Title: Explain what key determining social factors are currently influencing an individual’s health and wellbeing, drawing on statistical data, focusing on housing and homelessness.
The aim of this essay is to explain the different social determinants of health that influence an individual’s health and wellbeing. This will include an impact that homelessness and bad housing on an individual’s health as well as looking at three main arguments that take into consideration poor housing has on health.
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WHO (2018) believes that environment is the biggest social determinant of health. This is because where individual lives determine their level of success career wise. Lalonde (1974) came up with the idea that there are four ‘health fields’, these include lifestyle, environment, health care organisation and human biology. He also mentions that health care services are not the most important determinants of health in an individual’s life which led to his conclusion that to improve one’s health their lifestyle needs to change. This change will mean changing an individual’s diet as well as their environment. The environment they live in will need to be clean from all types of pollution with their human biology involving the use of methods of prevention that will reduce the chances of them contracting any illness or diseases that are being spread around. It is evidenced that the environment can have a major effect on a person’s physical and mental health as well as their life expectancy. Additionally, Chadwick (1842) came up with the conclusion that the lack of sterility in an environment leads to diseases such as cholera which then lead to an increase in death rates of which will then result in a decrease of life expectancy within a certain area. He was insinuating that people need to live in a clean environment for them to be free from diseases. During 1842 people lived in slumped, cramped, poor conditioned environment where they were prone to diseases. It was when they suggested that they should disinfect the slums and improve sanitation they started to notice that people’s health was starting to improve.
According to the World Health Organisation (WHO, 1986) health “is a resource for everyday life, not the objective of living, it is a positive concept, emphasise the social and personal resources as well as physical capacities.” Dahlgren and Whitehead (1991), came up with the social model of health diagram, which included layers of influence on an individual’s health. Dahlgren and whitehead tried to connect a relationship between individuals, the environment that they live in and disease. The diagram shows that individuals are at the centre. Influence on health is what is surrounded by them but this can be modified. First layer of the diagram is personal behaviour and ways of living that may promote of damage the health of the individual. This could be the choice to smoke or not-Individuals are affected by friendship patterns and the norms of their community. The social and community networks provide support to the community.
There are many ways to define the meaning of ‘homeless,’ however, the Shelter factsheet (2018) states that “being homeless is if the individual doesn’t have the legal right copy to occupy accommodation, or if their accommodation is unsuitable to live in”. In addition to that, the Housing Act (1985) section three mentions that homelessness is when an individual doesn’t not have an accommodation, or they do have someone to stay but they leave their environment due to violence in the home or other mitigating circumstances. Research stated in the Shelter factsheet (2018) believes that there is a connection between poor housing leading to poor health. When people become homeless it becomes harder for them to access health care (Lowry, 1991 pg13). Lowry (1991) also states that it is hard to find general practitioners for homeless people as the homeless are not easy to track as they are always moving around.
Furthermore, Shelter (2018) states that both young children and adults that are living in bad housing conditions are at a more risk of having poor health conditions that are likely to be respiratory related diseases due to their damp living conditions. It is said to be that around 32% of children who live in poor housing are more likely to suffer from health complication compared to the 24% of children living in good housing conditions. In addition to that 26% of adults living in poor housing suffer from these issues compared to the 17% who are living in good housing. The figures above conclude that poor housing does have a great impact on an individual’s health and wellbeing, however, there wasn’t a significant amount of evidence to support this. To add to the statement, there are different forms of homelessness. According to Hutson & Clapham (1999) “homelessness is experienced on a day-to-day basis, it can occur under closed door” the whole concept of homelessness was not understood in the 19th century as it is today. Certain individuals choose to be homeless as they find it hard to cope with their financial situations whilst just do not have a choice in the matter. Homeless has been around for many decades, yet not enough has been done to tackle the number of people on the streets.
According to Bine (1994) “those who live in hotels, living in bed and breakfast accommodation, and those sleeping rough were not only more likely to have health problems than the general population, but were also more likely to have multiple problems later in their life.” Marmot & Wilkinson (2006) agree with this statement because they believe that homeless people develop poor health which can range from physical and mental health problems. Shelter (2007) concluded that amongst the individual factors they are social exclusions, this is when a person does not have good qualification grade because they did not have access to good education and therefore affecting their chance of getting a well-paid job. Those who misuse drugs and alcohol will lack of personal control, lack of social support and debts especially mortgage or rent arrears. Suffering from mental health problems and getting involved in crime at an early age can also contribute to homeless. o Shelter (2007) stated that the number of households that were found to be homeless by the local authorities increased by 31% between 1997 to 1998 and 2003 to 2004. The Health Audit (2014) found out that 45% of those who were homeless had been diagnosed with a mental health problem compared to the 25% of the general population due their dependence on drugs, alcohol and smoking which are factors that can cause mental health problems. The Health Audit (2014) states that homeless people visit the GP’s 1.5 to 2.5 times more than the public each year. It is said to be lower than their comparative use of hospital services which is 4 times more. This concludes that they are still able to go to the hospital to receive the right care.
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However, when it comes to tackling the housing, homeless and the social determinants that have an influence on an individual’s health, there needs to be a way of preventing it. Marmot (2010) rounded up six actions targets that will enable tackling health inequality in the UK. These targets included giving children the best opportunity in life, building equal jobs for all, healthy living and forming healthy communities. In addition to this he also said that prevention will need to be increased from 4% to 7%. As mentioned above the biggest social determinate is the environment that an individual lives in. Marmot (2009) states that housing needs to become more affordable so that people have a lower risk of becoming homeless. In 2007 a law was put in place which was the smoking ban, this was to ensure people do not smoke in public places. This was done due to research showing that smoking has a link to lung cancer and other health problems. This is a good example of creating a safe environment.
In conclusion, poor health and poor housing are linked together due the effects they have on an individual. It is stated that the biggest factor that affects individual’s health and wellbeing is the environment that they live in. However, there is an unadulterated contrast between the appalling, unhygienic living conditions that were endured during the 19th century, but living conditions have improved since then. This because Britain now has clean water, comfortable living conditions, drainage and sewerage systems that are most available for almost everyone. In addition to this essay points out that being homeless can be a choice for certain individuals but for some it is not a choice. It also points out that there are certain factors that cause people to become homeless and these involve not paying their bills on time. This will later have an impact on their physical as well as mental health. In addition to all of this it was mentioned how varieties of polices that are in place can have an influence on individuals on the issues that people are going through. However, there is still a lot of work to be done to decrease the number of people that are homeless and living in bad living conditions.
- Chadwick, E. (1842). The Sanitary report. [ONLINE] Available at: http://www.historyhome.co.uk/peel/p-health/sanrep.htm. [Accessed 3 December 2018].
- Croydon Council (London Borough of Croydon) GB. (2018). Factors influencing homelessness. [ONLINE] Available at: https://www.croydon.gov.uk/sites/default/files/articles/downloads/Section%204%20-%20Factors%20that%20influence%20homelessness.pdf. [Accessed 28 November 2018].
- Economic and Social Research Council Shaping Society. 2018. The Dahlgren-Whitehead rainbow. [ONLINE] Available at: https://esrc.ukri.org/about-us/50-years-of-esrc/50-achievements/the-dahlgren-whitehead-rainbow/. [Accessed 11 December 2018].
- GOV.UK. (2017). Social determinates of health. [ONLINE] Available at: https://www.gov.uk/government/publications/health-profile-for-england/chapter-6-social-determinants-of-health. [Accessed 20 November 2018].
- Health audit results. (2014). The unhealthy state of homelessness. [ONLINE] Available at: http://england.shelter.org.uk/__data/assets/pdf_file/0010/39574/Homelessness_Factsheet.pdf. [Accessed 30 October 2018].
- Hutson, S. (1999) Introduction. In Homelessness Public Polices and Private Troubles. London and New York
- Housing Act 1985 https://www.legislation.gov.uk/ukpga/1985/68/pdfs/ukpga_19850068_en.pdf. Accessed 9 December 2018
- Lalonde, M. (1974). A new perspective on the health Canadians. [ONLINE] Available at: http://www.phac-aspc.gc.ca/ph-sp/pdf/perspect-eng.pdf. [Accessed 13 November 2018].
- Local Government Association. (2018). The social housing green paper – Local Government Association briefing. [ONLINE] Available at: https://www.local.gov.uk/sites/default/files/documents/The%20social%20housing%20green%20paper%20–%20Local%20Government%20Association%20briefing%2015%20August%202018%20WEB.pdf. [Accessed 25 November 2018].
- Lowry, S. (1991) Housing and health. Tavistock Square London: British Medical Journal.
- Marmot, M. and Wilkinson. G. (2006) Social determinants of health. United States: Oxford University Press.
- Seed house, D. (2001). Health: The foundation for achievement. 2nd edition. Chichester: Wiley. Chapter 1.
- Shelter Fact Sheet. (2007). Homelessness. [ONLINE] Available at: http://england.shelter.org.uk/__data/assets/pdf_file/0010/39574/Homelessness_Factsheet.pdf. [Accessed 30 October 2018].
- Shelter. (2018). What is homelessness. [ONLINE] Available at: https://england.shelter.org.uk/campaigns_/why_we_campaign/tackling_homelessness/what_is_homelessness. [Accessed 30 October 2018]
- Spiers, Fiona E. (1999) Housing and Social Exclusion. Pentonville Road London. Jessica Kingsley
- World Health Organisation (WHO). (2008). Closing the gap in a generation: health equity through action on the social determinate of health. [ONLINE] Available at: http://www.historyhome.co.uk/peel/p-health/sanrep.htm. [Accessed 3 December 2018].
- World Health Organisation (WHO). (2018). Social determinates of health. [ONLINE] Available at: www.who.int/social_determinants/final_report [Accessed 6th December 2018]
- WHO. (1986). Ottowa Charter of health promotion. Geneva, World Health Organisation.
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