The modern era that we live in have lead to immense developments in the fields of social care and health care. Crisis in the various sectors have paved the way for the wide spread acceptance and utilization of these settings. Concomitantly with the growing popularity and usage of these domains, the issues pertaining to discrimination, labeling and stigma have also penetrated that in turn thwart the living of the people affected by the situations. Thus adequate knowledge relevant to the social position and health supported by awareness regarding the impact of ill health on social roles and responsibilities is desirable to address the ensuing situations accordingly. Further, appreciation of the discrimination as encountered by specific communities as a consequence of illness and disability is considered integral to the facilitation of an ideal environment suitable for fostering health and equity. Therefore, the following assignment will emphasize on assessing and analyzing the various factors that exerts their effects on the diverse service user groups or recipients of healthcare as well as social care.
Among the prevailing conditions that link the association between the healthcare outcomes and the treatment modalities, discrimination is considered as a crucial determinant. Distinctions made between the individuals in terms of age, gender, disability, race, religion, sexual orientation generally leads to the discriminating behaviors and attitudes among the caregivers and professionals intimately associated with the healthcare and social care settings. The direct interaction with the public by these personnel poses great challenges and barriers to account for quality care in addition to maintenance of equality, diversity and social justice. Specifically in the social care network promotion of social equity is imperative to the acknowledgement and valuing of diversity (Thompson 2016). In this context, example may be cited of a clinical condition in which a person suffering from a specific mental health condition likes that of schizophrenia faces the adversities due to discrimination, labeling and stigma. The ensuing mental health as well as physical health issues stands on the way of leading normal lives in such persons. In schizophrenia, the person generally encounters problems that affect his or her perceptions, thoughts and emotions. Hence, the discussions may be carried out in this perspective where a person is having mental health problem. Further examples may be cited with reference to refusal of treatment provision for PLHIV (People Living with HIV/AIDS). Further care provision in case of these patients in a separate setting in clinics treating patients having sexually transmitted infections add to discriminating attitude.Health care system distrust has been identified as a resultant due to prior experiences of racial discrimination and racial differences. In a study conducted with respect to the African Americans and the Whites, it was found that the African Americans express greater degree of health care system distrust that may be attributed to the varied and higher encounters of incidence pertaining to racial discrimination compared to the Whites (Skosireva et al. 2014). Considering this, efforts related to the elimination of racial discrimination and restoration of trust is pivotal. Thus upholding the needs and demands of the healthcare receivers is crucial to address the health related issues, well being as well as the emotional needs of the concerned persons (Armstrong et al. 2013). The discrimination evident in the healthcare industry is not restricted to the service users alone, the fellow caregivers are also prone to discriminating behaviors because of presence of factors connected to gender inequality, aging, racism and mistreatment of the people belonging to the transgender community (Kydd and Fleming 2015). Further studies investigated the impacts of interpersonal as well as institutional racism in addition to the discrimination prevalent within the healthcare settings upon the healthcare provided to the racial or ethnic minority patients (Paradies, Truong and Priest 2014). Patient perceptions and implicit biases due to the care delivery provisions by the healthcare providers were among the frequently explored concepts relevant to the healthcare settings (Shavers et al. 2012). A study took into consideration the idea of perceived discrimination among homeless adults having mental illness within the healthcare settings. The purpose of the study was to explore the prevalence of perceived discrimination as a result of homelessness, poverty, mental illness, problems due to alcohol or drug and adjunct factors of race, ethnicity or skin color. The linkage of the perceived discrimination experiences to the characteristics defining the socio-economic demography, self reported measures of psychiatric symptomatology and substance use as well as Emergency department utilization was done. Understanding of the multiple concepts associated with discrimination that might lead to mental illness and other psychiatric disorders will help to pave ways for suitable strategies that might help to mitigate the problems. The findings of the study revealed that the persistent discriminations in the healthcare industry were related with greater amount of emergency department utilization, a higher degree of lifetime substance abuse in addition to mental health problems. Further the results suggested that perceiving discrimination of one sort was linked with greater chances of perceiving other kinds of discrimination. Thus, the policies and strategies may be designed in a manner to cater to the needs of the vulnerable populations without interruptions made by the health disparities. Social stratification comprising of unequal distribution of political rights, social benefits and status might culminate in the discriminating behavior, essentially considered as an observed phenomenon (Skosireva et al. 2014). Thus social position and health are intimately related to allay the negative impacts of discrimination.
The concept of labeling is there in the scene since a quite long time. It has been accepted as a sociological term supported by a theory that provide explanation for the deviant behavior that culminate in the behavioral clashes with respect to the societal norms. The concept is congruent with the view of deviance that indicates the deviant behavior as observed in a person to be a resultant effect of being labeled as deviant. In social context, labeling is evident in cases of the persons with disability and even in children having autism spectrum disorders. The prejudices and norms inculcated within the stereotypical mindsets of the people limit them from accepting any deviant behavior from such persons (Copel and Al-Mamari 2016).The labeling concept was proposed by Howard Becker in the 1960 s that manifests mental illness as a consequence of the societal influence. According to the final report published in the year 2008 by the World Health Organization Commission evaluating the social determinants of health, the causative factors for the generation and reinforcement of health inequities were identified. Social injustice coupled with poor social policies and programs, improper economic arrangements in addition to bad politics were the chief contributors of health related disparities. Social determinants of health encompass conditions in which a person is born, lives, work and finally age with the effects being carried by the circulation of money, power and resources. Thus the social gradient in health outcomes may be assessed considering these factors (Marmot and Bell 2012). Sound knowledge and understanding regarding the health promotional schemes and strategies offer ample insight into the domains concerning healthcare setting and social structure. In this regard reorientation of the various health services, development of personal attributes and skills in addition to strengthening of community action, development of health public policy and creation of supportive environment through incorporation of media play pivotal roles in encouraging health promotion primarily among five key organizational settings such as workplaces, schools, hospitals, neighborhoods and prisons (Naidoo 2016). Now extrapolating the concept of labeling to the healthcare settings it might be suggested that in case of the ill patients, it is suggested that the illness experience is depicted by the primary deviance. In the course of the secondary deviance, the diagnosis carried out by an authorized personnel or physician accounts for the labeling of an individual as either ill or healthy. Thus awareness regarding the impacts of ill health pertaining to social roles and responsibilities may be effectively rendered by means of acquisition of adequate communication skills relevant to health and social care. Empirical research has highlighted and laid necessary focus on skills related to acceptance, active listening, advising, advocacy, unbiased practices, evaluation, assertiveness, counseling roles, empathy, mediation skills apart from other qualities like those related to reflection, spirituality, supervision, time management and others (Moss 2015). In view of this an example may be cited of a study that emphasized on promoting integrated approaches in order to mitigate the health inequities prevalent among the low income workers through application of a socio-ecological framework. The results of the study suggested that both in the context of the workplace as well as the community, effective collaborations between the workers, employers, labor and community advocates as well as the public health practitioners facilitate the promotion of integrated and comprehensive health protection and health promotion schemes (Baron et al. 2014). Thus, propositions regarding holistic development in healthcare by virtue of proper training, adequate research and coalition between the community organizations and various healthcare resources and officials might determine the success of the proposed interventional approaches.
Stigma in health and social care is often perceived in negative senses and is associated with disgrace pertaining to a particular circumstance (Henderson et al. 2014). Till date a number of exploratory research studies have adjoined stigma as barriers to access of healthcare and social care services applicable to various settings. Stigmatization in most of the cases emanate from external factors that include members of the community or society at large, friends and families. Examples of stigmatization are most prevalent in cases of persons suffering from mental health issues. Patients having illness related to bipolar disorder or depression are commonly subjected to stigmatized notions by the society (Gaudiano et al. 2017). Internal stigma though not so common yet is prevalent and constitutes stakeholders belonging to the minority ethnic groups who have limited knowledge and awareness base. In order to procure sufficient knowledge and understanding regarding the stigma among the healthcare professionals towards the patients afflicted by substance use disorders and facilitate the positive outcomes in the healthcare delivery, adequate prudence and pragmatism is required. Analysis and exploration of the data retrieved brought to the forefront the negative attitudes on the part of the healthcare professionals account for suboptimal healthcare delivery in those patients and are quite rampant in those definite healthcare settings (Van Boekel et al. 2013). Further studies evaluated the primary healthcare decisions as a consequence of mental health stigma. The defiance and ignorance of the typical healthcare standards by the healthcare providers also pose impediments thereby making drastic alterations to healthcare decisions that is generally not in line with the usual modality of treatment intervention (Corrigan et al. 2014). The prejudices and societal norms and notions accompany the stigmatizing behavior in persons who seem to alienate others possessing slightly different physical or mental attributes thereby impacting the self esteem and self efficacy in the concerned group. The disabled individuals are worse hit by this stereotypical behaviors and attitudes. They are often encountered with challenges that rob them of their rights to equal and fair opportunity (Corrigan 2014). Therefore inclusion of the patient and public involvement with respect to the health and social care research will suffice these problems and render an atmosphere for quality health and social care facility (Brett et al. 2014).
The facilitation of good health and well being follows the dynamic interaction among multiple variables. Creation of social and physical environments uniformly applicable to all is conceived as effects of the social determinants of health. However, a major hindrance to the safe and sustainable health and social care promotion is offered by discrimination, labeling and stigma like concepts. However, stringent following of the existing guidelines along with proper awareness and educational interventions might aid in fostering an environment devoid of stereotypes, prejudices and discriminating attitudes. Thus in view of the impacts as observed in the service users, right and case appropriate attitudes and approaches by the healthcare professionals is recommendable to provide quality healthcare services to them. Hence, the future interactions with a person with disability or challenged by mental health issues call for showcasing more empathy and humanity to help them out in better tackling their conditions in a non-judgmental manner.
References
Armstrong, K., Putt, M., Halbert, C.H., Grande, D., Schwartz, J.S., Liao, K., Marcus, N., Demeter, M.B. and Shea, J.A., (2013). Prior experiences of racial discrimination and racial differences in health care system distrust. Medical care, 51(2), p.144.
Baron, S.L., Beard, S., Davis, L.K., Delp, L., Forst, L., Kidd?Taylor, A., Liebman, A.K., Linnan, L., Punnett, L. and Welch, L.S., (2014). Promoting integrated approaches to reducing health inequities among low?income workers: Applying a social ecological framework. American journal of industrial medicine, 57(5), pp.539-556.
Brett, J., Staniszewska, S., Mockford, C., Herron?Marx, S., Hughes, J., Tysall, C. and Suleman, R., (2014). Mapping the impact of patient and public involvement on health and social care research: a systematic review. Health Expectations, 17(5), pp.637-650.
Copel, L.C. and Al-Mamari, K., 2016. Stigma in Mental Health: A Concept Analysis.
Corrigan, P.W., (2014). The stigma of disease and disability: Understanding causes and overcoming injustices. American Psychological Association.
Corrigan, P.W., Mittal, D., Reaves, C.M., Haynes, T.F., Han, X., Morris, S. and Sullivan, G., (2014). Mental health stigma and primary health care decisions. Psychiatry research, 218(1), pp.35-38.
Gaudiano, B.A., Schofield, C.A., Davis, C. and Rifkin, L.S., 2017. Psychological inflexibility as a mediator of the relationship between depressive symptom severity and public stigma in depression. Journal of Contextual Behavioral Science, 6(2), pp.159-165.
Henderson, C., Noblett, J., Parke, H., Clement, S., Caffrey, A., Gale-Grant, O., Schulze, B., Druss, B. and Thornicroft, G., 2014. Mental health-related stigma in health care and mental health-care settings. The Lancet Psychiatry, 1(6), pp.467-482.
Kydd, A. and Fleming, A., 2015. Ageism and age discrimination in health care: Fact or fiction? A narrative review of the literature. Maturitas, 81(4), pp.432-438.
Marmot, M. and Bell, R., (2012). Fair society, healthy lives. Public health, 126, pp.S4-S10.
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Naidoo, J., (2016). Foundations for health promotion. Elsevier Health Sciences.
Paradies, Y., Truong, M. and Priest, N., 2014. A systematic review of the extent and measurement of healthcare provider racism. Journal of general internal medicine, 29(2), pp.364-387.
Shavers, V.L., Fagan, P., Jones, D., Klein, W.M., Boyington, J., Moten, C. and Rorie, E., (2012). The state of research on racial/ethnic discrimination in the receipt of health care. American Journal of Public Health, 102(5), pp.953-966.
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Thompson, N., (2016). Anti-discriminatory practice: Equality, diversity and social justice. Palgrave Macmillan.
Van Boekel, L.C., Brouwers, E.P., Van Weeghel, J. and Garretsen, H.F., (2013). Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review. Drug and Alcohol Dependence, 131(1), pp.23-35.
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