3. Psycho Social Influences * What are the psychological and Social causes for this inequality in health E.G. Why is heart disease more prevalent in lower socioeconomic groups? What are the direct and indirect influences on this inequality? * Structure * Housing * Education * Employment * Geographical and Social Isolation * Poverty * Agency Inequalities in health such as can lead to a variety of conditions such as 4.
The effect of social integration on health is conclusively documented in the theory of ‘social support’ [Cassel, 1976]1. The effect of social and economic inequality on health is profound too. Poverty, which is a result of social and economic inequality in a society, is detrimental to the health of population. The outcome indicators of health (mortality, morbidity and life expectancy) are all directly influenced by the standards of living of a given population. More so, it is not the absolute deprivation of income that matters, but the relative distribution of income [Wilkinson, 1992]2.
For instance, it is often perceived that people of a lower income (middle or lower class) are in less of a physical, mental and indeed, social state of health than those in a higher social class. This is evident from birth. Low birthweight is associated with a greatly increased risk of death in the first year of life as well as serious illness and lifelong disability. Longitudinal studies show that children who were low birthweight experience a greater risk of developing learning and behavioural difficulties and have lower educational attainment and socio-economic status as adults. (Institute of Public Health, Ireland, www.publichealth.ie, accessed 16/10/2007) The reason, as it is widely assumed, for low birthweight among less wealthy people is that they have a tendency to take less care of themselves than more privileged people.
These results also showed that social factors also affect your health. Those that are in lower ranks of society are subjected to more social stress, which leads to higher chances of morbidity—general illness, and increased chances of smoking and unhealthy eating. Although this study was conducted over 40 years ago, the relationship between socioeconomic status and health is still seen currently. Today, lower class native-born Americans and immigrants see are affected by social
The reasons for these inequalities are linked with socioeconomic status, ethnicity, gender and the geographical area in which people live. There is also statistical evidence which highlights the fact that Maori, Pacific Islanders and people from lower socioeconomic backgrounds are dying at a younger age and generally have poorer health than other New Zealanders (Ministry of Health [MOH], 2002). The Reducing Inequalities in Health report (MOH, 2002) states that the primary causes of health inequality in New Zealand are directly related to the distribution of and access to resources such as income, education, employment and housing. The report also states that another major influence on this inequality in health is the difference in how and when people access health care services and how that care may differ between those receiving the services. This is also said to have a significant impact both on peoples’ health status and mortality rates.
Sociologists propose a different cause. They examine patterns within society, and they seek social rather than biological answers and suggest that the differences in health and illness between different groups within society are influenced by social, economic, cultural and political factors. It is from these observations that sociologist believe that “being ill is not a simple thing”. The state of our health is very important to us, we spend a lot of time and money on trying to stay healthy, but what do we mean by “Health”? The World Health Organisation 1955 (WHO) describes heath as “Not the mere absence of disease but total physical, mental and social wellbeing”.
Social justice envisions a society that is equal in all matters to create physical and psychological safety. Social justice in the realm of healthcare demands that all individuals have the right to basic human dignity and have their economic needs met on a basic level. UHN has a commitment to bring social justice to the forefront of care in diverse cities and bring awareness that social factors affect all aspects of health. It is difficult for government agencies to address issues of violence and trauma without bringing awareness to racism, poverty, classism, sexism, homophobia and other stigmas that has been placed on various cultures. This has lead UHN to raise awareness to inequalities that have been ignored for years (Schim, Benkert, Bell, Walker, & Danford, 2007).
5. Social and economic factors which influence health The impact of social and economic factors on the health of individuals is well recognised and understood by the Health, Social Care & Well-Being Partnership, and is considered in the Needs Assessment. Most local authority services impact on health in some way and the first Health, Social Care and Well-being Strategy recognised the role of services such as social care, housing, economic development, education, and transport. But there are many others such as street cleaning, refuse disposal, building regulations which can also affect people’s health. This strategy once again prioritises a number of key influential factors which impact health in a significant way.
Ethnicity has repeatedly been shown to be a strong indicator of health status. Deprivation, socioeconomic factors such as income, education and unemployment, is recognised as a major indicator of health. These are demographic characteristics that will influence services, for example if a local community have a particularly high number of older people then residential homes and nursing homes are going to be more important that than services for children like nurseries and playgroups. I have chosen to look at teenage pregnancies and child poverty in Norfolk. Child Poverty Many children and young people in Norfolk face a variety of disadvantages that mean they are less likely to have positive outcomes for their lives.
Models of Health According to the World Health Organisation, “Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity.” (World Health Organisation, 2011) There are two main models of health which reflect different perspectives. These models are known as the social model of health and the medical model of health. The medical model of health focuses more on the cure for an illness, whereas the social model of health concentrates on the origins of the illness rather than the cure such as class, gender and ethnicity. (HSC, 2009) In the medical model of health, the main focus is on a person functioning correctly physically and defines bad health and illness as the presence of disease. The medical model looks at the body as a machine, where if it were to break down, a doctor would take on the role of an engineer and attempt to fix it.