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Health Inequalities in the United Kingdom - Essay Example

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This paper 'Health Inequalities in the United Kingdom' tells that research and healthy surveys in the United Kingdom have revealed that healthy inequalities are usually based on social-economic classes, gender. Health disparities can be measured using different outcomes such as the infant and adult mortality rates, life expectancy…
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Health Inequalities in the United Kingdom
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Health Inequalities in the United Kingdom Introduction Research and healthy surveys in the United Kingdom has revealed that healthy inequalities are usually based on social-economic classes, gender and ethnicity. Health disparities can be measured using different outcomes such as the infant and adult mortality rates, life expectancy and disabilities. Social classes in the UK emanate due to varying levels of income, education and wealth among the UK citizens. The major classifications of social classes include the professionals, skilled workers and non-skilled labourers. Statistics shows that the lowest social class is prevalent to more health problems as compared to the higher social classes (Steinbach 2009, par. 4). Studies reveal that, in the UK, women have a higher life expectancy than men. However, women are prone to illnesses than men. These diseases are related to fatigue, headaches pains and muscular aches. Men, on the other hand, are known to suffer from lung cancer, heart disease and psychological illnesses. Minority and Black ethnic groups experience more health problems than the natives of England (Williams 2012, p. 45). The social-economic level and positioning of these minority groups is one of the contributing factors to health inequalities. Health inequalities in different London boroughs In order to get an overview of health inequalities in the UK, the London Borough of Merton, and the London Borough of Hackney are used in this paper for comparison. The differences and similarities in health will be analysed based on gender, ethnicity and social classes. In both London boroughs, the health levels usually depend on how people were born and raised up. For example, smoking cigarettes is the main cause of lung cancer and the habit results from the social and cultural behaviours of a certain group of persons. Merton and Hackney have different deprivation and poverty levels and thus the health inequalities. Hackney is a diverse borough, which is growing very fast. It is one of the most deprived countries and, thus the residents are vulnerable to diseases related eating habits, smoking and malnutrition (Public Health England 2014, par. 3). On the other hand, Merton has deprivation and poverty levels lower than that of Hackney and the England average. Life expectancy of Merton residents is higher than the England average unlike Hackney, which has a lower value due to the social-economic differences (Public Health England 2014, par. 3). Child health in both London boroughs is almost the same since the obesity cases in children are worse than the England average as according to 2013 and 2014 UK public health statistics. Deprivation is a term used to refer to the social conditions and materials that are independent of wealth or incomes that are experienced increasingly down the social class hierarchy. Poverty is the lack of wealth and resources that make these social classes much better (Comstock, Castillo and Lindsay 2004, p. 111). Poverty and deprivation are the major causative factors of health differences in Merton and Hackney in terms of the illnesses, psychological stresses and behaviours such as smoking and alcohol abuse. These factors give enough evidence of why the health inequalities are usually based on social classes, gender and ethnicity. For example, in most deprived areas, the largest population consists of the minorities such as the Blacks and the Asians. These groups are prone to more health problems that the least deprived area occupants (Public Health England 2014, par. 7). Refer to the chart showing the percentage of deprived population in London and the two boroughs, that is, Hackney and Merton (page 2 of health profile document given). According to the statistical analysis by the Public Health England released in 2014, the health of the citizens in Merton is generally better than the entire England average. Thus, it shows that the living standards in Merton are better than in Hackney. Low deprivation levels indicate that the social classes of people living in this London borough are higher than that of Hackney. Hackney remains the borough with ill health since 2013 mostly due to the high poverty level because almost 18,700 children in 2014 live in poverty, which is 34.8% of the England’s children. Life expectancy also depends on how people live and eat and, Merton indicates a high life expectancy level than Hackney according to 2012-2014 England public health statistics (Public Health England 2014, par. 10). Refer to the charts showing the life expectancy between women and men in these areas (page 2 of the given documents on health profiles in 2014). Health differences based on gender in both London boroughs show that the life expectancy of women is higher than that of women. In comparison with the least deprived areas, the life expectancies of both sexes are much lower in the two boroughs. Another basis for comparison is the child health cases where the obesity cases in both regions are many as compared to the England’s average. However, the levels, of breastfeeding to children in both boroughs, are better than the England average. In addition, smoking at the time delivery in women is better in these regions than the entire England average. Having differences in income levels, social classes and deprivation levels in the two levels, one expects ethnic differences, which also contributes to health inequalities (Williams 2012, p. 47). Using the health reports released in 2014 by the Public Health England, the bar graph drawn below show the levels of admissions to hospitals due to emergencies of different ethnic groups between 2012 and 2013. Paying attention to these data presentations, one can observe that in Hackney, the Blacks, Asians and other groups attend hospitals more times than the Whites, the mixed groups and Chinese. In Merton, the figures of those admitted to hospitals during the same period were higher in the minority groups than the majority ones. Note that the numbers of the affected people are much higher in Hackney than in Merton (Public Health England 2014, par. 11). The graph below shows the health inequalities in different ethnic groups in Hackney. The graph showing health inequality based on ethnicity in Merton is shown on the attached document (page 3 of the Health profile 2014). Social Class Health Inequalities As stated earlier, the health disparities between the rich and the poor have persisted for a long time across all nations in the world. In the UK, most health issues related to malnutrition, psychological stresses and smoking are attributed to poverty and deprivation. The deprived citizens are indeed the lowest social group in any society (Steinbach 2009, par. 4). These health disparities based on the social classes also result from inequality in health facilities distribution where the poor have little or no access to health institutions (Bartley and Blane 2008, p. 123). Studies on social-economic health disparities reveal that the type of occupation of any individual largely determines his/her health status and prevalence to diseases. The different social classes based on occupations, created in 1911 include the professional, managerial, skilled, semi-skilled and non-skilled occupations. Those people who work in offices are in class I, II and III whereas the labourers in plantations fall under Class IV and V. Research carried out in 1970 to 1972 found that the workers in farms are more likely to die before attaining the age of 65 years than those who work in offices. The mortality rates were higher in lower social classes than in higher classes in both children and adults. More recent statistics released in 2008 shows that the social class health inequalities not only exists, but also increases over time. Despite the fact that measures and policies are put in place to reduce this gap, the problem has prevailed with the poorly paid citizens being affected more by diseases (Steinbach 2009, par. 4). The table below shows the relationship between social class and mortality rates according to Bartley and Blane (2008). Social class and health, 1991-1993 and 1993-1995 Social Class Still-birth rate Infant mortality rate Mortality rate (1-15 years) Standardised mortality ratio (men 20-64 years) I 4 4 18 66 II 4 5 16 72 III 5 5 16 100 III 5 6 26 117 IV 6 7 22 116 V 8 8 42 189   The table above illustrates the mortality rates of boys and men at different ages for every social class. It is evident that the mortality rates in each class increases with age. Note that the death rates increase as one goes down the hierarchy of social classes, that is, from class I to Class V. Gender-based health inequalities In most industrialised nations, women tend to live longer than men despite their exposure to many diseases. They experience illnesses more frequently than men. For example, the ladies can be anxious, fail to go to the workplace and also feel more depressed than men, as well. Men usually suffer from cancerous diseases or heart problems may be due to alcoholism, smoking, unhealthy eating habits and psychological stress. Research shows that women attend hospitals due to minor illnesses more frequently than their counterparts, who mainly seek medical services due acute diseases. The WHO gives the gender-based health differences a genetic explanation of why women live longer than men. Throughout the adult life, the females are more vulnerable to diseases and illnesses than the males. However, the mortality rate in the UK is higher in men than in women. The men are prone to road accidents and exposed to risky situations than the females. For example, few women work on construction sites or ride motorcycles and, for this reason, they remain safe from health threats, unlike men who are active in that sector. The fact that women have high life expectancies than men is still questionable due to various factors. For example, according to the Public Health England reports released in 2013 and 2014, the number of women affected by the sexually transmitted infections is higher than that of men. They are more vulnerable to these diseases and even cancer. The health risks to both sexes seem to be balanced and thus the high mortality rates in men than in women cannot only be based on socio-cultural explanations only. Ethnicity and Health differences Research on how health varies in different communities has started recently with an aim of alleviating the lives of the marginalized and minority groups in the UK. Measurements of ethnicity and health levels have been a problem over the past few years, and thus many reports do not give the actual data analysis about communities and health in the UK. Ethnicity may refer to the different groups of distinct languages, races, nationality or religion. According to research findings, the Blacks and other minority groups are affected by diseases than the United Kingdom natives (Public Health England 2013, par. 5). The ethnicity factor reflects on the income levels of these groups that indeed contribute to the prevailing health inequality in the UK. The table below drawn from Census 2001 represents the differences in health based on ethnicity and gender. The percentages shown in the people illustrate those people with illnesses in England and the Wales.  Ethnic group Males Females   Age-standardised proportion Age-standardised proportion White British 7.8% 8.0% White Irish 10.2% 9.3% Other White 7.4% 7.8%       Mixed 9.8% 10.4%       Indian 8.7% 12.0% Pakistani 13.5% 17.1% Bangladeshi 13.9% 15.5% Other Asian 8.7% 10.5%       Black Caribbean 10.0% 12.2% Black African 6.8% 8.4% Other Black 10.1% 11.9%       Chinese 5.6% 6.2% Any other ethnic group 8.2% 8.0%       All ethnic groups 7.9% 8.2% The White Irish, Pakistani, Bangladesh, Black Caribbean and Other Blacks have percentages, which are more than 10. All the other ethnic groups have percentages that are less than 10. This reveals that the minority groups are prone to illnesses more than the majority groups. Females are more prevalent to diseases as compared to men almost in all the ethnic groups. Causes of the ethnic health disparity in the UK may include migration, cultural behaviours and socio-economic differences. The migration process of some communities in the UK has been attributed to low health status because most of these people rarely access the health services offered by the government. The National Health Service (NHS) is the statutory body that mainly deals with the delivery of care to all UK citizens. The eating habits of the minority groups are relatively poor as compared to the dominant productive groups due to their difference in income levels (Open University 2012, p. 21). Another contributing factor is the socio-economic disadvantage of some tribes, which makes them unable to access health institutions. Research shows that there is unequal access to health services among the different groups (Public Health England 2013, par. 5). Minority groups may not get good health care due unequal travel distance to hospitals, unequal communication and transport services as well as high charges. These marginalized groups are kept off from the hospital owing to these high charges, as well, long waiting times in hospitals. Clinicians and other health professionals may fail to reach out to the local areas due to poor roads and communication networks (Wonderling, Gruen and Black 2005, p. 78). Those communities, living in remote areas rarely get access to information about the various diseases. On another hand, the majority groups such as the Whites mainly live the towns. They have adequate access to quality care, information and can afford to pay for better services unlike the poor. Usually, the poor minority groups depend on the public health sectors, and the rich can even seek medical assistance from private health practitioners (Scambler 2008, p. 40). The following graphs give a quick review of the mortality rates based on the occupations, class and age according to a report released by OPCS in 1978. These are some of the findings from that research. Analysis of the above graphical data shows that class differences persist throughout the life of a human being. The mortality rates of individuals at each age are higher in low social classes and low in the higher social status. The graphs illustrates that a child born in a well up family can is more resistant to diseases as compared to that child born in a poor family. Health Variations based on different explanations Cultural/Behaviour Explanation The social selection is another contributing factor to health disparities in the UK. The fact that healthy people can be promoted to better jobs than the unhealthy ones is valid and true even in other parts of the world. As a result, the wealthy and healthy people will become healthier than the poor ones. The social connection among people through work, political groups or family has impacted health for a long time (Steinbach 2009, par. 6). That social cohesion makes people healthier than those who live lonely lives. For example, the retired employees usually suffer from stress and other health problems mainly because of loneliness and separation from other people. The social and cultural behaviours have also contributed to gender-based health differences in the UK. In the traditional society, the men are known for undertaking risky tasks and women to carry out the domestic activities. The cultural behaviour has developed, in that, even today, men take dangerous jobs and women and girls undertake the easier ones (Ellison 2005, p. 50). In this way, one can link the prevailing high mortality rates in men to the masculine traits attributed to them. Smoking and alcohol abuse mainly happens to males, despite the modern society where women have indulged themselves in these drugs. The cultural explanation to the health disparities in thus not applicable today because women also abuse drugs and still live longer (Scambler 2008, p. 34). For example, smoking up to delivery is very common among pregnant ladies, which poses a threat to the health of children born. Material/Structural explanation The material explanation to social health disparities is correct and can apply to the modern society of the UK. It describes poverty, higher risk occupations and poor housing conditions as the main causative factors to low health status of the poor. On the other hand, the wealthy people have monetary resources work in clean environments and can afford healthy food diets. However, there is a trend of rich people becoming obese or addictive to cigarette smoking and alcohol making this explanation too general and non-applicable to all situations (Almgren 2013, p. 191). Distribution of wealth and income to citizens has an impact on health. In most areas where the level of income earned is low, there are more cases of ill-health than in areas inhabited by wealthy and high income earners. Level of education and its provision in a certain area also affects the health of the inhabitants. Mostly, in towns, many people are educated unlike in the remote areas where illiteracy levels are high. Thus the health status of people living in the remote areas is low as compared to the health status of town dwellers. Crowded housing either in slums or in the village has a significant impact on health. It, therefore, means that most people living in crowded houses are prone to diseases than those living in adequate room spaces. Statistical artefact explanation The approach involves the analysis of the interrelationship between social class and health, putting emphasis on the two correlated variables. The primary artefacts of the research and measurement process are class and health. The explanation suggests that health inequalities in the twentieth century is characterised by changing occupation distribution in the British society rather than material welfare only. The evolution of the social structure emanates from many occupations emerging from the existing ones making the health of the people with good jobs improve while that of the low-paying jobs deteriorates. Health inequalities persist because of the reduction of population in the poor occupational class and thus implying that those who rise in the occupational hierarchy have better health than the ones left in the low classes. A problem with this explanation arises when the recent changes in the distribution of people to these classes exceeds the original ones. Therefore, the description does not give the actual causes of health inequalities in social classes since it does not accommodate changes that are likely to occur. According to The Black Report, which was published in the UK in 1980, the social class health disparities were widening due to various socio-economic factors (Socialist Health Association 2013, par 2). First, the artefact factor had caused the gap in health status between the different social groups. The widening of this inequality was as a result of shrinkage of the poor people class, which made the average health of wealthy individuals move further from that of the poor. In addition, the health differences, the reports claim that the fact that social classes change over time widened the inequalities. The artefact explanation is valid in the sense that when rich people increase in the number and the poor ones decrease, health disparities can widen more (Somerville, Kumaran and Anderson 2012, p. 89). However, the change of social classes over time remains questionable in that, the new classes formed will have reduced the gap between the poor with time. Health reports released today show that health disparities in the UK have reduced since 1980 (Socialist Health Association 2013, par 6). In conclusion, the health disparities seem to be a significant problem in the UK public health sector. The inequalities can be classified on the basis of gender, social classes and ethnic backgrounds. In this way, the UK government can formulate policies that will improve health by solving the existing problems in each of the three aspects. According to research and statistics, one can observe that healthy inequality problem is caused by differences in socio-cultural behaviours, income levels, genetic make-ups and so forth. The causative factors to health differences are interrelated, and thus policy makers ought to address each these factors. As a result, they will improve the health status of UK in the coming years (Blas and Kurup 2010, p. 234). References List Almgren, G. R. (2013). Health care politics, policy, and services a social justice analysis. New York, Springer Pub. Co. Bartley, M. and Blane, D. (2008). Inequality and social class in Scambler G (ed) Sociology as applied to medicine. London, Elsevier Limited. Blas E., & Kurup, A. S. (2010). Equity, social determinants and public health programmes. Geneva, World Health Organization. Comstock, R. D., Castillo, E. M., & Lindsay, S. P. (2004). Four-year review of the use of race and ethnicity in epidemiologic and public health research, American Journal of Epidemiology 159(6). Ellison, G. T. H. (2005). Population profiling and public health risk: when and how should we use race/ethnicity? Critical Public Health 15(1). Open University (2012). Understanding Public Health Series. London, Open University Press: London School of Hygiene and Tropical Medicine. Public Health England (2013). Ethnicity and health: Health inequalities between ethnic groups [Online]. Accessed 23 Jan. 2015. Available at: http://www.empho.org.uk/themes/ethnicity/inequalities.aspx Public Health England (2014). Hackney: Health Profile 2014. London, Crown. Public Health England (2014). Merton: Health Profile 2014. London, Crown. Scambler, A. (2008). Women and Health in Scambler G (ed) Sociology as applied to medicine. London, Elsevier Limited. Socialist Health Association (2013). The Black Report 1980. [Online]. Accessed 23 Jan. 2015. Available at: http://www.sochealth.co.uk/resources/public-health-and-wellbeing/poverty-and-inequality/the-black-report-1980/ Somerville, M. Kumaran, K. & Anderson, R. (2012). Public health and epidemiology at a glance. Oxford: Wiley-Blackwell. Steinbach, R. (2009). Inequalities in the distribution of health and health care and its access, including inequalities relating to social class, gender, culture and ethnicity, and their causes. [Online] Accessed 23 Jan. 2015. Available at: http://www.healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-economics/4c-equality-equity-policy/inequalities-distribution on Jan 23 2014. Williams, G. (2012). Understanding health inequalities: theories, concepts and evidence. London, Cardiff University. Wonderling D, Gruen R and Black N 2005, Introduction to Health Economics. Oxford, Oxford University Press. Read More
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