Health Inequalities, Social Exclusion, Empowerment, and Advocacy

This essay delves into the multifaceted issue of health inequalities, examining the influence of social determinants such as social class, gender, and poverty. It explores how these factors contribute to social exclusion and impact access to healthcare and overall well-being. The essay analyzes various sociological theories, including functionalism and feminist theory, to understand the underlying mechanisms of social stratification and its effects on health outcomes. It also discusses the concepts of empowerment and advocacy within the healthcare context, highlighting the importance of equitable access to services and the need for interventions to address power imbalances. The paper draws on key policy documents like the Ottawa Charter and the Health and Social Care Act to illustrate the evolution of public health strategies aimed at reducing health disparities and promoting social inclusion.

Running head: SOCIAL INCLUSION, EMPOWEMENT AND HEALTH
SOCIAL INCLUSION, EMPOWEMENT AND HEALTH
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1SOCIAL INCLUSION, EMPOWEMENT AND HEALTH
Introduction
The unavoidable differences that exists in the health status and the unfair differences
that are present between the groups, individuals and the population in terms of the health
status is referred to as health inequalities. However there in an increase in the average level of
the health that has occurred globally in the recent years, in spite of this there are health
inequalities existing the members of the state (Hatzenbuehler, Phelan and Link 2013). The
reason behind the inequalities might be attributed to the avoidable diseases and the deaths
which are quite unfair as they are involved in wasting the human capital and therefore steps
should be taken to reduce it. There is also a prevalence of social distribution in terms of the
health of the individuals which is all the more well documented in the countries with high
income. There is also a significant gap present in the strategies and the policies and programs
related to the prevention of the diseases. This paper aims to highlight the existence of health
inequalities with respect to the factors that act as the social determinants of health in terms of
social exclusion. Additionally the paper also elucidates the various theories of sociology
which are directed towards these determinants and help to explain the social exclusion in
terms of these factors.
Health inequalities
The process of globalization has led to the reduction in the gaps in the wealth and
income that is owned by the individuals. Due to the various social determinants of health
which has an influence on the health related behaviours. Several models have been developed
which are able to portray that how these determinants can be interlinked in addition to the
fact that how the social determinants of health are able to affect the health that lies beyond
the direct impact of the health care (Durand et al. 2014).

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The Ottawa Charter for Health Promotion was the first international conference
that was conducted in the year of 1986, which acted as the primary response to the
expectations that were growing in relation to the health movement of the new public all
around the world. This involved health promotion as the primary agenda, which helped to
enable the people to increase the control over their health and to improve their health. The
need for the development of the Ottawa charter was mostly motivated by the desire to
improve the health of the various communities and also to reduce the social gaps and
economic gaps, which prevailed amongst the population within the nations and between
various countries. For the purpose of achieving the health promotion, the prerequisites of the
promotion plan needs to be met by the government though ensuring of the following
attributes like peace, education, shelter, stable eco-system and food-income and various
others (Braveman and Gottlieb 2014).
Saving Lives: Our Healthier Nation, was England’s long awaited public health
white paper, which highlighted the following aspects like choosing health over philosophy,
communications, child health and community health. Similarly the health and social care
act of 2012 implies the direct impact of the structure and delivery public health. According to
this the general practitioner (GP) along with their practise teams have an increased role which
is quite crucial role in the promotion of health and the prevention of the diseases. There were
certain changes made in the policy which helped to affect the population’s health and well-
being (Allen et al. 2014).
Social class
The social class of a person has an eminent impact on the physical health along with
the ability to receive enough health care and nutrition along with their life expectancy.
Although the factors like gender and race play an important role, however in explaining the

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health care inequality that exists, the socioeconomic status is the greatest of all determinants
that is related to the health outcome of the individual. The individuals having a low
socioeconomic status experience wide variety of health problems which was due to the
economic position (Badland et al. 2014). Most of these people are not able to use health care
as much as the people with higher status. However the people with a low socioeconomic
status to experience a much higher rate of health issues than those of high SES. The presence
of the social exclusion often makes it difficult for the achievement of the particular social
objective like the reduction poverty along with malnutrition which often act the hidden
barriers for the reaching the individuals who are socially excluded. The concept of social
exclusion most of the time involves the aspect of exclusion in more than dimension, which
plays a role in the reinforcement of each other. In relation to the factor of social class, the
sociological theory that can be utilised is the theory of functionalism (Benach et al. 2014).
This perspective helps to analyse the process by which the society operates. According to the
aspect of functionalism, there is an existence of several aspects of the society since all of
these serve a needful purpose. According to the theorists, Kingsley Davis and Wilbert
Moore, there is an importance of the function on the social role, with which there must also
be greater reward. According to this theory, there is a social stratification that is able to
represent the unequal value of the different work (Hatzenbuehler, Phelan and Link, 2013).
Gender
The next factor is gender. There is an eminent influence of social factors on the
gender health. However there is also a chance of development of social exclusion through the
long-term persecution. This phenomenon however can have an impact of the phenomenon of
creation of barriers to the education for the children and most of time for the girls. Provision
of education to the girls and the young women helps in the promotion and the enhancement
of the economic and the social development thereby the enormous strides that has been made

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on the developing countries in terms of education of the girls (Benach et al. 2014). The
phenomenon of social exclusion is involved in side-lining the members of the socially
excluded groups, thereby making restriction in the economic mobility and the denial that
some benefit is accorded to the other members of the community. Due to the presence of the
social stigmas, there is a development of the social exclusion process the key social stigmas
that has an effect on the social exclusion are the past trauma experienced at the hands of the
population existing as a majority or as the dominant, such as a recent history consisting of
dispossession or slavery of a homeland. In terms of gender stratification, the feminist theory
is able to analyse the gender stratification through the intersection of gender, then race and
the class. The feminist theory is the extension of the aspect of feminism going into the
philosophical and the theoretical discourse (Braveman and Gottlieb 2014). This theory aims
to perceive the nature of the inequality of the gender, which helps in the examination of the
social roles of the women along with their experiences and their interests. This feminist
theory emphasizes on the gender inequality along with the promotion of the interests of the
women (Durand et al. 2014).
Poverty
The next factor is poverty which forms another aspect of the social exclusion. Poverty
focuses mainly on the materials along with social deprivation, while on the other hand the
concept of social exclusion incorporates the concept of necessities and the ability of the group
to be able to participate in a social, political, economic and cultural life along with their
relationships to others (Badland et al. 2014). However poverty also has a major impact on
some of the aspects of social exclusion, there are the existence of various other causal factors
as well like age, disability, ethnicity, gender and employment status. In respect to the poverty
the sociologists use the concept of social class. Along with this, there is a concept of
consumption practices which is considered as the mechanism by which the people are able to

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demonstrate their individuality and explore their individual identities. In terms of poverty, the
consumption acts as an important element for the stratification and distinction.
Social stratification
Social stratification can be defined as a social system in which people or individual
amongst the society is ranked on hierarchical basis. Social stratification can also be termed as
social division. Social division existing between groups is often refereed in terms of race and
ethnicity in addition to the economic, cultural, and political lines which acts as the central
characteristic of public life in nations occurring throughout the world (Allen et al. 2014). The
social divisions that exist between the various social groups spans the political as well as the
geographic boundaries and reflects universal social dynamics. In such area, the ethics and
morals play an important role. In such cases, the use of the term social exclusion can be
interpreted in an inclusive way or used as a socially democratic policy (Hatzenbuehler,
Phelan and Link 2013). The concerns existing like the status of minorities along with the
immigrants, women or indigenous people who fit nicely into this school of thought. In respect
to this, there is an interactionist perspective which claims the interaction of the people with
each other by attaching meaning to each actions. This interactionism theory acts as the
founder of the influential theory of the racial assimilation which is called the race relation
cycle (Benach et al., 2014). This cycle has four stages; the conflict, contact, the assimilation
and accommodation.
Empowerment and advocacy
Empowerment and advocacy are both related to way power is distributed amongst
individual in a particular society. Empowerment in healthcare industry refers to the system
where patient is placed in the center of the healthcare service provided. In healthcare there are
a lot of issues faced by the patients coming different socio-economic backgrounds. Due to the

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high cost of the medical facilities available to the patients suffering from critical and terminal
diseases, only the patients hailing from affluent backgrounds can avail of the opportunities.
The patients belonging from the marginally lower socio-economic backgrounds are at a
disadvantage of being deprived from such facilities thus becoming victims of social
exclusion. It, therefore, becomes the duty of the government as well as the administrative
authorities to provide for an equal and inclusive healthcare services catering to the treatment
of the patients coming from diverse backgrounds irrespective of their economic backgrounds
(Ferlie et al. 2012). According to Marxist ideology, the inequal distribution of the factors of
production amongst the different classes such as the Bourgeoisie- the class owning the means
of production and the Proletariat- the class deprived of the means of production, resulted in
the emergence of revolts and rebellions thus resulting in the overthrowing of different
oppressing classes along different periods or epochs of time (Anderson 2016). If the
healthcare services, which are also a form of human capital are not distributed equally
amongst the different classes then there is an inevitable risk of revolt or rebellion breaking
out amongst the different classes in conflict. The Authorities in charge of the healthcare
services as well as the administrative officers must assess the situation carefully and make
sure that the feeling of deprivation as well as resentment does not arise in the minds of the
poor patients as well as the people suffering from disability.
Conclusion
The health of the individuals is a very integral part of the well-being of the human
being. Therefore in conclusion it can be stated that the access to health care along with
financing is responsible for the contribution to the overall health long with the health
inequalities. The social determinants of health like the income, social stratification ad
education tend to have a wide effect on the life course. Better health outcomes are related to
better financial incomes. The socioeconomic conditions most often underlie many of the

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health inequalities and play a part in compelling the attention to most of the social policies
that are responsible for affecting the health, the strengthening of the powers and additionally
the reduction in the prevalent disparities. This therefore shifts the health financing to reward
the improvements in terms of the individual and as well as the community health.
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