Health_Inequalities

Health Inequalities In this assignment I will be analysing social science concepts and policy issues surrounding health inequalities. This will look at how health illnesses are established and the way the illnesses are treated. I will also be evaluating statistical evidence for health inequalities and analysing the explanations. Reviewing health started 400 years ago when Pasteur developed a theory that suggested illness was due to an invasion of pathogens. This became our Medical Model of Health. Over the years the patterns of health changed and by the 1950’s people were dying from chronic diseases, so the definition of health had to change to “incorporate social and environmental factors” (Kidson, C, 2007). The two definitions are as follows: Medical Model of health defines health as the absence of disease or illness. Bio-Psychosocial and the socio-economic model of health, define health as a complete state if physical and mental well being and not merely the absence of disease or infirmity. There are different models of health used including Pluralistic and Complimentary Models. Pluralistic model looks at spiritual healing and the complimentary model looks at alternative methods of making the person healthy and also looks at the health of the person on a whole. Ivan Illich was one philosopher who was against modern medicine believing that it actually created illness and that treatment caused diseases and eventually brought about more suffering. He also believed that our pain was a personal challenge to overcome and that the people were now being treated as if they have technical problems. This was known as the Iatrogenesis method and was he believed that moving away from medicine was now the best way forward as it created a dependency on Orthodox medicine (Health Inequalities, Kidson, C, 2007). Edwin Chadwick first highlighted health Inequalities in 1842; he was the first to associate poor living conditions with poor living conditions. Edwin Chadwick highlighted the need to have Health Acts and to improve living conditions, along with the development of the Sanitary commission in 1842, the first Public Health Act in 1854, the Sanitation Act in 1866, which meant that people were no longer dying from Cholera, and the second Public Health Act was established in 1875. Along with the development of medicine, these helped to eradicate Infectious diseases. By the 1930’s although poor living conditions were virtually non existent people were still suffering from the effects of poverty. To establish the reasons why people were still suffering from the effects of poverty, the government commissioned a man named Beveridge in 1942. He realised that there were still five great evils in our society and they were Squalor, Disease, Ignorance, Want and Idleness and that health inequalities have always existed. To help eradicate health inequalities he proposed the development of the Welfare State and the NHS, he believed that these would make a fairer and more equal society and it would eliminate health inequalities, by giving people access to universal health care regardless of status or inability to pay. This would mean that the medical model would be mainly used, as everybody would be provided with a doctor, as this is the cheapest system to run compared to pluralistic model. The medical model is still used today. The government thought that the development of the welfare state and the NHS would eradicate health inequalities. In 1977, Douglas Black was commissioned to identify health inequalities and to establish if the NHS as help to eradicate them. He found that although people were living longer, the health of people was not that improved especially in the lower classes, and the differences were considerable. He believed that if material conditions were improved especially for the poor, disabled and children, this would also help to eradicate health inequalities. He also believed that the redistribution of money was needed through more social policies. He provided explanations to his findings on health inequalities and they were due to the artefact, social selection, culture and structural issues. He found that people in lower social classes were experiencing worst health than in the 1950’s, people were not using the NHS if they were in social class for the working people, that infant mortality was much higher compared to some developed countries. He also found that there was a relationship between the social classes and morbidity. Nothing was done with the Black Report until 1998, when his findings were researched. They found that the Artefact data was not consistent, as he may have put people in the wrong social classes, that the social selection looked at the survival of the fittest, the healthier you were, the longer you would live. They also found that he believed that our culture and where we live as an impact on the length of survival (Health Inequalities, Kidson, C, 2007). When new labour came into power they decided again to look at Health Inequalities in Britain, they commissioned Donald Acheson in 1998 to see if anything had changed since the Black Report. The government also wanted him to look at ways to eradicate health inequalities and if there were any specific trends. He not only looked at health inequalities, he also looked at governmental issues, in doing this he found that the gap between Social Class 1 and 5 had got worse and even though people were living longer, we were having less years of good health (http://.yhpho.org.uk/Download/Public/28/1/AchesonReport.pdf). He found that 3 times as many women smoked in social class 4 and 5, and 4 times as many men; this may be due to it being more socially acceptable in the lower classes. People who were socially deprived were the most obese, which means that there was more obesity in the lower classes, this was due to poor diet and the lower classes eating less fruit and vegetables. He also found that people in social class 4 and 5 suffered from Heart Disease especially men, he believed that this was due to people with deprived lifestyles drink and smoke more. He recommended that government should look at areas where funding would have the most impact, and that the governments’ main priority should be to eliminate health inequalities, unlike the Black Report, Achesons’ report was used to show where the money should be spent. The government have strived to eradicate the health inequalities raised by the Acheson Report. The Report found that there was “widespread evidence of health inequalities and recommended action in the NHS, and on poverty, housing, transport, education, and employment.” In 2003, the government published a report showing how they planned to improve these inequalities, they included welfare to work programmes, better housing and transport and also urban regeneration initiatives. (http://www.kingsfund.org.uk/news/briefings/health.html) Health Inequalities still exist today, but we are now not only dying from contagious diseases but from lifestyle disorders, such as smoking, race, gender, drinking and obesity. Smoking in Britain as increased over the years (see Fig 1), in the space of 2 months all of the statistics went up in the months of November and December, but went down in January, except for the first category where non-daily smokers increased in January. The government have strived to combat this with more people each day dying from Lung Cancer (See Fig 2). On July 1st 2007, the government stopped smoking in Public Places and vehicles. They hope that this will deter people from smoking and interacting with people who do not wish to be by smoke. Fig 1: Graph http://www.ucl.ac.uk/news/news-articles/0707/07072406 Fig 2: Graph http://publications.cancerresearchuk.org/WebRoot/crukstoredb/CRUK_PDFs/CSFSLUNG.pdf Bibliography Kidson, C, 2007 Health Inequalities, Kidson, C, 2007 http://.yhpho.org.uk/Download/Public/28/1/AchesonReport.pdf accessed on 28th October 2007 http://www.kingsfund.org.uk/news/briefings/health.html booklet distributed by Celia Kidson 2007 http://www.ucl.ac.uk/news/news-articles/0707/07072406 accessed on 28th October 2007 http://publications.cancerresearchuk.org/WebRoot/crukstoredb/CRUK_PDFs/CSFSLUNG.pdf accessed on 28th October 2007