Nov 20, 2020 in Health

Inequalities in health

1. The Impact of Social, Economic and Environmental Developments on Changes in Morbidity and Mortality in the



Just like all organism and the nature in general, diseases that threaten human health have been changing. They have evolved as the years have gone by (Bywaters 2009). The patterns of health and diseases have continued to change from generation to generation. These changes in health patterns can very largely be attributed to the social, economic and environmental developments that are taking place constantly. The changes in social and economic development carried out by humans have had a profound impact on the ecology. Compared to the 18th century, human beings are now affected by many more different types of diseases (Raphael 2012). In those early years acute diseases, such as waterborne diseases, parasitic infections, malnutrition disorder, and tuberculosis (Tb), were some of the most common diseases that affected the human population (Marmot 2010).

The causes of ill health back then were mostly due to overcrowding, poor sanitation, poor living conditions and the lack of proper health care facilities. As social and economic developments have taken place, such illnesses became a thing of the past and are very rare today. So as to fight and eradicate these diseases, the deterioration report was made and the Public Health Act was formed. Their purpose was to combat filthy urban living conditions that caused various health issues and to resolve the sanitary conditions (Frank & Haw 2011). The Act required all new residential constructions to include clean running water and internal drainage systems. Thus, the problem of acute diseases was solved mostly by applying social, economic and environmental developments.

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Today, the lifestyle people lead is largely related to some preventable chronic degenerative disorders, such as strokes, obesity, heart disease, cancer, and diabetes. Therefore, the acute diseases affected people in the past, while chronic disorders are affecting them now (Marmot 2010). This change depicts what crucial effect social, economic and environmental changes have on the variations in morbidity and mortality rate in the United Kingdom and all over the world. In addition, variations in income levels have a direct correlation with morbidity and mortality rates. For instance, affluent economies have access to quality medical care. Such clusters of people register few preventable deaths. On the other hand, people at the bottom of the pyramid cannot afford good living conditions. This class of people dies of preventable illnesses. Therefore, morbidity and mortality rates are high among populations residing in such areas (Marmot 2010).

2.1 Patterned Inequalities in Health and Illnesses

This section refers to the emerging trends and forms of health and illness inequalities. Such inequalities occur due to various reasons and factors. However, the main reason can be attributed to the developments in the social, economic and environmental sectors. A proper example is a comparison between the poor and the rich residents of the country. Poor people tend to have diseases related to poor sanitation and similar issues. For rich people, the lifestyle is the main cause of illness, when mainly such diseases as obesity and heart attacks are common.

The Black report categorized people into 5 social classes, which were referred to as the social class gradient. The 1st class consisted of doctors and CEOs, the 2nd class of teachers and other professionals, the 3rd one of skilled technical workers, the 4th one of the semi-skilled workers, and the 5th one included unskilled labourers. This report showed that the rate of death of men in the 5th class was twice as large as that of those who belonged to class 1 (Marmot 2010). The more disturbing point was the fact that this disparity was clearly widening. This distribution of diseases cut across the society due to the prevailing social, economic or environmental factors. Inequalities in health, according to the Marmot, Black and Acheson reports, are clearly a problem that has haunted the United Kingdom for decades. The access to health facilities is a right of every citizen, and the fact that the poor people are not provided with the proper facilities even in dire situations is a shame to the country (Marmot 2010). It does not matter whether the person is rich or poor, everyone deserves equal access to medical care. Hence, this issue should be addressed and given the importance it deserves.

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2.2 Evaluating Sources of Evidence

According to the Black report, as one ascent higher up the social gradient, the longer one is likely to live. The babies born to the 5th social class were more at risk than those born in the 1st social class. This claim is based on the argument that people in higher classes have the means to access health facilities, as opposed to those in the lower classes. This inequality basically happens due to income disparities, education, and to some extent ethnicity. This report was criticized with the suggestion to gather data from a wide range of sources. The author divided the data himself, and some critics even suggested that it was biased.

The report suggested that health was determined by social factors, which mostly related to gender, social class, ethnicity, and age. Hence, it may be concluded that poverty goes hand-in-hand with ill health. This fact supports the social gradient theory. Belonging to a higher social class would generally mean being high up the social gradient, hence more likely to live longer. The report was said to be not tenable, and was published and soon forgotten. About two decades later Donald Acheson was commissioned to design a report to find out what policies can be tenable and put in place. Acheson discovered that there was still a social gradient. It was even more surprising that the gap had nearly doubled after 20 years.

2.3 Evaluating Contrasting Explanations for Health Inequalities

There are various explanations for health inequalities in the UK. The first one is advanced by the Artifact explanation. The Artifact explanation analyses the relationship between health and social class (Owen & Wall 2008). Artifact explanation places emphasis on the artificial nature of the correlated variables. Both health level and class belonging are artefacts of the measurement process. In addition, it is implied that their observed relationship may in itself be an artefact of little casual significance. Hence, the of the pattern of health inequality in the 20th century may be more a reflection of changing trends in the occupational structure of the British society than a causal link between material welfare and health (Cunningham & Cunningham 2012)

The second alternative is materialistic, or structural explanation. In this explanation the health of individuals is strongly patterned by their socio-economic status. It tends to imply that there exists a direct relationship between the mortality rates and the poverty levels. Simply put, the poor groups tend to have more health-related problems than the rich ones (Marmot 2010).

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3.1 Relationship between Theories of Health and Welfare Inequalities and the Development of Health Policies

The applications of healthcare theories, such as the Dorothea Orems self-care theory in health and welfare inequalities, have helped to mitigate numerous challenges (House 2002). The use of appropriate theories has helped with the adoption of recommendations in the health sector and also provided suggestions on how such problems can be tackled. For instance, the deterioration report is just one of many reports that have helped with the creation of policies to improve the welfare and health status of the nation. In addition, the theories of health have been instrumental in the process of developing guidelines or government policies aimed at promoting health equality. For instance, various theories have been widely used for planning and research, and the findings have been instrumental for promoting proper health levels across the population (Alcock 2008).


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