In general the phenomenon of health inequality can be experienced due to the difference in socioeconomic factors such as an individual’s income or their educational background and credentials. Inequality in health status or condition has also been associated with access to health care services, as when people do not find adequate care services cannot stabilize their health condition. Apart from health faciliation, there are other significant factors too that bring health inequality in different parts of the world. This paper would tend to examine how inequalities in health have increased with the advent of the 21st century, where the factors such as socioeconomic, environmental, social, geographic and demographic which are related to cause health inequality will be discussed and elaborated. The author would try and examine the complete prevailing factors that are responsible for inequalities in health and add to the literature that is present on the subject. The Global Perspective The Black Report According to Black report by Smith (2006), most of the European countries are identified with health inequalities due to the inequality in the education systems of the countries (Bartley, 2012). The report depicted that countries like Norway and France where there were significant educational inequalities in the period 1990s, there were major healthcare inequalities in such countries. In both Norway and France, the less qualified and educated people had higher morbidity rates than those who were educated or counted in high occupation. Similarly, people who were in the white collar jobs had less illness and morbidity than those who were in ordinary work positions in both countries (Smith, 2006). The Black report identified that mortality due to work accidents got common in Europe during the 1990 period. The report identified Wales, Finland, France and Norway as countries where worker’s accidental mortality was common (Fonta, 2011). It was the unskilled labor that mostly received the accidental mortality. People working in the unskilled worker position had four times higher mortality than people working in the senior positions such as managers or corporate heads (Bartley, 2012). Similarly, in countries such as Finland, Wales, England, Japan and France, the morbidity rate of the unskilled worker population was higher than of the skilled worker population. Most of the unskilled workers in such countries were found with chronic diseases such as cardiovascular, cancer, cirrhosis,and cerebrovascular disease (Smith, 2006). The Geographic Factor According to the contemporary literature, geographic inequalities are significant to bring health inequalities in societies. It is because of geographic differences, the people are exposed to different health issues (Scambler, 2012). When environments change, the living patterns change and so as the life styles which eventually brings the differences in the morbidity and mortality rates of the people in general. This is how with geographic discrimination, the differences emerge in the health section of the society (Riva, 2009). The urban life style is much different from the rural life style as described by the contemporary health literature. Empirically, urban population is closer to morbidity than rural population and it is because that urban population is much onto the unhealthy living and unhealthy life style (Lenard & Straehle, 2012). The urban population is excessive in the consumption of drugs, alcohol, and junk food which eventually are not common in the rural population (Lenard & Straehle, 2012). The rural towns are safe from unhealthy living, because they are safe from industrial toxic wastes which cause pollution in the urban part of the world. Although, the rural geographies are not common with good health treatment facilities. There are less hospitals and treatment centers present in the rural part of the world and therefore are the major cause of morbidity and mortality in the rural distinction (Fonta, 2011). According to a study by Riva (2009), researches brought in Canada, America and Australia depict that due to shortage of health treatment facilities, the rural population is closer to morbidity and mortality than urban population (Fonta, 2011). The studies brought in the following countries assert that due to the availability of effective care infrastructure in the urban distinction, the urban population has control over morbidity and mortality (Riva, 2009). Empirically stating, the rates of mortality and morbidity are higher in these countries’ rural geographies than in their urban places (Riva, 2009). According to the contemporary literature, the causes of death or mortality in urban distinctions are significantly different from the causes of mortality in the rural part of the world. There are more suicide, drug and accident cases recorded in the urban part of the world, which are no so common or frequent in the rural distinctions (McCracken & Phillips, 2012). As the urban life is comprised of large population, major traffic and high industrialization, which the rural life is not off course, therefore the causes of death in urban locations are more dissimilar than the causes of death in rural part of the world. In rural geographies there are more common cases of infectious killing, mortality due to food contagion or mortality due to water contamination which are not so common in the urban part of the world (Beckfield, 2013). So the differences in the lifestyles and in the healthcare system, bring differences in the health situation of urban and rural life. These differences are created due to difference of geographies and environments, which eventually cause the health inequality in between both urban and rural population (McCracken & Phillips, 2012). The literature in health and education depicts that education is also one major factor that brings health inequalities in societies (Beckfield, 2013). People who are less educated and do not hold high grade qualification are unaware of the effective care programs and unfortunately cannot retrieve the full benefit of the healthcare opportunities. Education is one significant factor to create healthcare inequalities. Gender is another significant factor to bring health inequalities in different parts of the world. The Eastern European Country Austria has significant health inequalities on behalf of gender (Bartley, 2012). The country depicts high inequality in women and low health inequality in men gender. The western Europe such as the countries like Ireland, Latvia or Estonia show depict less health inequalities on behalf of gender (Smith, 2006). In such countries (Western European Countries), gender difference is not a significant factor to create health inequalities (Beckfield, 2013). The European Perspective The Socioeconomic Factor The contemporary research and study in health inequalities depict that inequalities of health come to people due to differences that exist in the environment and the society. These could be differences of the social class, the financial status, the life style and the differences in the health opportunities which people attain for health management that lead significantly to health inequalities and health differentials (Bartley, 2012). A rich in illness could acquire better treatment and health management facilities than a poor, so the socioeconomic differences are significant to outburst health inequalities in societies. Health inequalities are inevitable when there are differences prevailing in the living standards and social occupation of the people. These are silent but significant reasons of why health inequalities are mass spreading in different parts of the world (Riva, 2009). The researches conducted in health and medicine in the year 2000 depicted that it is because of social status divide, the differences of health and healthcare intrude the society. According to the National Audit Office report (2010), in England in year 2000 the poor members of the society died more prominently and vigorously than the rich which had all the luxuries to afford their life health management programs. The disease and mortality rate was higher in poor occupations than in the richer parts of the country (National Audit Office, 2010). Similarly, the rich were able to bring the best primary care, the secondary care and preventive care which a poor cannot even go closer to. The same is true today in all the modern developing parts of the world, where social status divide is a common factor to prevail. It is a contagious factor and therefore a factor that raises up the health inequalities in societies (National Audit Office, 2010). There has been several sociological reports in the period of 1970s and 80s that reported health inequalities in the Europe due to sociological, cultural, financial and economic inequalities. When societies outburst these inequalities, then societies invite the unavoidable health inequalities. This is the law of nature as what sociologists describe in their post-modern definition to health inequality (Scambler, 2012). The history which reveals the social status divide, the divide in terms of power and occupation also reveals the divide in health which prevailed in the European corners of the world, due to societal and socioeconomic divide. The factors are although less discussed and less digged out in the history literature but still are the significant to describe health inequalities (Scambler, 2012). According to Marmot (2010), the point of worry is that even in the recent years, where there is large industrialization and technology, the eastern and western Europe has raised up its poverty. Due to the prevailing economic crises of the year 2008, both the eastern and the western Europe has increased its poverty lines (Marmot, 2006). The population of the people living in the deprived setting has got increased in the recent years, which is a point to bring worries both for the government and the health planning institutions (Marmot, 2006). Comprehensive and effective plans are needed to manage the health inequalities of the world which are getting prominent and due to the rising socioeconomic divide. This socioeconomic divide has to be eliminated to eliminate the health inequalities present worldwide due to such socioeconomic discrimination (Nutbeam, 2004). The 21st Century Context of Healthcare Inequalities: The Privatization Aspect Even though universal access may not completely eliminate health inequality, however can have a significant impact on its reduction. Privatization of healthcare systems in these countries has provided individuals with the option to choose from different healthcare institutions. However this privatization of healthcare system has allowed health inequality to prevail within society. Individuals that have vast economic resources available to them tend to obtain the best health care that is available to them (Veugeulers & Yip, 2003). The privatization of healthcare makes it seem that citizens are consumers who are provided with the options regarding the choice of healthcare they want, with the cost of healthcare increasing with the increase in the healthcare’s quality. When viewed from a neoliberal approach this phenomenon puts a great deal of pressure on the common man rather than on an entity such as the community as a whole or the government of a particular country (Hacker, 2006). The cause of inequality however is not restricted to universal access to healthcare. Countries such as Canada and China where universal access to healthcare is provided to everyone, inequality still prevails in these countries. Globalization and health inequalities: According to Walby (2000)to understand twenty first century one must grasp the concepts of two processes of twenty first century that is globalization and modernization. The main driving force behind globalization has been the continuous improvement in communication technology. The introduction of new technological methods of communication has not only affected the business community of the world but has also been a significant factor in shaping our modern political and cultural processes. Modernization in common terms is referred to as the transition of industrial community of the world from traditional methods of conducting tasks to modern methods (Walby, 2000). Different experts provide us with different opinion on the exact impact of globalization on healthcare systems. Those arguing in favour of globalization tend to suggest that globalization facilitates growth of the economy and its security, this in turn, in the long run would, benefit the healthcare system of a particular country. They base these suggestions on the fact that there globalization has decreased inequities that have been observed between various countries over the past few decades (Frankel & Romer, 1999). Furthermore, it is suggested that although with globalization certain individuals within the economy tend to become richer and richer the overall impact of globalization is the reduction in poverty, which again implies an improvement in the healthcare system (Feachem, 2001). On the other hand there are some who believe that globalization would lead to the exclusion of a number of individuals and countries from the global market could have adverse effects on the healthcare system (Huynen et al., 2005). Experts believe that the risk of exclusion from the global market runs high in developing countries and their chances of a successful participation in the global markets are very low (Oman, 1996). Discrimination in healthcare: Ethnic minorities across the globe have been gravely affected by the poor healthcare they receive from healthcare givers. In majority of cases it is observed that healthcare givers let their medical judgements be influenced by their own personal perception of the individual’s symptoms based on their race or ethnic background (Van & Burke, 2000). A study conducted by Sorkin et al(2010) suggested that healthcare within United States highly discriminates African Americans, Hispanics and Asian/ Pacific Islanders. Of the overall individuals that took part in the study 13.1% African Americans, 13.4% Hispanics and 7.3% Asian/ Pacific Islanders were subjected to medical procedures that were low in quality. The study also suggested that race, cast and creed played a major role in the overall healthcare system that is provided to certain individuals (Sorkin et al., 2010). Recently evidence has surfaced that suggests that there is discrimination against patients based on the kind of disease they have. A survey carried out in U.K hospitals tends to suggest that HIV patients, because of their diagnosis, are not provided access to a number of basic medical facilities and medical staff of those hospitals refuse to perform any kind of medical procedure on such patients. The study carried out by Elford(2008) suggested that 26% of participants faced discrimination from their dentist, 18% from a general physician and 10% from the staff of the hospital (Elford, 2008). Even though refusal to provide proper healthcare to an individual is unlawful, under the equity act, there have been cases where the government has sided with the hospital on refusal to provide medical treatment to an individual (Elford, 2008). Difference of healthcare in rural and urban areas: Riva et al tends to suggest that there is a great deal of difference between healthcare that is provided to individuals living in rural and urban areas. The status of healthcare in areas where the population is smaller is not as great as areas with large population. Moreover the author also suggests that areas with a smaller population suffer from inequality in health (Riva et al., 2009). Conclusion Assessing the contemporary literature, it can be said that socioeconomic factor is one significant factor to bring health inequalities. The socioeconomic factor is a widely documented factor in the literature. A debate in the literature is precise that there it is the class and wealth discrimination which causes health inequalities in societies. It is a widely accepted debate that socioeconomic differences bring differences in healthcare and health facilitation. The need is to now break the ice of socioeconomic divide which is prevalent in different forms and in different parts of the world. This is one solution to the modern uncertain world. It is a solution that has some answer to the mass spread health discrimination. List of References Bartley, M., 2012. Explaining Health Inequality: Evidence from the UK. Social Science and Medicine, 74, pp.658-60. Beckfield, J., 2013. Health Inequalities in Global Context. American Behavioral Scientist, 57(8), pp.1014-39. Elford, J., 2008. HIV-related discrimination reported by people living with HIV in London, UK. AIDS and Behavior, pp.255-64. Feachem, R.G.A., 2001. Globalisation is good for your health, mostly. BMJ, pp.504-06. Fonta, J.C., 2011. 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