The Black report published in the 1980s showed that there was a pattern to the wealth and health experienced by the different social classes, based on occupation the report showed health inequality and suggested that professionals fare better than managers, managers fare better than skilled workers and so on down the line. However there are also theories that try explaining the results of the Black report, suggesting that the system of health care is not such an important factor as other life circumstances that affect the health of different classes. The artefact theory suggests that the use of surveys for statistics is inaccurate because it fails to take into consideration the clinical iceberg where it is unknown how many people suffer illness as they don’t always report it also most health care happens in the home usually women treating symptoms by self care, in the case of postal surveys not everyone will respond and women often fill in forms for other family members. It is also unreliable because the figures relate to males of working age and not females and older and younger people and the statistics change all the time. However another study known as the Whitehall study gave evidence that there is a “real” relationship between social class and health outcome.
To explain inequalities in health and social class, which has been highlighted in explanations such as the artefact explanation, “theories of natural or social selection, materialist or structuralise, and cultural and behavioural explanations” (Townsend and Davidson 1988 p, 104). Therefore in theory, reducing inequalities in health will be adopting strategies that will modify or tackle the explanations given above. One-way of achieving this is already attained; though not specific in particular populations. This means identification of local inequalities targets such as that by “King’s Fund Policy Paper” which recommends strategies for reducing local inequalities in health and “Our Healthier Nation” which was set up by the government in England to improve the health of the worst off in society and to narrow the health gap.
Various studies have shown that social class and environment may influence a person’s health and illness. For e.g. living in poverty, damp housing and low income can cause raised child mortality rate of the lower class. The elderly in society are often diagnosed as sick because they are most vulnerable to illness; a large number of the elderly are in hospitals not because they are sick but because there is no one to look after them at home and also because health and welfare services fail to provide enough care in the community.
The health and illness that affect the social classes is often influenced by their environment for instance the child mortality rate of the lower classes can be caused by living in poverty, damp housing, low income, inadequate diet, through unemployment, all the issues which contribute to stress and depression as the lower class is caught in an never ending circle where each problem contributes to another and so lifestyles tend to stay the same. This diminishes hope and limits choices causing a threat to health. The lower classes also have the worst facilities of health care. Doctors and specialists who are able to choose the areas they work will more often choose middleclass areas where they will have the advantage of better staff and equipment. Hillary Graham’s work on women and smoking suggested that smoking might help women in poverty to cope because it is a method of relaxation, her way of having a break from the main interaction with small children.
The socially constructed perception of health is further influenced by the social class system (Registrar General Social Class Schema)
From researching for this assignment it seems to me that the concept of health is a socially constructed phenomenon in that society influences our behaviour and moulds our perception of health. This, of course, varies depending on the class, cultural beliefs, ethnic background and society in which we live. Inequalities in health are prevalent in our society today. Its existence between social classes, men and woman and age has been clarified in the black report and in governmental publications such as “Our healthier nation” and local organizations such as “The King’s Fund policy paper” When we are healthy we are able to benefit from life’s opportunities. Although some factors that influence our health are beyond our control, such as age, sex and heredity, influencing factors like our eating habits, life styles, social relationships and our environment can be adjusted to promote our well-being.
I think that there is a need for a holistic approach to health promotion. The government has put in place strategies to help reduce inequalities in health by “ensuring that the needs of people who have suffered the effects of inequality for too long are placed at the centre of plans for health and social improvement”. This is a good start as far as reducing inequalities is concerned but the government also needs to make sure that these people who have suffered the effects are not only aware of this proposal or by making health, housing, education, or employment opportunities more accessible but trying to educate people in promoting their own health for example
REFERENCES
1. Health Promotion Foundations for Practice (second edition)
Jennie Naidoo and Jane Wills (2000)
2. Inequalities in Health (The Black Report)
Peter Townsend and Nick Davidson (1980)
3. The Sociology of Health and Medicine
Nicky Hart (1991)
4. Our Healthier Nation (Reducing Inequalities: An Action Report)
Department of Health (1998)
5. Local Inequalities Targets
A Kings Fund Policy Paper – Liz Kendall (1999)
