In Australia there is a high prevalence of inequity between the various social classes, leading to disparity in health issues (Peiris, 2008). There has been established a link between morbidity and mortality rates arising from class disputes. While the Aboriginals and Islander people continue to be socially backward with limited access to health facilities, these factors arises from social patterns and not from individual choices. Major areas in Australia continue to receive high quality of health treatments and they have predominantly low incidence of various diseases compared to the SES group. There are various explanations which can be related to explain the causes behind the inequities experienced by the group (Baum, 2014). The scope of this report focuses on my understanding of various inequities faced by the socially backward classes and social model applied that can be used to overcome the same.
The scope of the research is on the class of public effects the inequities in health as result from procedures adopted and data collected. Artifact explanation proves that people’s profession, standard of living and by sex greatly impacts levels of health care (Blas, 2008). I have noted that this analysis of health and class relationship, has improved in 20th century due to the change in occupational structure due to change in education. I have noted that health awareness has enhanced in young generation compare to old. Therefore social changes in environment have gradually improved the class of people and their health in my area This hypothesis has been exculpated by The Black Report (DHSS 1980), which was published by Thatcher government, which includes that artifact explanation are irrelevant in view of inequalities in health and the ways department of health working on health improvement of people. The report layout that deep penetrate statement needs to prove the artifact explanation. According to Sir Douglas Black, class was major cause of health inequalities in 19th century and is natural and the change is inevitable. We live in society where still class exits, but theory of black report was not accepted and was theory being always disapproved by Macintyre (1997) (Van Doorslaer, 2008).
In 1980, the publication of Black Report, by the group on the subject of inequalities in health after Chairman Sir, Douglas Black, President of Royal College of Physicians report revealed that death is natural and usual, it cannot only be avoided by social awareness and is not only depended on class and health. My understanding of the Black report also recommends that though there is continues improvement of health among the people after the introduction of health awareness by wealth division but it marks the wide spread of health inequities, and the death rate ratio has also doubled for lower class compare to that in upper and middle class. But according to social researcher and me, the factor of the Black Report cannot be accepted (Friel, 2011). As per Sally Macintyre (1997) education, profession, circumstances, income have equal role which represents the inequalities in health. Natural Health issue directly associated to social changes as I have noticed since childhood. Poor health effects the education in children, work, and income of the people, lifestyle and behavior among the class. Black Report was issued by government and only limited 260 copies being printed and published on the bank holiday weekend and later in 1982 it was printed by Penguins.
A backward class is more vulnerable from being exposed to life threatening diseases and illness due to staying in unhealthy conditions. I come from a middle income socio-economic background; however I have certain acquaintances from SES group, who experiences lower life expectancy and health status as well. They cannot avail medical facilities and are also mentally backward to come forward and avail such facilities. Hence, due to these factors they experience lower qualities of life and lower life expectancy compared to others (Bourke, 2012). Thus, it can be concluded that socio-economic status greatly influences belief in social or biomedical health models.
Culture of an individual has great influence on their health that is predominant from the rate of hospital admissions. Lifestyle of people can causes of illness as SES group mostly adapt to unprotected sex, drug abuse, illicit use of alcoholic substances and so on. Cultural behaviors are different among the classes (Krieger, 2014). People’s culture of addiction of smoking, inhaling drugs, consumption of alcohol characterize more poor health and high death rate and it cannot be taken as health inequality as per class differentiate. Bad foods habits contribute to the increase of diseases as well as healthcare cost in people are another factor counted as cultural behavior of people which affects the health. From my personal experiences I can reflect on the various factors that contribute and lead to high incidence of diseases. While being socially and culturally placed in non-SES group becomes a hindrance in analyzing the first hand factors that contribute to such diseases. These are the factors which had gone through long debate and Wilkinson (1996) concluded that it cannot be considered as health inequity and personal cultural particular behavior can be handled more easily at a social level by imposing ban on such health injuring drugs like cigarette, cocaine and alcohol.
Professions too according to me affect the health of individuals, depending on stress level at work. Business class people tend to have more stressful life compare to lower class (Beckfield, 2009). Therefore individual health can be cure faster than overall social group by educating them to change their lifestyle. Black Report has stress more over Social behavior rather than an individual marked by Macintyre(1997). Thus, while resorting to poor lifestyles and unhealthy habits, low intake of fruits and vegetables can lead to diseases. A cultural that is more dependent on consumption of meat, cereals and other substances is more prone to lifestyle diseases than others.
Marxist and Weberian (Waitzin1983; 2000; Connell 1988) way of understanding, nature of society is more responsible than an individual behavior that contributes to health care. The role of country’s economic change, political atmosphere also education level of an individual has great impact on health of individuality. Well-being of an economy has growth prospect and state of affairs among the people as it lowers levels of unemployment. I have noted that higher the income, lowers the levels of chronic diseases according to Mathers & Sheffield (1998). As per Black Report, the health of people is directly related to standard of living which is the effect of their employment and unemployment (Kickbusch, 2010).
Poor people cannot afford better lifestyle and hygiene which increase rate of diseases and which cannot be cured due to scarcity of money. Further every decision regarding health and social care including educational institutions, medical profession, nursing, allied health professions and health care institutions affect health care industry along with the state government. Though the government has taken several steps and adequate measures to ensure that health care can be availed by all making them affordable to all extent. ‘Neo Marxism’ healthcare depicts the organization for low SES group. Marx and others elucidation of modern health risk factor cannot be agreed always upon. Economic growth increase the capital of country as whole as well work prospects in people, which opens the door of success, which in turn helps them to make money and better living in regards to food, education, health living Marx’s theory too proves that class and living condition is directly linked to disease and death ratio among the different group of people. While the state government is adopting various measures and taking steps to ensure access of health care facilities for SEs group in Australia and globally, they have not been able to penetrate the impacts to broader sections of the society. More the literacy, more the employment and better the awareness of diseases with increase income. However, structural factors are integral in determining health care penetration rates amongst individuals of the society.
Psychological factor about the income inequality among the social group can be consider as important factor for health inequality, according to the theory by Marmot and Wilkinson(2005). As per them, economic and social growth of the country results in higher income among the people with different standard of living. Unemployment of people with less education leads to stressful life. Concern for daily needs makes them more worried and falls into life rejection. Psychological non acceptable standard of living effects health and practice unhealthy lifestyle in poor as well as higher income group people. Primary health care (PHC) in Australia has been marginalized however, the social model for health care can greatly help to reduce inequities in health care especially amongst low SES group (Germov, 2014).
White hall service invented by Marmot (British Civil Servants,1960) that the expectation of people for increment in work higher there years of living compare to that of lower position employee. The White Hall studies proves that the health inequality does not only occurs in poor people but moreover among the higher grade employees with the probability of heart attack, cancers and other diseases related to more stress (Awofeso, 2011). Another Risk factor which has relatively less effect on health are social living habits of an individual like, smoking, taking drugs, over alcohol and so on, which is more predominant in high class standard people. Lower the income; lower the standard of living, less the factors of chronic diseases according to Richard Wilkinson (1996). PHC is the way forward in health care system to cater to inequities amongst SES group. While PHC in totality has been marginalized but comprehensive PHC can lead to effectiveness in catering to the group in health care systems (Broom, 2014). Selective PHC can lead to reinstating inequities in health care systems, hence structural factors needs to accommodate for PHC such that it can be extended to cater to all.
Reference Lists
Awofeso, N. (2011). Racism: a major impediment to optimal Indigenous health and health care in Australia. Australian Indigenous Health Bulletin, 1-8.
Baum, F. &. (2014). Why behavioural health promotion endures despite its failure to reduce health inequities. Sociology of health & illness, 213-225.
Beckfield, J. &. (2009). Epi+ demos+ cracy: linking political systems and priorities to the magnitude of health inequities—evidence, gaps, and a research agenda. . Epidemiologic reviews, mxp002.
Blas, E. G. (2008). Addressing social determinants of health inequities: what can the state and civil society do?. The Lancet, 1684-1689.
Bourke, L. H. (2012). Understanding rural and remote health: a framework for analysis in Australia. . Health & Place, 496-503.
Broom, A. &. (2014). Global public health.
Friel, S. &. (2011). Action on the social determinants of health and health inequities goes global. Annual review of public health, 225-236.
Germov, J. (2014). Second opinion: an introduction to health sociology| NOVA. The University of Newcastle’s Digital Repository.
Kickbusch, I. &. (2010). Implementing health in all policies: Adelaide 2010. Adelaide: Department of Health, Government of South Australia.
Krieger, N. (2014). Discrimination and health inequities. International Journal of Health Services, 643-710.
Peiris, D. B. (2008). Addressing inequities in access to quality health care for indigenous people. . Canadian Medical Association Journal, 985-986.
Van Doorslaer, E. C. (2008). Horizontal inequities in Australia’s mixed public/private health care system. Health Policy, 97-108.
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