All over the world,
there are huge discrepancies can be seen in mortality and morbidity, in
particular the mortality rate in UK is growing alarmingly. Inconsistency in
mortality is due to the developmental progress of UK, and this discrepancy
reflected discrimination of access to safe health care equalities (Nilsson,
Griggs, & Visbeck 2016). Mortality indicated the impact of human
development. Low socio-economic and environmental developmental level generally
associated with the high level of mortality and morbidity rates. These
behavioural choices and societal contexts marked as the risk factors that
directly affected the survival of the individuals (Liu et al., 2016).
Over the last few
decades, it was estimated that by the improvement in societal development in UK,
the health of the population also improved and a significant reduction in the
mortality rates have been observed in the society. Societal development has a
great impact on the mortality and morbidity rate in any country by providing the
adequate health care facilities to the needy and helpless people who are not
able to get all the things. In societal development, it is the main priority of
the developmental process to fulfil the health oriented needs of human beings.
Social inclusion promoted by social development. It improved the cohesiveness
of the poor and helpless people so that they could able to get and empowered
for obtaining their basic needs (Eikemo et al., 2016).
UK government with
civil society and private sectors working on the societal development to help
the needy and helpless people so that mortality and morbidity rates could be
decreased. Researches indicated that societal development has a great impact on
decreasing the mortality and morbidity rate of society. Besides the societal
development, environmental development also has a great impact on the human growth
and development of the people. Researches indicated that nearly 26% of the
total mortality rate contributed due to the environmental factors of the
country (UNEP, 2016). Environmental factors promoted infectious and parasitic
diseases like pneumonia, diarrhea and malaria. It was estimated in 2015, these
diseases responsible for around 16%, 9% and 5% of mortality in the UK (Liu et
al., 2016).
Exposure of carbon
monoxide responsible for introduced pneumonia in society. Other than these
diseases, there are also many diseases which were responsible for increasing
the mortality due to the environmental factors. By environmental, developmental
mortality and morbidity rate will be decreases. Economic development also has
its own impact on the mortality and morbidity rate. The economic status of any
country is related to the living standers of that nation. Several studies
indicated that by improving the living standers, mortality and morbidity rate
would be decreased because of the high living standers (Eikemo et al., 2016).
Different living
standards due to the economic situation of the people expressed about the
inequality between economic situations. By this situation of inequality of
economic development also indicated the given rights and opportunities of the
people. Many studies indicated that health and socioeconomic status and social
relationship were interlinked with each other. Higher socioeconomic status
people experienced a lower rate of mortality and morbidity. Health equity is very important for the reducing the mortality ratio. The importance of health equity in health care cannot be overlooked. Unfortunately, the inequality of
health issues is obvious in society.
Root Causes of Health Inequalities
An explanation of the
inequality, three categories have been proposed (Conley, 2014). First is a causal mechanism in which health
and risk of mortality are affected by the socioeconomic status and social
relationships whereas in second category inferior health status is responsible
for the social isolation of the individual and this unhealthy individual also
reduces their social position due to the isolation (Wilkinson & Pickett,
2015).
This category of inequality is known as selection or reverse causation.
In the third category, less frequently appealed explanation includes
artifactual mechanisms, such as measurement error. Studies indicated from
different disciplines that inequality is mainly due to the causal processes
rather than by selection or artifactual mechanisms and proved that mainly there
is an association between socioeconomic status of people and the health and
illness. Welfare societies are working on these health inequalities of society.
Rich welfare societies require a high degree of division in their working
labours (Eikemo et al., 2016).
These societies give
incentives to educate the labour, but these division created inequalities
between the working conditions and the income of the labour that leads towards
the inequality of their socioeconomic status and this socioeconomic inequality
indicated the health and illness inequality of the labours. Where the societal
health inequality occurs in society, societal development is the most crucial
part of that society (Conley, 2014). If this health
inequality followed a large number of people in society, then that society is
not contributed to good health and societal development. Additionally, the
health of the people works as a prerequisite for people’s freedom to live a
healthy life and for the development of the society it is the main priority of
the people (Lynch et al., 2014).
The inequality in
health care facilities can be seen everywhere with regard to age, gender,
ethnicity and races. The female receives more sympathy and protocol at health
care centres due to feminism. While in contrast male experience substantial
difficulties. Similarly, the black African found to be least facilitated in
England health care system compared to the British. The literature is enriched
with racial discrimination concerning the health care system. As far as the age
is concerned, the recent empirical data suggested that the health inequalities
have been found with the elderly population of the society (Bright, &
Kuper, 2018).
Theories of Causation in Health Inequality
Theories of health
inequality and welfare are fundamental in the formulation of policy as it
provides a framework according to priorities and the responsibilities regarding
different groups, and it constructs and notifies people. According to WHO,
certain plans, decisions, and actions that are adapted for the accomplishment
of certain health welfare goals in a community are referred to as health
policy. Directed health policy can attain the following goals: it develops an
intuition for the future, which leads towards the development of goals and
allusion for terms (short and medium).
According to the
bio-psycho-social model, long term discrimination elevates experienced
frequency, intensity, and duration of stress (Eikemo et al., 2016). The people
experience discrimination often develop physical as well as mental instability.
It also effects on cognitive processes which may further impact on the modules
of the stress response, and such behaviour response cycle assist in making
policies to control the adverse impact of discrimination on human minds
(Wittenberg, 2015).
The theories provide
an in-depth understanding regarding how discrimination in health care
facilities impact on different age, socioeconomic or gender groups. Various
theories provide aid to eradicate welfare inequalities; according to social
cognitive theory inequalities (discrimination, prejudices, and stereotypes) can
be counteract through adequate cognitive resources, effort, and motivation,
people can concentrate on the distinctive traits of individuals, and not on the
batch they belong to, in devising opinion, and behavior with each other.
The policies to
educate nurses on how to practice equality in health care with people belongs
to a diverse background found to be effective. Inequality can be eradicated by
the following means: (a) by strengthening internal motivation and by reducing
external pressure, (b) by improving understanding the psychological basis that
causes biasness, (c) by upgrading caretakers trust in their capabilities to victoriously
interact with socially unalike patients, (d) by increasing emotional regulation
to promote positive emotions, (e) by intensifying perspective-taking and
affective empathy, (f) by improving communication with patient (Gori, Fernandez, & Wittenberg, 2015). The inculcation of
such factors helps in making effective policies for the fabric of society
(Nilsson, Griggs, & Visbeck 2016).
Through various
modifications in the model of health promotion and disease prevention, people
are rewarded with health, by providing them with self-regulatory skills to
supervise their health habits and to uphold their modified health habits
through social support. Social cognitive theory, discourse both
socio-structural and personal determinants; individuals rely on their
collective efficacy to attain social change, hence play an important part in
the creation of policy and public health approaches for health promotion and
disease prevention (Gori,
Fernandez, & Wittenberg, 2015). Individual's health depends on the following
contextual factors: gender roles, socioeconomic status, and cultural
differences.
According to conflict
theory, inequality is not defined as the difference, and it can be better
explained as some are availing more in comparison with others; in a social
context-inequality is a disadvantage. In 1945 Davis and Moore presented the
theory of functionalism that states for proper functioning, society should have
people performing their tasks in harmony like judge, politician, doctor, and
teacher, etc (Gori, Fernandez,
& Wittenberg, 2015).
Then according to
their professions, people should be rewarded. According to functionalist
inequality in society is beneficial as it encourages people to earn more
rewards. Another theory presented by Karl Max (1818-1883) known as conflict
theory which states that inequality in society can elevate the level of
competition in society and among people in the society which can cause an
increase in stress within society (Nilsson, Griggs, & Visbeck 2016).
Inequalities are mainly due to differences in social status, income, wealth,
gender, and race. Sexism is the cause of welfare inequality- based on gender
roles are assigned to individuals. Moreover, unequal opportunities provided to
people are due to gender inequality.
Usually, women are
victims of gender equality, issues like HIV/Aids, poverty and illiteracy are
referred to as women issues. Based on racism, a large number of black and
minorities are facing welfare inequality. According to a survey black and
ethnic minorities experiencing inequality within United Kingdom mental health
system, access to higher education, access to culturally appropriate facilities
and services, communication issues, and in acquiring help (Arday,
2018). In response to this discrimination, the government of the United
Kingdom introduced the following policies. The equality Acts of 2006 and 2010
served to arrange and combine all equality rules within Great Britain. Race
relation Act was first introduced in 1965, which was repealed as race relation
Act 1976; this law was given to abolishing the discrimination based on colour,
race, and national origins. The health and social care Act of 2012 puts
clinicians at centre of commissioning, approve providers to empower, innovate
patients and give a new focus to public health (Nilsson, Griggs, & Visbeck
2016).
Furthermore, the
government is working for providing better health care, NHS England shared a
vision about the future NHS England based on new models of interventions and
preventions, collaboration with other agencies and providing better health
choice and control to patients (NHS, 2014). Measures are also being taken to
regulate provider payment, improving efficiency in hospitals, more productivity
in hospital progress and early discharge of patients (The King's Fund, 2015).
The government of the United Kingdom is also providing long term care which
includes residential or institutional care, daycare, home-based facilities and
professional support services like aids and adaptations, occupational therapy
or social work (Wittenberg, 2015).
Conclusion
Although theories have
helped enough in making remarkable policies to promote equality in the health
care system. Still, many gaps have been observed concerning the advancement in
the culture of England. Therefore, more theories and policies should be
formulated to eradicate discrimination or inequality in the health care system.
The formulation of theories and polices can bring about a considerable change
in society, that can leads to the prosperous health care system. England has
achieved a substantial reputation in the health care standard as compared to
other countries. . Individual's health depends on the following contextual
factors: gender roles, socioeconomic status, and cultural differences. These
factors need revised management according to continuous change in the society
and advancement. Therefore, to maintain the level and for making more progress,
fulfilling the current advancement demands are imperative. Furthermore the health equity principles must be intact in society for the betterment of the people's health.
Recommendations
The following recommendations have been made considering the
above-highlighted gaps.
·
Racial inequalities should be eradicated from society to promote
equality, not only for health care facilities but also for community fabric and
social status.
·
The nurses, and health care practitioner should be properly
guided regarding the equality practical implementation as well as vertical and horizontal health care facilities.
·
Polices should be only documentation purposes; the government
should investigate if the policies are being followed in health care centres on
a regular basis.