Critics of Townsend’s deprivation index argue that some of characteristics of the index are not necessarily associated with deprivation but could be merely cultural differences (such as not having a cooked breakfast or having a joint of meat). They argue that he did not attempt to discover whether it was income or choice that led people to appear deprived on his index. (Haralambos & Holborn, 2004, pg 242)
Ultimately, it is extremely difficult to get an exact measurement of what is poverty because people are all different and have varying notions of what they believe they need to lead a fulfilled life.
Explanation of the role of social policy in seeking solutions to poverty
Social policy is the measures that the government puts in place regarding social issues and the wellbeing of the public. Surveys such as Rowntree and Townsend’s have been influential in the creation of government policies which aim to provide a minimum of standards and social protection. Examples of such policies include; Social Security, State Pensions, Child Benefit, Child Maintenance Bonus, Child Trust Fund, Cold Weather Payments, Council Tax Benefit, Disability Living Allowance, Housing Benefit, Incapacity Benefit, Income Support and Jobseeker's Allowance (taken from the Department for Work and Pensions website). The minimum wage was put in place in 1999 to bridge the gap between the rich and poor, eradicate the exploitation of vulnerable people desperate for employment and to provide a level of equal pay for both men and women. The government has also created an increase in benefits for low income families through the Working Families Tax Credits system and The New Deal, which is a programme that gives people on benefits the encouragement, help and support they need to look for work (Jobcentre Online).
The government’s public health policies were put in place in a bid to alleviate the link between poverty and illness, their core concerns are provision for the health of the public, health promotion, prevention of disease, the treatment of illness, care for those who are disabled, and the continuous development of the technical and social means for the pursuit of these objectives (Baggott, 2000, pg1). The National Health Service is publicly a funded healthcare system and was set up to provide free healthcare to everyone in the UK, regardless of their state of health, income or social class. They provide free school dinners to children whose families are on low incomes as well as free dentistry and eyecare. They are committed to promoting health awareness, healthy eating and stopping smoking.
The government have put a number of significant policies in place in to tackle poverty issues however the link between poverty and ill health continues. Most evidence suggests that although the welfare state has attempted to reduce economic inequalities in society, its impact on gender and racial inequalities has been limited. Research shows that women are more likely to experience poverty than men as 62% of adults who receive income support are female. Women are more likely to be unable to work through having to look after children especially considering that 96% of lone parents on income support are women, those that are able to work are generally paid less than men. Poverty within ethnic minorities is also an issue with twice as many black people being unemployed than white, and on average earning less per week. Immigrants can also suffer as state pensions are only available to those who have been resident in the UK for twenty years.
Inequalities in health
The above graph shows that for the period 1997–99, life expectancy at birth in England and Wales for males in the professional group was 7.4 years more than that for those in the unskilled manual groups.
The graph above shows that there were substantial variations in reported health status by social group. Among those in employment, rates of not good health for people in routine occupations were more than double those for people in higher managerial and professional occupations (8.6 per cent and 3.4 per cent respectively). Those who had never worked or were long-term unemployed had even higher rates of not good health (18.5 per cent).
The Black Report (commissioned by the Labour Government in 1974, published in 1980) studied life expectancy, mental illness and causes of death of people in different social classes and discovered that, although there had continued to be an improvement in health across all the classes since the introduction of the NHS, there was still a link between social class and health inequality.
So, although we have social policies in place, why is the link still there? The Black Report suggested that there were four differing sociological explanations that social scientists had offered:
- Statistical artefact
- Social selection
- Cultural differences
- Material differences
Statistical artefact
The artefact approach suggests although the statistics show a link between ill health, mortality and social class, the inequalities shown in statistics don’t really exist and are more a reflection of the methodologies used to measure mortality and social class.
According to Haralambos & Holborn (2004, pg 312) critics such as Illsley (1986) argue that the statistical connection between social class and illness exaggerates the situation as it focuses on the differences between the highest and lowest classes instead of focusing on the improvements in the middle classes. Others suggest that there is not a link and it is just people Interpreting statistics and highlighting certain areas.
Social selection
Social selection is the viewpoint taken mainly by the new right and functionalists. It claims that social class does not cause ill health, but that ill health may actually be a significant cause of social class. Wadsworth (1986) found a close relationship between illness in childhood and downward social mobility career (cited Haralambos & Holborn, 2004, pg 313). Illsley (1987) argued that healthier people are more likely to progress up the career ladder as they have the energy to work harder and earn promotion (cited Haralambos & Holborn, 2004, pg 313). The differences in social class reflect the fact that healthier people are more able to work their way up the social class structure. Critics say that those from poorer backgrounds have more economic, social and employment concerns which can cause ill health and therefore is a result of poverty rather than the cause of it.
Cultural
Interactionists believe that differences in health can be explained as a result of the culture and lifestyle choices of individuals or groups. The table below shows below that in 1998-99 15% of professional male workers smoked compared with 45% of manual workers.
Source: National Statistics Online
Haralambos & Holborn (2004, pg 314) quote statistics from The Stationery Office (1999) which state that in the period 1991 – 1993, four times as many unskilled men died from lung cancer than those in professional employment therefore showing that working class have higher death rates due to unhealthier lifestyles. Individuals from lower social classes also tend to drink more alcohol, have an unhealthier diet (higher sugar intake and eating less fresh fruit), and are not as aware of the types of health care available to them compared to those from middle class backgrounds, who tend to take more exercise and have a wider range of social activities outside of the home which can reduce stress levels and lead to an all round healthier lifestyle (Haralambos & Holborn, 2004, pg 313 - 314). However, some would say that this point of view fails to ask why it is that these groups have such poor diets and high alcohol and cigarette consumption in the first place. Other’s point out that there could be reasons why people are ‘forced’ into an unhealthy lifestyle such as, hazardous work, bad housing, low income and unemployment, all of which can lead to sickness.
Material / structural
The final approach, put forward by Marxists and the left wing, argues that it is the structure of society and the way that it is organised that systematically disadvantages certain groups so that they experience poor health (Haralambos & Holborn, 2004, pg 314). Poor housing, bad diet and limited access to services and amenities are all hazards which people on low incomes cannot avoid being exposed to. Engels (1974), argued that ill health for the poor is a direct outcome of the capitalist pursuit of profit. Whilst undertaking a study of factory workers, he concluded that dangerous work, long hours and poor pay (leading to undernourishment) all contributed to the early death of workers (cited Haralambos & Holborn, 2004, pg 314). Jobs can be dangerous and lead to accidents in the workplace. Respiratory diseases are common amongst construction workers and chemicals and asbestos have been known to cause work related cancers and illnesses (Haralambos & Holborn, 2004, pg 315). Material ownership also affects those on lowers income as supermarkets selling cheaper food can often only be accessed by those with cars, resulting in those on lower incomes having to pay a premium at local shops. These, and other factors, can lead to a lower quality of life and a higher mortality rate. Critics would say that a purely structural explanation ignores individual choice and labels them as the puppets of the society.
All four explanations suggest that, generally, the higher up the social class you are the better your health is likely to be. I would argue that it is a combination of both cultural and structural explanations that cause the differences in health modern British society. Low incomes and lack of material assets can force people in similar circumstances together, forming social groups. Within these groups cultures are formed, creating norms and values within. Poor quality housing, bad diet, lack of exercise, smoking and drinking can come about by lack of material wealth and are accepted as the norm within lower class cultures.
Bibliography
Taylor, P, Richardson, J et al, 2005
Sociology in Focus. 1st Edition
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Haralambos, M & Holborn, M, 2004
Sociology. Themes and Perspectives. 6th Edition
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Public Health: Policy and Politics. 1st Edition
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http://www.jobcentreplus.gov.uk/jcp/customers/outofworkhelplookingforwork/getting_job_ready/programmes_to_get_you_ready/new_deal/index.html
Accessed: 11th April 2008
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Published on 17 January 2006 at 9:30 am
Accessed: 11th April 2008
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ww.statistics.gov.uk/focuson
Accessed: 11th April 2008
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http://www.statistics.gov.uk/STATBASE/xsdataset.asp?More=Y
Accessed: 14th April 2008
