Healthcare Needs of Immigrants in London2008IntroductionIn any multi-cultural community, health differences and hence healthcare requirements are determined by the cultural, social and economic parameters. Analysis of determinants of health differences between communities is then essentially one of studying the materialist conditions resulted by the social inequalities in terms of environmental factors. However, social hierarchies may not always obviate the differences in health attainment. Although health researchers accept the fact that socio-economic status - the most obvious and obtainable data - is the bedrock of studying public health, there may be various levels of differences in the socio-economic strata that complicate the matter.
To explore the matter, the materialist approach that is by studying the absolute differences in absolute poverty, is different from the psycho-social approach, that is studying differences in relative poverty that affects public health and healthcare requirements also through differences in relative value perceptions of socio-economic status. In this paper, I will analyze the healthcare requirements of the immigrant communities in London. To begin with, I will discuss the effect of urban poverty – both absolute and relative - on health will follow since a large section of the immigrant population is poor.
Then, I will discuss in detail the composition of the immigrant population in the city of London and peculiarities of health and healthcare requirements of these communities. I will then detail the risks of epidemics and contagious diseases originating from the immigrant population. This will be followed by a discussion on cultural health of different communities and the implications for nursing. The paper will be rounded up with listing of scope for future research.
Urban Poverty and HealthNot only does absolute poverty result in various public health problems, income inequalities and relative poverty aggravate many diseases. Hence, it is important to understand the sociological backdrop in order to properly tackle public health problems, particularly in urban areas like London. Malnutrition, overcrowding, lack of hygienic sanitation and living near industrial premises have severe effects on the health of the urban poor. They, particularly the children, are prone to work-related diseases and environmental hazards. Not only does lack of income inhibit their access to proper medication, the subsistence income and casual nature of jobs do not allow them to take leave from work even when they are ill (World Bank).
In the social approach, differences in health among groups of population can be explained through socio-economic differences, that is differences in income, social stratification, access to social capital, social connectedness, gender and other such social parameters (Philips, 2005). Income inequalities between different groups of people are found to result in differences in life expectancy and mortality rates (Fiscella & Franks, 1997). The relationship between income inequality and mortality rate is found in differences in investment of social capital, that is investments in social trusts and membership of voluntary groups for health matters (Kawachi et al, 1997).
In this approach to public health, social cohesion is seen to be a more important factor than individual lifestyle parameters for establishing the basis for public health and epidemiology. As a corollary, interventions strategies to improve community health needs to be targeted towards the social parameters. Treatment approaches then focus towards building the “social capital” rather than “individual treatment”. Hence, the political environment that ‘sensitises” the social divide and income inequalities are more important than individual causal model (Lomas, 1999).