Public Health: Evaluating Interventions Addressing Inequalities

This report explores the impact of social factors on health and critically evaluates two public health interventions developed to address health inequalities: the UK’s Universal state-funded Healthcare through National Healthcare Services (NHS) and the United States Patient Protection and Affordable Care Act 2010 (Obamacare). It discusses how social determinants like economic structures and living conditions contribute to health disparities, affecting life expectancy and overall well-being. The report analyzes the pros and cons of both NHS and Obamacare, highlighting their effectiveness in promoting universal healthcare access and increasing patient protection, while also acknowledging challenges such as long waiting times and increased taxation. Ultimately, the report concludes that these interventions have been largely effective in improving healthcare access and reducing health inequalities, despite certain disadvantages, and emphasizes the importance of addressing social factors to improve public health outcomes. Desklib provides access to this report and other study resources.

PUBLIC HEALTH STRATEGIE 1
PUBLIC HEALTH STRATEGIES
Institutional Affiliation
Date

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Introduction
Public health is an area of great concern for many governments across the world. Not
only is it's a concern for governments but also some non-governmental organizations, and
community-based groups have had a role to play in the public health sector. It involves
promoting human health, prolonging of life and prevention of diseases through collective efforts
from individuals, communities, public and private organizations and governmental agencies.
Social deter of health are those conditions shaped by factors such as distribution of resources,
power and money. They are the conditions in which individuals are born, grown and die. These
economic and social conditions are the main influencers of differences health status among
groups and individuals (Wilkinson and Marmot, 2003).Health inequalities refer to differences in
the distribution of health determinants in different groups and disparities in health statuses of
such groups (Marmot and Bell, 2010). A public health crisis refers to intricate occurrences
whose impact on human beings in similar or different geographical areas is enormous. Public
health strategies are focused on preventing injury and disease, protecting and promoting health
for particular populations. This report will explore the impact of social factors on health and
critically evaluate two public health interventions developed to address health inequalities.
Impact of social factors on People’s Health
Social health determinants refer to the interconnection between individual’s economic
structures responsible for health inequalities. They include circumstances in which people are
born and live often shaped by the distribution of resources power and money. Examples of social
determinants are societal factors, structural factors, physical and social environment. Social
factors affect people’s health in multiple ways (Wadsworth, Butterworth and Wilkinson, 2006).
Social factors determine people’s life expectancy and disability rate
Marmot observed that the likelihood of people in an affluent neighborhood to die earlier
than that of people living in a poor neighborhood was minimal. He found that poor people are
likely to die seven years before those living in a rich neighborhood. According to Marmot,
people in a deprived neighborhood are more likely to live with disabilities as compared with
those from the rich neighborhood with the average total difference being 17 years.

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Their social circumstances determine People's experience
Social conditions are a significant determinant's of peoples general well being, health
status and length of life. For example, young children with low cognitive scores but who grow up
in well-off families improve their scores towards the age of 10 as compared to those from needy
families whose cognitive scores worsen as they approach the age of 10 (Marmot,2014).
INTERVENTIONS DEVELOPED TO ADDRESS HEALTH INEQUALITIES
To get rid of health inequalities, numerous interventions have been put forth both at the
national and local levels in different countries. The focus of these interventions has been
promoting equitable distribution of health resources and minimizing the spread and impact of
diseases. Suitable examples of such interventions aimed at alleviating inequalities in health care
include UK’s Universal state-funded Healthcare through National Healthcare Services and the
United States Patient Protection and Affordable Care Act 2010 commonly referred to as
Obamacare (Baggott, 2010).
Universal state-funded healthcare in the United Kingdom
National Healthcare Services in the United Kingdom is used to refer to the Country’s
publicly funded healthcare system divided into NHS Wales, NHS England, NHS Ireland and
NHS Scotland which operate independently. The system Introduced through the 1946 National
Health Service Act is funded by the taxpayers and has been described as the world's most
extensive Single payer system of health care.NHS was initiated in the year 1948b as part of post
second world war social reforms. It was mainly focused on ensuring that health care in the
United Kingdom was Free, universal and comprehensive for United Kingdom Residents (Béland
et al.,2014).This system, however, did not include optical care and dental treatment. The system
focuses on providing most health care services to all UK residents free of charge. It also provides
infectious treatment disease treatment and emergency treatment for both residents and visitors.
Pros and Cons

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Numerous merits and demerits are associated with the United Kingdom’s free universal
healthcare
Pros
Equal access to healthcare
The most important benefit is that the system it makes healthcare affordable for all people
including those who cannot afford healthcare services. It does not discriminate against any
citizen irrespective of their social class. The system also helps the unemployed by ensuring that
they can access healthcare at any time (Cowley et al.,2015).
Improved Public Health
As a publicly funded healthcare system, it means that the cost of healthcare is spread out,
meaning that everyone can get access to primary health care. By promoting equal access to
health care, the system also facilitates the improvement of general population's health and aids in
the reduction of the spread of infectious diseases through the facilitation of free, timely treatment
(Greener, 2008).
Elimination of Medical bankruptcies
Research has shown that medical related expenses are the leading cause of bankruptcies.
In the United States, for example, medical bankruptcy stood at 62% of all cases of bankruptcies
in 2007.Universal healthcare in the United Kingdom has eliminated instances of Medical
bankruptcy leading to a healthier population.
Cons
Lack of options for patients
With the country’s Universal healthcare system, patients are left with no ability to go for
the treatment or physician of their choice as for the case of privately provided healthcare.
Time Consuming

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Although run independently for the four regions, the system has taken a lot of time to be
fully implemented. Adoption of universal healthcare does also involve sacrificing other factors. it
also involved a lot of technical difficulties and trial errors (Matsuyama et al., 2014).
Long waiting time
Long waiting time is a significant issue in the Britain healthcare system. With free access,
the demand for healthcare services in the public sector also increases. People are forced to wait
for so long before they can get access to medical services (Weightman et al.,2015).
OBAMACARE
Obamacare or Patient Protection and Affordable Care Act 2010 is a reform in the United States
intended to improve healthcare access and curb spending through taxes and regulations. The Act
signed into law in 2010 by retired president Barrack Obama had its primary focus on improving
the quality of health insurance and healthcare and ensuring that more Americans got access to
inexpensive health Insurance. It was also intended to reduce the amount of healthcare spending
by individuals in the US and to regulate the Country's health insurance sector.
Pros
Increased Access to Health Insurance
Thanks to Obamacare, Millions of Uninsured Americans have gotten access to high
quality and affordable health insurance. The number of those who obtained insurance in the first
five years of Obamacare has been estimated at over 16 million Americans (Hartz, 2013).
Increased patient protection
Obamacare promotes equality concerning healthcare provision. It reduces the possibility
of patients to be dropped from coverage anyhow or being denied treatment. It also encourages
equity by ensuring that patients are not charged more by belonging to the female Gender.

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Obamacare also gives patients a right to appeal and protects patients from unwarranted hikes in
insurance rates by the Insurance companies (Wickham et al., 2016).
Reducing health care cost
The most notable benefit of Obamacare is that it minimizes the increase in healthcare
costs. This is possible through its facilitation of free preventive care and provision of Insurance
for millions of Americans. For example, in the year 2016, a 1.2% increase in the cost of
healthcare was recorded. This was much lower compared to 4% recorded in 2004 (Jones,
Bradley and Oberlander, 2014).
Cons
A short-term increase in healthcare cost
As more people were covered, the overall cost of healthcare was escalated due to the rise in the
number of people being tested for the first time and those receiving preventive care. This was
also as a result of treating illnesses that had hitherto been ignored.
Increased taxation
Obama care has also led to the creation of many new taxes for its facilitation. Suppliers
of medical devices have been forced to pay more taxes. This has also been the case with
pharmaceutical sales. The system is also funded through increased taxation of the rich (Wickham
et al., 2016).
Increased cutting of working hours for employees to avoid covering them
As per Obamacare, employers with more than 50 fulltime employees are expected to
offer insurance or cover their employee's healthcare expenses. To prevent this, businesses have
resulted in reducing employees working hours to below the full-time weekly hour threshold.
Effectiveness

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Based on the above analysis, it can be seen that the two interventions have had both
advantages and disadvantages. However, the overall conclusion is that the advantages outweigh
the disadvantages. The two interventions have been effective in that they have promoted the
universality of healthcare and increased access for both the rich and the poor in the two
countries. They have made more people able to access health services than it was possible
previously. For example over in the United States of America over 20Million people have
acquired healthcare insurance since the introduction of Obamacare (Bakalar, 2018).
Conclusion
In conclusion, social factors have many impacts on people health. People’s options for
access to health services are to a large extent determined by their socioeconomic class.
Differences in life expectancy, cognitive score and disability rate are some of the impacts of
inequality in healthcare. In an effort to address health inequalities several interventions have
been established. Examples of such interventions are Obamacare in the United States of America
and NHS Universal state-funded healthcare in the United Kingdom. The interventions have been
effective in the countries in that they have improved the overall access to healthcare to the
residents of the two states. However, the two interventions have come with both advantages and
disadvantages. Among the most common benefits are equal access to healthcare, improved
public health, reduced medical bankruptcies, reduced healthcare cost, and increased patient
protection. On the other hand, disadvantages include long waiting time, increased taxation
especially for the rich, lack of options for patients and reduction of working hours for employees.

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