P3

P3 – Explain patterns and trends in health and illness among different social groupings.
For this task I have been asked to produce a report to investigate which social groupings are most in need of health and social care services. To assist in the planning of care provision in my report I will be explaining patterns and trends in health and illness among different social groupings identified according to factors such as gender, social class, geographical location, ethnicity and age.

SOCIAL CLASS AND PATTERNS OF HEALTH AND ILLNESS
Social class is an intricate issue that consists of status, wealth, culture, background and employment. The association between social class and ill health is far from being straight-forward. There are many influences on health and one of them is social class.

The Black Report on Inequalities in Health Care was commissioned by the Department of Health in the United Kingdom by Health Minister David Ennals in 1977. They wanted to point out why the NHS was failing to reduce social inequalities in health and to investigate the problems. Ennals would do this by analysing people’s health records and lifestyles from different social class backgrounds. Ennals found that the overall health of the nation had improved but the improvement was not equal across all social class backgrounds. The gap in inequalities in health between the higher and lower social classes was widening.

Ethnicity
“According to the 2001 census 8% of the UK’s population is of an ethnic minority. It represented an increase by approximately 50% in the decade 1991-2001. The majority of the ethnic minority were Indians, Pakistanis and mixed ethnic backgrounds. (1)”

In many population groups whether they are grouped by ethnicity or religion have many difference in ways of illness behaviour and seeking help with beliefs and health queries. In some ethnic groups, some illnesses and diseases can be more common than others, for example “men from Indian backgrounds are more susceptible to cardiovascular illnesses. (2)” As a result of these statistics it has promoted further investigations into the detection of cardiovascular diseases and the risks within different ethnic groups.

Social Class
The two social groups that are being compared are social class and ethnicity. These two groups can effect health elated issues and explain sociological perspectives, patterns and trends.

Poverty and inequality in social order have consequences on the social, physical and mental well-being of individuals. “The infant mortality rate (IMR) children born to underprivileged parents are at more risk than that of a child born to more privileged parents. (3)” People from higher social classes are much less likely to die of illnesses such as cancer, heart diseases and strokes and would be likely to live longer compare to others of lower social classes. The Black Report which was introduced in 1980, studied the health differences of people by dividing the population into five social classes and offers information on how social and environmental issues of health and illness and life expectancy can be related to one another. “There is overwhelming evidence that standards of health, the incidence of ill health or morbidity and life expectancy vary according to social groups in our society especially to social class. (4)” An explanation of this is that the higher social classes can afford to pay for private health care. Their level of income is a lot higher which results in a better lifestyle and accommodation. Whereas people who were in less paid jobs result in poor housing and a reduced amount of money to provide food and heating.

According to the Office of National Statistics, “life expectancy in the United Kingdom increased by approximately 20 years for both males and females between the periods of 1930-2009. Life expectancy in 1930 for males was age 58 and for females 63. A 33% increase occurred since then which put life expectancy up to age 78 for males and now a 30% increase for females to age 82. Life expectancy was at its highest in England between the periods 2007-2009. (5)” “Increase in life expectancy could be mainly due to the decrease in infant mortality rates. From the period 1930-2010 there was a fall which was recorded as the lowest. (6)”

There is also a difference in health between the different ethnic groups. “According to the 2001 census Pakistani and Bangladeshi men and women in England and Wales reported the highest rates of ‘not good’ health. Women are mostly likely to rate their health as ‘poor’ compared to the men. (7)” Reporting poor health has been linked with the use of health services and mortality. Pakistani and white Irish females in the England had higher doctor contact rates than females in the general population. Males from Bangladesh were three times likely to visit their doctor than males from the general population after standardising for age. (8)”

“According to the January 2007 report by the Parliamentary Office of Science and Technology, Black and Minority Ethnic (BME) groups generally have poorer health than the rest of the general population, it was proposed that the poor the position of socio-economic BME groups is the main reason which is motivating ethnic health inequalities. A number of strategies have aimed to challenge health inequalities in recent years, although to date, ethnicity has not been a continuous focus. (9)”
Race, culture, religion and nationality can have a major impact on an individual’s identity. There are many different levels of identification within ethnic groups; many see themselves as British, Asian, Indian, Punjabi and more. Health inequalities are differences in health status that are influenced by variations in society. Influential factors on health may include lifestyle, wealth, housing conditions, discrimination and health services. These factors over periods of time could be passed down through generation through maternal influences and could affect infant and child developments.
Patterns of ethnic inequalities in health can vary from health condition to the next. For example BME groups tend to have higher rates of cardiovascular disease than White British people do but lower rates of many cancers. Ethnic differences in health vary across age groups so that the greatest variation by ethnicity is seen among the elderly people. Ethnic differences in health vary between men and women, as well as between geographic areas.
Ethnic differences in health may vary between generations. For example, in some BME groups, rates of ill health are worse among those born in the UK than in first generation migrants. Sociologists try to describe how society ranks itself but there are many different philosophies for this which often clash with one another. Some of these philosophies include Marxism, Functionalism and Interactionism. Each sociological perspectives has many different views. “The Marxists theory is an explanation of how society works, how and why history unfolded and an account of the nature of capitalism. The theory believes that society is in conflict between two classes. (10)”
“Functionalists argue that society is organized much like the Human Body. Everything must function correctly in order for society to work as a whole, just like every organ in the body must function correctly in order for the body to work as a whole. (11)”
“Interactionism to a play; everyone must play their respective roles in order to create a successful performance - in society everyone must do their jobs in order to create a successful society. This approach is much like the functionalism viewpoint. (12)”
Biomedical Model
It is mainly used by physicians in diagnosing diseases. This approach concentrates on physical processes such as physiology, biochemistry and pathology of a disease. This model signifies freedom from any disease, infection, pain or defect is considered as being healthy although this model does not take into consideration social factors of an individual and the diagnosis is a result of the doctor and patient. It considers the body as a machine and if a particular part of the body is not functioning it must be fixed in order for the body to continue working properly.
The Social Model
The social model is based on how society and the environment affect everyday health and well-being. Influential factors may include social class, household income, education, occupation, poverty and poor housing could lead to ill health. Social media aims to encourage society to provide better housing and to fight poverty to help prevent future ill health in all individuals. Individuals can play a little or no part in interventions to restore the body to health. There is no consideration of the individual’s interpretation of health and ill health or social factor that may contribute to ill health.
Culture
Culture plays an important role in the cause and reasoning of mental health. Cultural beliefs can shape the way people identify stress and the way in which they may seek help. In some cultures people suffering from depression and anxiety disorders can present with physical/psychosomatic symptoms. Britain becomes more culturally enriched, striving as opposed to a salad bowl of clearly defined ethnic groups our society is show adapting. There are many cultural factors which influence mental health for example Asian people in particular immigrants, language, age and gender can be contributing factor. Knowledge of English is an important factor which can influence access to care. Asian languages are not usually spoken outside of the ethnic group. Age is another factor, the younger a person is when they migrate the better chance they have of adapting to living in that particular country. Also gender contributes; men seem to have acculturated quicker than women though this may change as more women enter the working environment. According to the traditional belief system mental illness is caused by a lack of harmony, emotions and sometimes caused by evil spirits. Social stigma, embarrassment, and ‘saving face’ often prevent Asians groups from seeking behavioral and professional health care help.
Mental Health
Labelling of mental health is stigmatizing too much, it makes people think that mentally ill people are a completely separate group of people from others. Society overlooks the fact that they are simply ordinary people who have severe emotional difficulties which they may be failing to cope with. Misconceptions of this label can be fuelled by things such as the media and describe the mentally ill as being dangerous and violent people. Stereotypes like these seem to be contradicted by people’s experiences of mental health, which than can affect not only themselves but their family, friends and even work colleagues. The use of the word mental illnesses could be very misleading, it could be seen that the majority of mental health problems are caused by biological or medical factors. Whereas, in fact, mental health problems result from complicated interactions of biological, social and personal factors. For example someone who is vulnerable to depression but has a strong social support could make them less susceptible to becoming severely depressed.

(1) news.bbc.co.uk/2/shared/spl/hi/uk/03/census_2001/html/ethnicity
(2) www.parliament.uk/documents/post/postpn276.pdf
(3) www.ons.gov.uk/infantmortality
(4) Stretch, B, 2007, Page 361
(5) www.ons.gov.uk/ons/taxonomy/?nscl=Life+Expectancies
(6) www.ons.gov.uk/infantmortality
(7) www.publications.parliament.uk/pa/cm200809/cmselect/cmhealth/286/28608.gif
(8) www.publications.parliament.uk
(9) www.apho.org.uk
(10) www.marxists.org.uk
(11 & 12) www.healthknowledge.org.uk/public-health...health-illness