This essay discusses the health inequality in the UK, focusing on the social and economic factors that contribute to disparities in health outcomes. It explores the impact of education, occupation, and income on health and highlights the need for reducing health inequalities.
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Contemporary Debates1 Contemporary Debates
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Contemporary Debates2 Table of Contents Essay.................................................................................................................................3 References.........................................................................................................................8
Contemporary Debates3 Essay Understanding of the health inequality in UK Inequality in health refers to a condition where the health of one group of people in the countryismuchworsethantheothergroup.InUK,therearesignificanthealth inequalities which are prevailing across the country. The health differences in UK are causedduetoeconomicandsocialinequalitiesintheenvironmentunderwhich individuals are born, work, live, and age. The social gradient for inequality in health is the differences between the social positions of the individuals. The social position refers to different aspects which include education, unemployment, low income, and gender. Significant concern is expressed by doctors in UK in context of social equality and poverty and their negative effects on the physical and mental health as well as life expectancy of the individuals in UK (Bma, 2016). The differences in social position of the individuals become the major reasons due to which inequalities are created in the health. Education plays a significant role in creating health inequalities. The section of people which posses higher level of education are observed to have better health outcomes in comparison to those with low level of education. This is because an educated person has more literacy towards health which means that an education individual will have the appropriate understanding, knowledge, confidence, and skills to evaluate,access,andusetheinformationrelatedtohealthandsocialcareand services. Education is connected with health literacy and health literacy is connected with health outcomes and the use of services. Limited education directly leads to the behavior of unhealthy lifestyle such as lack of physical activity, smoking, and poor diet intake.Itisalsoobservedthatpeoplewhohavelimitededucationusesmore emergency services and are unable to manage positive healthy living in the long term which also leads to incurring of high costs of healthcare. In UK, 42% of adults who are of working-age are not able to understand the use of information related to everyday health. Also, 61% of this population is not able to comprehend the information when there is a requirement of numerical skills (Public health England, 2015). Occupation and income are the social gradients which are directly related to poverty. Unemployment and low income leads to poverty. People repeatedly move between
Contemporary Debates4 work and employment in UK which has become an epidemic problem. Due to recession, it has increase to more than 60% since 2006. In addition to this, low payment to workers is also a factor which leads to poverty. As per the report of ONS (Office for National Statistics) 2014, one out of every five employees is paid low in UK. The low paid employees are women aged between 16 to 24, temporary and part-time employees, employees working in low-skilled occupations, and also the employees working in retail, care, and hospitality sector. Unemployment and low payment impacts the health on individuals in child, adolescence, and later stage as well. In UK, the weight of the babies born in poor areas is 200 grams less than the babies who are born in rich areas (Lee et al., 2013). Poverty results inpost-natal depressionin womenwhichleads to low breastfeeding rate which impacts the mental and physical health of the babies in negative manner. Also, the likeliness to suffer from chronic diseases like diabetes, asthma, obesity, malnutrition, and tooth decay in higher in the children living in most deprived areas as compared to least deprived areas. As per the report of NHS, 12.5% of the children taking admission in the schools in deprived areas are obese while that of least deprived areas is 5.5% only. In children of six years of age, the rate of obese children was 26% in deprived areas as compared to 11.7% in least deprived areas in UK (Koshy and Brabin, 2012). Due to unemployment and low income, the parents in deprivedareasareunabletoprovideenrichingenvironmentforchildrenwhich negatively impact the emotional and social development of children and hinder their mental well-being. Likewise, the health conditions such as lung cancer, stomach cancer, and respiratory diseases are also high in deprived population. Thelong-termhealthconditionssuchasarthritis,diabetes,hypertension,and obstructive pulmonary disease are commonly observed in adults belonging to lower socio-economic groups. For instance, 2/5thof the adults aged between 45 to 64 and income less than the average income suffer from long-term illness twice than the adults with above average incomes of same age. The low income and unemployment also causes stress in adults which disturbs their mental wellbeing. According to the report of Mental Health Foundation, three out of every four people with low income experiences problems related to mental health (Berry, Clarke, Jenkins, and Patel, 2013). In people with adequate income, the mental health problems are experienced by only six out of
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Contemporary Debates5 tem men. Clearly, the deprived group suffers from more physical and mental health problem as compared to non-deprived population. Professional practice and its influence In 2016, the life expectancy gap in England between the people residing in most deprived areas and least deprived areas was 7.3 years for females and 9.3 years for male due to the social gradients of inequality in health. However different approaches have been used by the government in addressing the issues of inequalities in health due to social gradients. The authority of public health care has moved back to local government of UK and in this context, Public Health England (PHE) and new structures of NHS were formed back in 2013. It is recognized by PHE that unsuitable, poor, and precarious housing impacts the mental and physical health of children, old-age, disables people, as well as people with long-term medical conditions. It is believed by them that goodhealth comes fromgoodhomes.Inthis regard,anMOUis signedby UK government in 2014 with 20 more partners to work together in ensuring that every individual in the country shall have a decent home for healthier living. The partners of MOU aim to ensure positive pace in provision of decent homes in the coming years. Spatial planning for natural environment and built is undertaken by PHE through which policy is informed and local actions are supported (Publichealthmatters, 2018). Homeless women and men die at the young age. 43 for women and 47 for men are the average ages of homeless individuals to die. In comparison to general population, the general 79.5 years is the average age of males and 83.1 is the average age for females for living. Physical problems related to health such as addiction problem, diabetes, and heart diseases are observed in 41% of the rough sleeper while it is observed in only 28% of the general population. Also, 45% are diagnosed with issues related to mental health and in comparison to 25% of general population. In this regard, the Homeless reduction Act came into force in 2017 to control the rising homeless population in UK. A statutory duty is placed on local authorities under this act to reduce homelessness. The purposeof this actistoanalyzethehomelessness patternacrossUKandtake promising interventions for prevention of homelessness. The people who are living in the most deprived areas are expected to spend 20 less years in good health in comparison to those who are living in least deprived areas.
Contemporary Debates6 Health Equity Collection page is developed by PHE to put together all the resources related to health inequalities so that the relevant data, tools and evidence can be identified easily and better actions can be taken to reduce it. Over 30 resources are contained in this page and it also shows the driving factors of differences in the life expectancy between least and most deprived communities. For example, it shows respiratory diseases, cancer, and CVD are the major factors for the life expectancy differences. In addition to this, a guide for reducing the inequalities in health is published under which actions are set out for local health systems so that an impact can be made. It also contains segment tools which provide information related to the causes of death which drives the life expectancy inequalities at the level of local area. This information is used further to target the reasons behind the deaths which contribute in the differences oflifeexpectancyandsignificantlyreducetheinequalitiesinhealth (Publichealthmatters, 2018). Reduction in equalities related to health means equal opportunities shall be given to everyone irrespective of who they are and their place of living. People residing in most deprived locations of UK lives 20 years less in good health as compared to those residing in leas deprived areas. In order to tackle these inequalities, more attention is given to the population who are at greater risk of poor health. The core mission of PHE is to reduce the inequalities in health. In this context, the location actions are done in support of the reducing the health inequalities. Four areas including promotion of good quality of jobs, reduction in social isolation, improvement in health literacy, and use of Social Value Act are promoted. The Social Value Act came into existence in 2013. Under this act, all the commissioners of public sector are required to consider the procurement activities for improvements in the environmental, social, and economic wellbeing of their population. This includes provision of housing and work opportunities for unemployed people. The features related to the provision of quality work include protection from any kind of physical hazards, adequate payment, and security against the jobs (Publichealthmatters, 2015). By providing quality jobs, the deprived population is able to generate higher income for living and raise their standard of living. With better standards of living they are able to provide education to their children and save them mental and physical problems at the initial stage of their lives. This has resulted in
Contemporary Debates7 improvement in the mental health of the individuals as social isolation is reduced due to engagementinworkandparticipationinsocialgatherings.Withreductionin unemployment, thedeprivedpopulationinUK is abletoreceiveeducationwhich improved the health literacy among them. Literacy towards health enables the individual to distinguish between what is good and what is bad for health (Sorensen, et al., 2012). For example, a literate person will know the benefits of consuming health diet and harmful effects of tobacco and alcohol consumption on health while an illiterate person will not be able to do so. Therefore, these factors aids in reducing the health inequality gap in UK. Political factors influencing social inclusion Political factors also play a significant role in influencing social inclusion. In UK, the Department of Health, Secretary of State of Health, and Parliament are responsible for the general policy and health legislation. Under the Health Act (2006), it is the legal duty of Secretary of State to promote health service which provides charge free care in addition to the exiting services. NHS also has the right to provide care irrespective of discrimination and also provide services such as planned hospital care and emergency. The stewardship of overall health of the system is provided by Department of Health and responsibility to run daily operations of NHS is held by NHS England which is a separate body. The provision of these services does not depends on any kind of social factorssuchasareaofresidenceandeducationleveletcandthereforeaidsin improving the inequalities in healthcare by providing equal treatment to everyone who is in need. In addition to this, the NHS budget is also set by NHS England to ensure that the objectives set by Secretary of Health are met which includes health goals as well as efficiency. The local government holds the public health budget for improving the health and well-being boards so that the coordination between the local services can be improved and also the health disparities can be reduced. In practice, NHS pays and providespreventiveserviceswhichincludeimmunization,screening,vaccination programs, dental care, mental health care, eye care, and services for those with disabilities in learning such as palliative care (Commonweakthfund, 2019). All these efforts are put forward by the government to provide equal healthcare services to all individuals in UK and reduce the inequalities in health.
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Contemporary Debates8 References Barry, M.M., Clarke, A.M., Jenkins, R. and Patel, V. (2013) A systematic review of the effectiveness of mental health promotion interventions for young people in low and middle income countries,BMC public health,13(1), p.835. BMA (2016)Collectove-voice.[Online]. Available at:https://www.bma.org.uk/collective- voice/policy-and-research/public-and-population-health/health-inequalities(Accessed: 24 March, 2019). Commonwealthfund(2015)Countries.[Online].Availableat: https://international.commonwealthfund.org/countries/england/(Accessed:24March, 2019). Koshy,G.andBrabin,B.J.(2012)Parentalcompliance-anemergingproblemin Liverpoolcommunitychildhealthsurveys1991-2006,BMCmedicalresearch methodology,12(1), p.53. Lee, A.C., Katz, J., Blencowe, H., Cousens, S., Kozuki, N., Vogel, J.P., Adair, L., Baqui, A.H.,Bhutta,Z.A.,Caulfield,L.E.andChristian,P.(2013)Nationalandregional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010,The Lancet Global Health,1(1), pp.e26-e36. Publichealthengland(2015)Government.[Online].Availableat: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/ attachment_data/file/460710/4b_Health_Literacy-Briefing.pdf(Accessed:24March, 2019). Publichealthmatters(2018)aguidetooutnewequityhealthcollection.[Online]. Availableat:https://publichealthmatters.blog.gov.uk/2018/01/16/a-guide-to-our-new- health-equity-collections-page/(Accessed: 24 March, 2019). Publichealthmatters(2018)Addressinghealthinequalitiesatlocallevel.[Online]. https://publichealthmatters.blog.gov.uk/2015/09/16/addressing-health-inequalities-at- local-level/(Accessed: 24 March, 2019). Publichealthmatters (2018)Improving health and care through the home.[Online]. Availableat:https://publichealthmatters.blog.gov.uk/2018/03/20/improving-health-and- care-through-the-home/
Contemporary Debates9 Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z. and Brand, H. (2012). Health literacy and public health: a systematic review and integration of definitions and models,BMC public health,12(1), p.80.