Is there a relationship between poor health and poverty?

activities and have the living conditions and amenities which are customary, or at least widely encouraged or approved in the society in which they belong.Æ(Townsend 1979 in Blackburn1991pg 10). Here poverty is concerned with social needs as well as physical needs. Poverty is generally understood to be the level at which deprivation is inevitable. In TownsendÆs study of poverty in Britain in 1960Æs he calculated that in order to avoid relative poverty a certain income level was needed. æIt is possible to define income levels that are sufficient to enable people to live in varying degrees of discomfort and to indicate a level of income that permits social participation.Æ(Townsend 1979 in Ackers & Abbott1996). The most common way to measure poverty is by household income. There is no official poverty line in the U.K., but where we draw the line depends on what we view as a minimum level of income and standard of living for family and individuals. Poverty in most British studies has been defined as anyone with an income on or below the level of income supplement (100% benefit) is defined as living in poverty. Anyone with an income of 100%-140% of income support is defined as æon the margins of povertyÆ. Surveys have shown that the majority of people regard the poor as being responsible for their own poverty and are suspicious of those who live æfor freeÆ on government handouts. Many people believe that those on welfare could find work if they were determined to. These views are out of line with the reality of poverty whose numbers are made up of the over 65Æs, under 14Æs, ill and disabled the low paid and single parents. Income is a key resource for families and the ones with low incomes are least able to afford or have access to good housing, generally live in poor areas with no play facilities for children and have poor access to health, education and leisure services. Poor incomes donÆt enable these families to buy the correct foods thought to be important to health (e.g. fresh fruit and vegetables) or to be able to keep their homes dry and warm. æPoverty is an experience of doing without that touches every part of life and family healthÆ (Blackburn1991pg12). Official statistics reveal class inequalities when looking at health, with some groups obviously more disadvantaged than others. These statistics were initially revealed in æThe Black ReportÆ 1980, which looked at inequalities in health. Nearly every kind of illness and disease is linked to social class, with poorer people tending to die young and become ill more often than the richer people. Other reliable measures of health came from medical models which suggest that health is related to a host of social factors including income, education, housing and environmental conditions. æDifferences in health experiences and life expectancy between the social classes, between ethnic groups and the genders are the most distinctive form of health inequality in Britain today (Blackburn1991).Æ Social class is the most widely used indication of a personÆs social and economic circumstance. Occupation is also used as the best indicator of socio-economic status and is the basis for The Registrar Generals social class classification. Social class and poverty affects the health of people from birth to old age. æAt almost every age, people in the poorer social classes have higher rates of illness and death then people in the wealthier social classes.Æ(Whitehead1988). Studies of child mortality clearly show a difference in causes of death between the social classes. Low birth weight in babies is associated with social class and thought to be associated with parental poverty and poor maternal environment rather than the quality of medical care. Childhood death rates from accidents (the largest single cause of death in childhood) are a clear example of how living in a poor area, without safe play areas has a serious consequence on the health of children. (Blackburn1991). Class inequalities in health are narrower in adulthood than childhood and statistics tell us that death rates are far higher for the lower classes compared with the higher ones. (Whitehead1988) The poorer social classes are ill more than their richer counterparts and use the health services more often. Almost all major killer diseases affect manual classes more than non-manual classes and in some instances are twice as high in class V, than in class I. According to Browne and Bottrill(1998) there are two main explanations for this, which can be seen, as cultural and material. Cultural explanations look at how health inequalities are rooted in the behaviour and lifestyles of the individual and that those suffering poor health have different attitudes, values and lifestyles which mean they donÆt look after themselves. Inadequate diet, smoking, drinking and lack of exercise all have direct effects on the health of a person. Low income confines the type of food that poor people can buy and therefore the amount of nutrients an individual can eat. (Blackburn1991) These adults in low-income families continue to smoke excessively and the female is more likely to deprive herself of a sufficient diet to enable her to afford the cigarettes. Even though these adults know the adverse affects it will have on their health, they continue with this lifestyle because to them it is a way of coping with the everyday stress that living in poverty has on them. According to Ackers & Abbott (1996) Material explanations enforce the idea that those with poor health canÆt afford to have a healthy diet, live in poor housing with poor working conditions etc. Our Healthier Nation recognised this link and the government has now set targets for improvement of living conditions and aims to address inequality which arises from poverty, low pay and poor housing. By looking at poor health from a social class perspective we can see there is a link between poverty and health. It has been agreed that social class inequalities are products of society and these social and economic factors have major influences on patterns of illness and health. æThe link between poverty and ill health is clear. In nearly every case the highest incidence of illness is experienced by the worse off social classes.Æ(Whitehead1988). The Black report discussed a number of explanations to try to explain why health inequalities exist in relation to the poor. The æartefactÆ explanation argues that the method of measuring occupational class used by the Registrar General increases the size and importance of health differences. That the apparent differences in health between lower occupational groups and those in higher occupational groups are the result of statistical inaccuracies, in relation to the size of the groups measured. Another view is that of æsocial selectionÆ, which argues that people in poor health tend to move down the social scale and become concentrated in the lower socio-economic groups, whilst those in good health experience upward mobility. In other words it is health status that determines social class and not social class that determines health status and that it is inevitable there will be a gap between the higher and lower classes. The third explanation looks at the æbehaviourÆ of people in lower classes and stresses the differences in the ways some social groups choose to live; the behavioural and voluntary lifestyles they adopt. æInequalities in health evolve because lower social groups have adopted more dangerous and health damaging behaviour than higher social groups, and may have less interest in protecting their health in the futureÆ (Whitehead 1987 in Akers & Abbott 1996). It has been noted that people in lower groups tend to smoke more, drink more, take less exercise etc, than those in higher groups. The final view looks at the æstructuralÆ explanations of the causes of inequality. This stresses that those in lower occupational groups are more exposed to poverty and deprivation and that these are the main causes of ill health and early death. That these social circumstances are outside the control of the individuals and emphasise that external environment and conditions in which people live and work play a great part in their health. The Black Report and Healthier Nation, both noted that class differences in health remained and that it could not be blamed on lifestyle choices, as some of the poorer classes donÆt have the freedom of choice others have and because of their circumstances they canÆt always choose to have a healthy lifestyle. Therefore when looking at inequalities in health we must recognise that cultural, material and behavioural factors do play a part and that poverty does affect the health choices of an individual. The present view is more in keeping with the structural explanation and the present government, because of the obvious strong links is trying to address both issues of poverty and health. Bibliography Ackers, L & Abbott, P. 1996 Social Policy for Nurses and the Caring Professions. Open University Press. Browne, K & Bottrill, I 1998. Our Unequal Unhealthy Nation. Sociology Review Nov.1998. Blackburn, C. 1991 Poverty & Health. Open University Press. Giddens, A.1989 Sociology. Polity Press. Rowntree, B. S. 1941 in Blackburn C.1991 Poverty & Health. Open University Press. Townsend, P. 1979 in Blackburn C. 1991 Poverty & health. Open University Press. Townsend, P. 1979 in Ackers, L. & Abbott, P. 1996 Social Policy for Nurses and the Caring Professions. Open University Press. Whitehead, M. 1988 The Health Divide. Penguin Books.