The Implications of Social Issues in Health and Social Care
This essay will discuss how society can impact health and wellbeing through the influence of socio-economic factors. These factors will be used to give a broader representation of reoccurring trends of health and illness in society to develop a depiction of inequality and poverty in society.
Health inequalities describe the differences in health status and in people accessing healthcare provisions, they arise between different populations in geographical areas, ethnic groups and social classes (Barry and Yuill, 2008). Focus will be given in this picture to understand the health experiences of women in poverty using a variety of theories recognise how groups and behaviours can become deviants in society and look at ways to reduce stigma around these experiences by raising awareness and education.
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In 1980 The Black Report was commissioned; the purpose of the report was to investigate and determine the causes of inequalities in the UK. The lifestyles and health records of people from all backgrounds and social classes were analysed. The report’s discoveries were that health improvement between social classes had not been equal and that the gap was widening. It was uncovered that the problem was driven by social and economic factors such as income and poverty (Socialist Health Association, 2005).
In 2008, the Secretary of State of Health requested Sir Michael Marmot to chair an independent review to recommend effective approaches to decrease health inequalities in England. ‘Fair Society, Healthy Lives’ was the final report and published in 2010, it determined for health inequalities to reduce in society six policy aims would need to be carried out; ‘to give every child the best start in life, enable all children, young people and adults to maximize their capabilities and have control over their lives, create fair employment and good work for all, ensure a healthy standard of living for all, create and develop healthy and sustainable places and communities and to strengthen the role and impact of ill health prevention’ (Marmot, 2010). It was established that the higher socio-economic position a person has in society, they have a better opportunity of life chances and more prospect to lead a prosperous life resulting in better health (Marmot, 2010). Throughout all the reports on health inequalities since The Black report in 1980 there is a devolution and a running theme that socio-economic background and health are linked; the more privileged people are socially and economically, the better their health and the higher life expectancy (Matthews, 2015).
Race and ethnicity are increasingly being used as variables in health research (Audit Commission, 2004). It has been recognised that ethnicity has an impact on the social distribution of health, this is a serious issue. It is suggested in research that on average persons from black and minority ethnic backgrounds show larger levels of poor health than the general population (Barry and Yuill, 2008). It has been suggested that this may be in relation to inequalities in life chances, such as housing, employment and education leading to poverty. For instance, as late as the 1970’s landlords could advertise property with one of the provisos of tenancy being ‘no blacks’, overt racism was a major factor before the Racial Discrimination Act in 1975 (Matthews, 2005).
Issues surrounding education leading to inequality can be linked with lower academic achievements, there is research to suggest that in particular women that are of ethnic minority graduates are less likely to be employed due to institutionalised racism and incomes are generally lower than those of white people (Larkin, 2011). Income poverty is identified as one of the key determinants of health leading to lack of resources, lack of income can lead to destitution with an inability to afford essentials such as food, clothing, rent and fuel which are all essential for good health (Blenkinsopp et al., 2016). Those in destitution are said to use radical methods as coping strategies to economise such as skipping meals in order to afford other essentials, which often lead to malnutrition and cheap fast food cultures reducing life expectancy due to ill health. It is said that those in poverty have a reduced life expectancy of 25 years compared to the rich in society as a result of income (Pickett and Wilkinson, 2014).
Women in all ethnic groups have lower incomes than men in the same ethnic groups, Pakistani and Bangladeshi women have the largest gap and Chinese and Black Caribbean women the lowest. Poverty rates are higher for women in all ethnic groups compared to White British men, Pakistani and Bangladeshi women having the highest poverty rates at around 50 percent and a higher proportion of Black African and Black Caribbean women being lone parents at around 18 percent compared to 6 percent of all women in other groups (Nandi and Platt, 2010).
The ethnicity pay gap is a long-standing phenomenon, research suggests that people from ethnic minorities tend to earn less than white people this is often associated with social disadvantage and arguably caused by discrimination. New arrivals to the country may experience language barriers, possess qualifications that are not recognised and be unfamiliar with the countries culture, these factors all affecting pay. Immigrants entering the United Kingdom are often in low paid jobs and are over qualified for the job they do (Brynin and Longhi, 2017). However, this is seen to be rectified by the more time immigrants spend in the country they gain the necessary knowledge, connections and skills to move into their desired occupation and earn higher salaries (Matthews, 2015).
Feminist theories would argue that women are disadvantaged due to structural oppression and inequality as a result of capitalism, patriarchy and racism. Women are significantly oppressed economically due to the gender wage gap which shows that men typically earn more than women for the same work. An intersectional view of this also reveals that women of colour are even further penalised relative to the earnings of white men. Social feminists agree with Karl Marx and Marxist theories that the working class are exploited because of capitalism, but they extend on the theory by arguing that the exploitation is not just due to class but also gender. Although, they offer the insight that not all women suffer oppression in the same way and that the same forces that work to oppress women also oppress people of colour and other marginalised groups (Crossman, 2019). Karl Marx and his Marxism theory criticises capitalism as an economic system but also in terms of the social conditions associated with it. He identified that at the heart of capitalism there is a class struggle between the bourgeoise and the proletariat. The bourgeoise owning the means of production and the exploitation of their workers by paying them less than the value of their labour allowing them to extract surplus profits. His theory explains that the proletariat have no other choice than to accept the conditions through pressure and ideology, as a communist he believed that the proletariat should have a revolution and overthrow capitalism (Tutor2U, 2018).
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As ethnic and racial identities and their social economic factors have implications on health it is important to have focus on drives for positive improvements for these diverse communities. Increased awareness and understanding can improve well-being and the delivery of health services through improved engagement and targeted resources (Cosford and Toleikyte, 2018). This can be addressed by means of empowering and advocating individuals to take charge of their health in ways of educating them through health promotion and preventative interventions working collaboratively with individuals to improve their health and access health services (Thompson, 2006).
It is well known that people with disabilities have poorer health than their non-disabled peers and die at a younger age, these differences are to an extent unavoidable and therefore are defined as health inequalities (Turner, 2017). People with disabilities often have unmet health needs partly due to difficulties in identifying and treating symptoms. On average the life expectancy of women with disabilities is eighteen years shorter than women in the general population (NHS Digital, 2017). Allerton and Emerson (2012) analysed data to investigate the premature deaths of adults with a chronic health condition or impairment and it was discovered that fourty percent of people with a disability reported difficulty in using health services compared to only eighteen percent of people without a chronic health condition or impairment. A number of factors are identified as causing barriers to disabled people accessing healthcare and creating health inequalities such as a lack of accessible transport links, anxiety or lack of confidence for people with a disability, lack of understanding from health care professionals and failure to make a correct diagnosis (Mencap, 2016).
It has been uncovered that the determinants of health inequalities in disabled people are caused by social influences, disabled people having a disproportionate risk of being poor with an income of below sixty percent below the national average. Additional living costs and benefit dependency being key reasons for this (Turner, 2017). Disabled people are twice as likely to be unemployed as those without a disability or more likely to be in part-time, low status jobs with less security and regard for human rights (Allerton and Emerson, 2012). Disabled women are more likely to be in poverty than disabled men by twenty five percent. Women with disabilities make up only one and half percent of the populations work force, facing both stereotypes about people with disabilities and women in the workplace. Both are viewed as less capable in the workplace making them less likely to be employed, there are other barriers present such as work spaces not being accessible and policies that are against those with disabilities. Without employment in spaces that are accessible women with disabilities are forced into a benefit culture keeping them impoverished (World Health Organization, 2018) Many people with disabilities do not receive appropriate education, their education opportunities are limited due to others perceptions of their abilities rather than their actual abilities, this is especially prevalent in girls due to stereotyping and stigma which prevents them from accessing higher paid jobs later in life without education to prepare them for later in life girls with disabilities are less likely to obtain secure employment that pays well enough to lift them out of poverty (Edmonds, 2016).
The social model of disability identifies that social exclusion from society, negative attitudes and systematic barriers are the cause of disability rather than a health condition or impairment, meaning society is the main contributing factor in disabling people. It looks at ways of removing barriers that restrict life choices for disabled people (Disability Nottinghamshire, 2019). Health research about disability and impairment is dominated by positivist theories, focusing on ways to reduce impairments it examines environments as well as the individual. However, functionalists theories emphasise on the role of medicine to cure and to maintain normal functioning within society. Within this theory there is focus on the ‘sick role’ involving compliance and wanting to get well, this can make people with disabilities seem to be deviant. The link between disability and social deviance that functionalists make influences health care and supports dominance of professionally controlled health and welfare services for people with disabilities devaluing individuals (Oliver, 1998).
There is evidence to suggest that a proportionate amount of people with disabilities do not access health checks due to barriers, studies have shown that health care professionals can vastly improve this through empowering and encouraging individuals to attend appointments by reminding them and facilitating follow up phone calls (Mencap, 2016). Service delivery can be improved by making a range of modifications and adjustments, to facilitate access to health care services by means of changing the layout of services making them accessible to people with mobility issues or communicating information in formats that are accessible such as braille. People with disabilities can be empowered to maximize their health by providing peer support, information and training (World Health Organisation, 2018).
In conclusion, it has been highlighted that health inequalities across social classes are hugely impacted by socio-economic factors in society, reducing access to health services and therefore having an impact on health, poverty particularly having an adverse effect. Race and ethnic minorities have been discussed and how institutionalised racism and discrimination play a huge part in influencing health.
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