The clinical iceberg
Clinical iceberg is the term used to describe large amount of illnesses that go unreported. This happens because it is thought that the ‘true levels of illness are largely concealed. This usually happens because individuals who are ill do not visit their doctor often. For example the Medical Statistics are created based on information obtained from the doctors, these statistics go on to make government policies on healthcare. An example of the clinical iceberg is when an individual doesn’t go to his or her doctor when he or she is feeling sick. Therefore there will be no data that another patient was sick (Stretch & Whitehouse, 2007).
(P5). Using statistical data from a range of sources compare the patterns and trends of health and illness in three different social groups from the list below:
- Social class
- Gender
- Ethnicity
- Age
- Geographical location
Social class
Within the black report the difference in the social class are highlighted. The black report was published by the Department of health and social security in 1980. Sir Douglas Black was the chair person who was looking into the health inequalities, as a result of this committee the black report was introduced. This committee found out that there were marked and widespread health inequalities even if the society’s general health was improved. On the other hand the Acheson report was a report on health inequalities which was published by the department of health in 1998. This report looked after health inequalities and suggested areas for the development of policies. Also, this report highlighted areas where health inequalities can decreased for example education, more funding for schools and restrictions on smoking. According to the National statistics online (2001) individuals that are unemployed have a higher risk of acquiring a long-term illness or disability (Hetherington, Rasheed, Wyatt, 2007).
Gender
The life expectancy and certain illnesses vary between the male and the female gender. The life expectancy has increased for both genders but the statistics show that the causes of illness and death vary between the genders. The social trends states that in 2002 a life free of disability mostly last 63.0 years for women and 60.9 for men. Though, it has been proven that women have a longer life expectancy but are most likely to spend years in poor health or a form of disability (Hetherington, Rasheed, Wyatt, 2007).
Ethnicity
It is impossible to find evidence for a link between race or ethnicity and illness because there are difficulties of definition. Also, because a high percentage of individuals from minor ethnic groups live in deprived areas in inner city areas which have common issues such as poor housing, pollution and a high rate of unemployment. Therefore it is impossible to recognize whether these individuals have poor health due to ethnicity or poverty (Stretch & Whitehouse, 2007).
Though studies have shown that compared to the white majority, these ethnic groups have:
- a higher risk of acquiring rickets in children from the Asian sub-continent due to the lack of Vitamin D in their diet
- a lower life expectancy
- a higher infant mortality rate
(Stretch & Whitehouse, 2007).
There are issues of access to the health services apart from the health implications of higher levels of poverty. Factors such as cultural barriers and language may limit full access of health services. For example Asian women refuse to see male doctors and since some of them only have a basic knowledge of English most of the information is not translated into minority languages. Individuals may also fear racism which will make the individual stressed and refuse to see a doctor. If the health and care professionals do not understand the religious beliefs, cultural beliefs and the practices of minority ethnic groups, the individual’s care needs are unlikely to be met. Thus, leaving the individual vulnerable to higher levels of ill health (Stretch & Whitehouse, 2007).
(M3). Explain the patterns and trends of health and illness in the three different social groups that you have chosen in the previous question. Do this by using the four sociological explainations for health inequalities.
- The statistical artifact explanation
The statistics produce a biased view themselves and the statistical evidence is false which is therefore invalid. For example the statistical artifact suggests that is it the age structure and patterns of employment of individuals in the lowest social classes that really explain the differences rather than the social class. Although statistics show a link between the health and the class this does not automatically mean that the class and ill health are connected. This may be due to the way how data is obtained or the method in which the class is defined. Gender inequalities may be the result of how data is obtained. For example men do not seek advice because they are considered as emotionally reserved. On the other hand women seek more advice than men. Ethnicity inequalities occur due to the method in which information is obtained and interpreted (Hetherington, Rasheed, Wyatt, 2007).
- Natural or social selection
This suggests that it is not the lower social class factors such as low wages, poverty and poor housing that cause illness, high infant mortality rates and low life expectancy for adults. The natural and social selection suggests that it is quite the opposite. It states that for example individuals find themselves in the lower social class because of poor health, lack of energy and absenteeism. Though this explanation has not been proven because there is no evidence that ill health is cause by deprived circumstances rather than causing it. Since there is no evidence this explanation has been rejected by sociologists. As a result of genetic or biological factors, health inequalities happen. Though, in this explanation inequalities are seen as an advantage to our society. According to a consensus health and inequality are linked. Ill health can cause a individual to be in a certain social class. For example if an individual is healthy and fit he or she will be more able to obtain a better job, therefore she or he will be in the middle class, also known as the working class. In this explanation women are viewed as weaker than men. Both genders are most likely to be subject to different types of illnesses. For example women are more prone to illnesses such as breast cancer while men can have a prostate cancer. Different ethnic groups are at risk of different diseases or illnesses. For example African Americans are more prone to sickle cell disease rather than other ethnic groups (Hetherington, Rasheed, Wyatt, 2007).
- Cultural or behavioral explanations:
This explanation focuses on the lifestyle choices and the behavior in the lower social class. For example if individuals in the lower social class smoke more, drink heavily and eat more junk food. However these examples are sometimes used in order to help individuals cope with everyday difficulties. In order to decrease health inequalities it is essential that the society educates people with media and education. Social class is defined as the differences to lifestyle choices made by individuals in specific classes. In this explanation men and women are described as having different behaviors. For example men are most likely to smoke and drink excessively which can with a health risk. On the other hand women rarely exhibit this behavior. As for ethnicity this explanation states that those differences from ethnic minorities may be due to unhealthy behavior of individuals from these groups (Hetherington, Rasheed, Wyatt, 2007).
- Material or structural explanations
This explanation states that the social groups for whom infant mortality rates are high, life expectancy is short and a high percentage of poor health is present due to inequalities in wealth and income. As a result of poverty, poor health and a short life expectancy occur. Poverty is linked with poor housing, poor diets and dangerous and insecure employment. Due to an unequal society individual become ill. Ill health occurs in the lower class because of social structures. This explanation states that social inequalities of gender and poor health are associated. The material and structural explanations also show that individuals form minor ethnic groups are most likely to be discriminated against or have poorer life chances (Hetherington, Rasheed, Wyatt, 2007).
(D2). Evaluate four sociological explanations for health inequalities in terms of explaining the patterns in the three groups you have chosen. This evaluation involves reviewing the evidence for the different explanation and forming a conclusion based on strengths and weaknesses of their cases.
Artefact
Strength-
The artifact states that inequality happens due to the way which statistics are obtained. One must improve the way in which statistics are obtained. For example if one surveys five persons there will be chance of a false error but if one surveys ten persons the result will be more clearer. If a research is done in a matter in which statistical errors are included in the information the artifact will be decreased.
Weakness-
However if a survey is done in the Artefact manner the data will not be clear. For example in a survey 75% of the population is happy and 25% are not. The information does not state why 25% of the population is not happy.
Natural/ Social Selection
Strength-
This explanation believes that no action in order to reduce health inequalities because health inequalities is seen as beneficial. This explanation also states that any interface can be dangerous. For example if a child is born with an extra limb it can be dangerous to interfere with an operation because the health of the baby may be at risk.
Weakness-
This explanation will lead individuals to a deterministic acceptance of ill health. For example an individual with a cancer will not struggle to fight cancer by having the necessary therapy.
Behavioral
Strength-
In order to help individuals improve their health it is important to re-socialize the society. For example, using publications such as posters and brochure in order to educate people on how to lead a healthier life.
Weakness-
This explanation does not state that may other factors impact one’s health. For example if an individual is stressed he or she will not consider the risks of smoking because smoking reduces his or her stress. Another weakness is that not every individual cares about the promotions that can help individuals lead a healthier life.
Structural
Strength-
This explanation states that in order to find a solution the resources have to be redistributed. This will impact positively upon the underlying causes. For example the higher social class can give money to the lower class in order to make their lives better.
Weakness-
This explanation does not consider that any person’s responsibility for his or her own health. For example if the resources are given to the lower social class the individuals will not be encouraged to be responsible enough to go to work and earn their own wage and buy the necessary treatment and medication that they might need.
Conclusion
In this assignment I have:
- Described different concepts of health
- Compared patterns and trends of health inequalities to explain the patterns and trends of health and illness in three different social groups
- Evaluated the four sociological explanations for health inequalities in terms of explaining the patterns and trends of health and illness in three different social groups.
References
Anon. (n/d). Defining impairment and disability. Retrieved 10th May 2010 from
Hetherington, A., Rasheed, L. & Wyatt, L. (2007). Btec national: health and social care. London: Hodder Arnold
Marshall, G. (1998). Iatrogenesis. Retrieved 10th May 2010 from
Smith, S. (2010). What is the sick role ?. Retrieved 10th May 2010 from
Stretch, B. & Whitehouse, M. (2007). Btec national health and social care, book 1. UK: Heinemann.
