Multiple Poor Health Outcomes in New Zealand - Coursework Example

Social Inequality, Health and Multiple Poor Health Outcomes in New Zealand of Introduction In recent times, New Zealand has reported an increase in the interest in the unequal socio-spatial distribution of environmental, social, economic and political factors that affect the delivery, accessibility and quality of healthcare in the country (Jamie et al., 2011). Consequent to these socioeconomic, political and geographical factors, several health outcomes and inequalities implications have emerged (Jamie et al., 2011). Unfortunately, earlier researches on health inequality have been more focused on the socioeconomic factors, than on the political and geographical factors that affect healthcare equality and outcomes (Hartwell, 2008). This paper is about how broad health issues of New Zealand are shaped by many external factors that result in social inequalities throughout the population. More recent studies have attempted to inculcate and integrate the geographical, socioeconomic and political factors affecting health and social inequalities, thus recognizing the multi-factorial and multidisciplinary nature of the physical and social environment (Levin et al., 2014).. The essay also reflects on global health issues caused by inequalities. Sociology Perspectives on Social Inequality Financial inequalities in the populace have been identified as the main factor contributing to the unequal social environment in New Zealand. Research and literature also show that people with good and expansive social networks live longer because they are at reduced risk of contracting diseases such as coronary heart disease (Jamie et al., 2011). In addition, people with greater social networks are observed to suffer less depression compared to those with poor and narrow social network (Curtis & Riva, 2010). According to the social perspective of social and health inequality and poor health outcomes, health status is determined, to a large extent, by factors that are outside the healthcare sphere. Instead, the determinants of health inequalities fall within the wider socio-economic settings of citizens. Exclusion and poverty are the key socioeconomic factors that affect or contribute to health inequalities and poor health outcomes in New Zealand (Jamie et al., 2011). The same factors identified in New Zealand are also observed in studies elsewhere. For instance, in a study targeting China, Chunping (2014) claims there are numerous health implications of a population’s socioeconomic characteristics, subjective social status and the perceptions of inequality. The same implications are real for not only New Zealand but also other regions. Chunping (2014) also asserts that health is associated with peoples’ socioeconomic status, subjective social status and their perceptions of inequalities. All these factors integrate to influence the nature and quality of healthcare accorded to individuals and the outcomes of these health services. In Chunping’s (2014) study, the health outcomes of psychological distress and self-reported health were studied and their association with the three dimensions of health inequalities examined. The study revealed that subjective social status, socioeconomic characteristics and perception of inequalities are associated with self-reported health and psychological distress. In China, some of the easily identifiable socioeconomic characteristics that affect healthcare delivery are income and membership to the Chinese Communist Party. The other socioeconomic factors that affect health and social equality in China are migrant and rural statuses (Chunping, 2014). Subjective social status also affects or is associated with health outcomes. Notably, the perception on the extent and sources of inequalities in societies vary across different health outcomes. Hence, the relationship between health and health outcomes and social inequalities is quite complex and multidimensional (Chunping, 2014). Income is the other determinant of social status that greatly affects or harms peoples’ health. According to Beckfield (2004), there is a strong relationship between income inequality and the health of a population. These findings by Beckfield (2004) concur with cross-national findings and evidences. Nonetheless, the hypothesis that income inequality harms population health remains controversial, with methodological shortcomings cited as the main causes of controversies. Beckfield (2004) reported that whereas there is an association between income inequality and life expectancy, there is a stronger relationship between the Gross Domestic Product and health outcomes or life expectancy (McLeod et al., 2003). In addition, the relationship between income inequality and infant mortality is in the same direction as the relationship between inequality and health. However, the relationship varies across nations and regions (Beckfield, 2004). From these literatures, it is evident that there is need to ensure the poor, the marginalized and the socially excluded people in society live comfortable, healthier and longer lives, just like the rich, able-bodied and socially included. Fortunately, there have been many cases of positive responses to this call. Many countries and international organisations are currently in the forefront to redirect policy and research to focus on the examination of the socio-economic factors that underpin disease occurrence and ill health, to achieve more effective health planning policies and practices that would benefit the poor, the marginalized, and the disadvantaged, the disabled and other vulnerable people in society (Beckfield, 2004). More research should be done to examine the relationship between socio-economic conditions and health outcomes through the identification and participatory assessment techniques. Through such studies, the primary socio-economic factors that act as significant pathways for poverty to increase the susceptibility of low social status households to diseases can be identified. It is only by such studies that the reasons the poor and the marginalized have poorer health can be established (Osei-Wusu & Buor, 2012). Summarily, research has established that social stratification and inequalities affect the quality of life of people in society. Therefore, social suffering and inequalities have implications on societal health (Wright & Perry, 2010). Geographical Perspectives of Social and Health Inequalities Besides the socioeconomic factors, social inequality, health and poor health outcomes can be attributed to geographical factors, hence the concept of health geography (Turrell et al., 2013). There is an association between geography and population health. Notably, there are variations in human health which can be explained from a geographical perspective (Turrell et al., 2013). Spatial modelling and statistical modelling and the complementary use of qualitative techniques are the main technique by which the relationship between geography and human health can be studied and established (Turrell et al., 2013). Geographers have since established that populations in different settings have different health advantages and disadvantages. Geographers recommend a historically informed approach to establish the human health implications of geographical variations (Bailey, 2010). Geographical research on human health inequalities and outcomes emphasizes the importance of the activities, processes and relationships in space and time that affect or regulate human relationships with their immediate surroundings. One such geographical factor is geographical mobility through migration. A range of other place-based factors influences health, namely physical circumstances such as altitude, temperature regimes, and pollutants, the social context consisting of social networks, access to care, perception of risk behaviors, and economic conditions composed of quality of nutrition and access to health insurance (Norman & Boyle, 2010). Because geographical factors are numerous and constantly shift just as people move around at unprecedented rates, understanding the health impacts of geographical circumstances of people most challenging, yet important, contemporary geographical and health problem (The National Academies Press, 2010). In addition, the geographical perspective focuses on human relationships with one another, relationships that have been found to be quite complex and nonlinear (Bailey, 2010). The other key area that geographers study in relation to human health inequalities and outcomes is conventional disease ecology, which emphasizes the concept of a vibrant equilibrium between demographic, social and biophysical factors in influencing human health status and outcomes (Song & Lin, 2009). The complexity theory, extensively used by geographers in studying the sociological inequalities and their effects on health, predicts that the equilibrium is quite unstable. For an illustration, the multiplicity and interconnectedness of human contacts is often portrayed in terms of the emerging and evolving networks of open systems, which help diffuse infectious diseases (Curtis & Riva, 2010). The appearance and renaissance of diseases should thus be set within the wider context of economic, political, social and environmental changes. The main challenge for human health geographers is to integrate their research agendas to equality and justice agendas, to help alleviate social and health inequalities, which violate the tenets of care ethics and human rights (Carmalt & Faubion, 2010). Hence, the fight against health inequality is based on the principle that some things are morally good and morally bad, regardless of the people involved and where or when they occur (Sernau, 2013). The concept of universal health care, while playing extremely different roles in human rights and care, is thus relevant for care ethics as well as human rights geographers (Carmalt & Faubion, 2010). Health equality should thus be supported based on the premises that grand moral values are universal. Equality in health care thus starts with the argument that people care about those related to them or with those they have similar or same experiences of kinship or affection. To human health geographers, receiving and giving health care are life-sustaining activities and universal elements of the human condition (Carmalt &Faubion, 2010). Without equitable healthcare care, people cannot be healthy. People often require health care, which is an essential principle of care ethics, which serves as the point from which care geographers make their normative call for new theories of social relations, accountability and relational ontology. Human health geographers believe that caring is core to human life, at all places and all times (Carmalt & Faubion, 2010). They also believe that geographical spaces are founded on caring relations that are deeply embedded in societal norms (Carmalt & Faubion, 2010). The indispensable message is that people can only exist with quality and equitable health care that arises from social and geographical connections in society (Institute of Medicine, 2006). Political Studies Perspectives on Health Inequalities Geographical and social factors are not the only determinants of health inequality and poor health outcomes; even the built environment has extensive influences on heath inequalities and outcomes. Besides geographers and socio-economists, political study professionals and students also explore the implications of political and related factors on health inequalities and outcomes (Pons-Vigués et al., 2014). Political studies on social inequalities, health and poor health outcomes are particularly concerned with offering guidelines to public and private health practitioners to enable them understand how health issues interact with policy agendas (Buse, Mays & Walt, 2005). Political studies concerned with human healthcare cite several factors; processes and powers that affect the understanding and implementation of healthcare policymaking processes (Hardee et al, 2012). The key elements identified as integral in policymaking processes that affect health equality are the context, the actors and the processes. These factors are quite instrumental in improving skills used in the navigation and management of equitable health policy processes, irrespective of the socioeconomic or geographical issues or settings of citizens (Buse, Mays & Walt, 2005). Public health healthcare and corporate interests integrate in a rather bristly process to shape the political agenda for health inequalities observed in society (Veugeulers& Yip, 2003). For instance, citizens or patients have divergent views and perceptions from that of governments and politicians on what is electorally palatable on issues pertaining to health inequalities (Qureshi, 2013). Additionally, through the jostling of interest parties has affected the health issues of evidence-based policy and technical aids, which has resulted in health inequalities policies being depoliticized ( World Health Organization, 2011). However, the truth is that health issues and politics are integrated since the political class makes and implements health policies. In Ireland, for instance, the Institute of Public Health has designed a health policy that seeks to improve the population and reduce health inequalities. This policy is developed and implemented in conjunction with the Department of Health and other national health agencies (Institute of Public Health, 2014). The Institute of Public Health works directly with government departments to support the process of developing evidence-based equitable and patient-centered health policy. In New Zealand, the Ministry of Health works with other agencies to develop and design the health policy. In addition, parties such as the Green Party has developed a health policy document built on the principles of a holistic approach to health and well-being, focused on promotion of positive health and lifestyles, prevention and reduction of the risk and costs of illness, respect for personal autonomy, and improvement of the quality of life. The political studies also emphasize the need for effective public health strategies to deal with the limited of individual healthcare. This perspective also outlines the major actors or stakeholders in health policy framework (Buse, Mays & Walt, 2005). These actors could be individuals, organisations such as the World Bank or multinational companies or states and governments. Nonetheless, these stakeholders have to work together, regardless of the differences in their languages, values, cultures, sex, race and socioeconomic statuses, translating into equitable and equal health and social service delivery to the population (Frohlich & Thomas, 2014). These stakeholders have different interests, which must all be included in deliberations on matters of social and health equality. Notable examples of these groups are non-state actors, interest or pressure groups, civil society organizations, all of which are interest in influencing the political class and the government to institute health and social policies that meet their goals and interests (Osei-Wusu & Buor, 2012). Finally, social movements also come into the fray by demonstrate strong feelings about particular issues of interest to them (Qureshi, 2013). Hence, policy makers such as the legislature and the executive arms of the government ought to ensure equality and equitability in their social and health service policy documents, to meet the divergent and unique needs of the population. References Bailey,A. J. (2010). “Population Geography: Life Course Matters.” School of Geography, University of Leeds, Leeds LS2 9JT, UK Progress in Human Geography, 33(3); 407–418. Beckfield, J. (2004). “Does Income Inequality Harm Health? New Cross-National Evidence.” Journal of Health and Social Behavior, 45(3); 231. Buse, K., Mays, N., and Walt, G. (2005). “Making Health Policy” London School of Hygiene & Tropical Medicine. Carmalt, J. C., and Faubion, T. (2010). “Normative Approaches to Critical Health Geography.” Progress in Human Geography, 34(3); 292–308. Chunping, H. (2014). “Health Implications of Socioeconomic Characteristics, Subjective Social Status, and Perceptions of Inequality: An Empirical Study of China.” Soc Indic Res, 119:495–514. 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