Health and Its Determinants - Coursework Example

Health and its Determinants Introduction WHO constitution defines health as "a of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (WHO). We can also say that along with it health is the ability to organize socially and economically creative life. There are many factors that can influence on the health of a person like; Income, Employment, Health Deprivation and Disability, Education, Skills and Training, Barriers to Housing and Services, Crime and the Living Environment. In this study we are going to discuss few of the factors that may effect on the health. Education and Health The majority of education professionals would probably agree that learning can and often does have positive effects upon learners’ health, particularly their physiological health. Such beliefs are the basis of government funded initiatives such as National Healthy School Standard, and the education streams of Health Action Zones and Health Improvement Projects. The green paper entitled ‘The Learning Age’ (DfEE, 24) sets out a board vision of learning: “Our vision of the learning age is about more than employment. The development of a culture of learning will help to build a united society, assist in the creation of personal independence and encourage our creativity and innovation.” It is well-established in the research literature that individuals who have been in education for longer and who have higher qualifications tend to be more physically healthy and less prone to depression than their less educated counterparts. Of course, this might be because relatively healthy individuals and/or individuals who are likely to be healthy in the future tend to stay in education longer and achieve educational success. An alternative explanation is that education itself makes people healthier. Research analyzing the inter-relationships between years of education and health throughout people’s lives indicates that both explanations account for the associations between education and health (Demaine, 6). What is of interest here is that there is evidence that education does have an impact upon physical health and does protect individuals from the onset and progression of depression. Education benefits individuals by enabling them to move up or retain their position on the socio-economic ladder. However, assuming that overall levels of wealth remain unchanged, this aspect of education does not improve the situation of those who are left behind. Income and Health Inadequate health care from prenatal to early childhood and on into young adulthood results in higher mortality and morbidity rates as well as lower immunization rates for low-income and minority groups. Unfortunately, poor health care is not an isolated factor, but instead influences the development of characteristics that subsequently constrain employment and occupational choices and, therefore, socioeconomic mobility. (Poulton , 1640) In addition, low status and income occupations frequently are more hazardous and have substandard work environments. All of this suggests there are strong mutual influences between health care, health states, and income. Human capital and marginal productivity theory envision individuals making choices concerning their personal productive characteristics with respect to their expected future rate of return. Individuals who are future oriented, ambitious, self-sufficient, and productive choose to invest in education, training, and health and, consequently, receive a compensatory rate of return. Those individuals who freely and voluntarily choose not to invest in their human capital also receive their fair economic reward. The different rates of return result from voluntary choice and reflect different characteristics. (Sacker, 765) Neoclassical economics celebrates the concepts of individualism, self-sufficiency, utilitarianism, and efficiency. These words have been the underlying justification behind much of the health care debates. Individualism and free choice have been the watch words that propelled both industry, government, policy, and the medical profession. Any impingement on these basic rights hinders economic efficiency and reduces social welfare. The accepted theories of health, both in the nineteenth and twentieth centuries, have typically been reductionist and individual based. The responsibility of health and the quantity of health care purchased is placed squarely on the individual, as is the distribution of income (Department of Health, 11). This emphasis encourages policymakers to ignore the social patterns of mortality and morbidity rates and avoid any discussion of social change. While neoclassical economics focuses on the individual, institutional economists recognize as important and fundamental processes that neoclassicism ignores. Institutionalists argue that the norms of the institutional arrangements are significant in the determination of income. (Mackenbach, 1656) They acknowledge the role of power, corporate and government, and of other social structures that are integral in distributional decisions. The development of medicine as a scientific field institutionalized a status of respect for the profession. It also led to physicians protecting their vested interests in an evolving world. In conjunction, the conflicts between the corporation and the worker, the corporation and the state, and the state and the worker have played themselves out historically in the context of health and income distribution. It is within these evolving relationships that institutionalists should focus their analysis in addressing the interconnection between health and income. Living Environment and Health If all of those whose life style choices have health consequences were required to bear the full burden of those consequences, there would be few of us (and few diseases or injuries) that would not be implicated. While the medical hazards of smoking and alcohol consumption are well known, the medical consequences of other kinds of action are less established or less obvious. Those who consume excess fat or insufficient fibre have increased risk of some kinds of cancers (and, possibly, heart disease). On the other hand, those who eat too many carbohydrates run the risk of the most common disease, dental cavities. Those who engage in unprotected sex run the risk of several different illnesses; those who engage in protected sex run risks from certain types of protection; (Ridgley Ochs, 61) those who engage in no sexual activity may run yet another set of physical, emotional, and psychological risks. People who choose to live far enough away from where they work or shop so that they have to drive to those sites substantially increase their chance of death or serious bodily injury in an automobile accident. Those who choose to work as miners or police officers or loggers run a greater risk of violent or accidental death than do the rest of us. Although being unemployed also substantially shortens ones life expectancy. Those who participate in certain sports (including skiing, boxing, hang gliding, and statistics suggest, baseball and football) risk severe injury. Poverty is a lifestyle with adverse health consequences. (Suzanne, 34) Those who are poor are at much higher risk of illness than those who are rich. People who do not become vaccinated against measles are at risk for that disease, and those who forego their winter flu shots put themselves at greater risk of that sometimes fatal disease. (Kristin, 19) Those who allow themselves to live with high blood pressure put themselves at risk for a whole range of diseases. Those who do not participate in a symptomatic screening for breast cancer, colon cancer, lung cancer, heart disease and other diseases are at greater risk of death from those diseases. Employment and Heath For most individuals, basic life requirements are met through employment. However, works does much more than supply the means for meeting physical needs; it also can satisfy creative urges, promote self-esteem, and provide an avenue for achievement and self-realization. Conversely, unemployment might be expected to increase anxiety and depression, lead to lower self-esteem, and produce adverse physical health consequences, particularly when efforts to locate work are met with failure over a long period of time. Unemployment has occurred in the lives of many people in this country during the past decade. Despite some recent decreases in the numbers of persons unemployed, it has been estimated that more than 9 per cent of the work force will be out of work in 1984. (Kennedy, 62) Individual accounts of the divesting impact this can have on day-to-day living cannot be ignored. In terms of research regarding the effects of unemployment, both macro and micro studies have contributed to increased understanding over the last two decades. However, research results sometimes have been conflicting and ambiguous partly due to differing research methods, different populations under study, and different interpretations of the data. The strengths and weaknesses of previous research have been done rather extensively by others. One underlying theme which helps to provide some organizational perspective in reviewing previous findings regarding unemployment is that unemployment is considered a stressful event which has the potential for affecting mortality and/or morbidity whether one is examining national trends in health and death rates (macro) or specific changes in selected individuals over time (micro). The extent to which life and physical and psychological health are affected is the subject of study, Catalano and Dooley emphasized the need to broaden the concept of unemployment stress to the stress of economic change. Kansas City economy showed that residents reported more stressful events and affirmed more depressive items following economic fluctuations. (Braginsky, 70) The Work and unemployment Project, a panel study looking at the effects of involuntary loss of jobs by husbands showed that being without work was strongly associated with higher levels of psychiatric symptoms. Once reemployed, the strain observed during the unemployment period diminished to levels below those of the control group (those persons not experiencing unemployment during the study period). Other investigations dealing with psychological consequences of unemployment have shown that inpatient first admissions to hospitals in a state system are significantly related to economic downturn for low status occupational groups and that there are significant relationships between hospital readmission rates for psychiatric reasons and unemployment. (Brenner, 145) Physical Disability and Heath Youths with disabilities often face extraordinary problems and stresses that augment the usual problems experienced by adolescents without disabilities (Wallander & Siegel, Press). That is, the tasks of adolescence, when superimposed on the limitations created by developmental disability, often lead to self-doubt along with difficulties in coping, parent-youth communication conflicts, family adjustment concerns, and family care giving problems. Although there has been a heightened interest in research on health behaviour of able-bodied adolescents (Schulenberg, Maggs, & Hurrelmann, Press) and adolescents with some chronic physical conditions there has been a paucity of information about specific health behaviours of youths with developmental disabilities. The available current discussion seems to focus on understanding the young peoples use of coping strategies, the medical management and conceptualization of health risks, and the importance of societal integration in school and vocational job training opportunities. Gaining emotional as well as physical competence is often quite difficult for youths with disabilities, especially when it is further compromised by cognitive limitations, frustration with communicating, lack of normal biologically expected developmental changes, physical problems, coping with inaccessibility, and lack of new opportunities for making choices. Depression, then, is one of the most frequent secondary conditions associated with the emotional status of adolescents with disabilities. Their depressed state often contributes to inconsistent personal care leading to other physical and medical secondary conditions, sometimes accompanied by acting out in the family, inappropriate sexual behaviour, and even substance abuse and is frequently associated with learning disabilities (Bergman, 54). Consequently, youths successful health adjustment to adolescence may be based on their stress-processing mechanism (Wallander & Varni, 210), that is, youths cognitive appraisal and coping strategies interlock with youths functional independence, individual condition parameters (degree of severity, brain involvement, and visibility), and intrapersonal (temperament, competence, motivation, and problem-solving ability) and socioecological factors (family environment, social support, parental adjustment, and utilitarian resources). Together they mediate their degree of psychosocial stress (condition related problems, major life events, and daily hassles) and ultimately affect youths overall adjustment. Thus, successful adaptation in adolescence requires not only the attachment of a positive outlook to ones disability, the use of competent stress processing, and the appreciation of developmental maturation but also an access to tangible services. Conclusion In conclusion of the above discussion on the impact of different factors on the health of a person we find that each additional year of education has positive returns in terms of income and socio-economic status along with it individual s of higher socio-economic status tend to be relatively healthy both physically and psychologically a phenomena referred to as health inequality. It was found that poor families are much more likely to ignore or postpone medical care until it is too late and serious health consequences have resulted. In addition, occupational status further exacerbates the health gap between rich and poor. In general, those individuals and families living in poverty are much more likely to experience the social and economic effects of ill-health, including low income. To ignore the effects of ill health on income or the effects of income on health is to ignore the invidious uses of power. The allocation of health services and the dominant theories of disease are reflected in public policy decisions, which then serve to further entrench the status quo. The rich variety of life style choices for which individuals may bear moral responsibility and the various health consequences of those choices suggest that no analysis of the propriety of imposing that responsibility may apply to every person or every condition. We find that unemployment produces adverse psychological symptoms and that utilization of health services, when they are available, is increased substantially. Some individuals may be able to cope better with the stress of unemployment than others. People with strong support systems and greater self-esteem seemed to experience less unemployment stress (Phillips, 36). Identifying those who are at high risk for psychological and physical problems and finding ways of preventing them from suffering the adverse effect of unemployment are important areas for further study. Current health care policies have been remiss in promoting good health for youths with disabilities. It has become apparent that good health represents a quality-of-life issue and reflects many complex factors. The contexts of adolescence address the effects of affiliations, educational transitions, maturation, and health-risks connection. The social work role encompasses a proactive family-cantered approach emphasizing growth-producing behaviours and resource-based interventions. In this way, youths with disabilities will be able to reap the full benefits of life. 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