Individual Responsibility for Ill Health - Essay Example

Introduction The rising concerns on the growing persistence of ill health in society has led to enhanced debate on the factors encouraging the unhealthy way of living leading to outgrowth of diseases and also an investigation of who should be responsible for it. There has been a great emphasis on an individual's responsibility towards health as well as the elaboration of unhealthy practices adopted by them causing illness. It is true although to some extent that individual do tend to have unhealthy lifestyle and adopt negligent behaviour towards their health. However, there also happen to be several environmental and structural causes behind such practices that are ignored by the concept of individual responsibility altogether. Factors such as lack of education, insufficient access to medical facilities, social background, income level, and employment condition tend to have a significant impact on the promotion of unhealthy activities on the part of people. Understandably, these factors driving human behaviour are beyond the control of people and hence, individuals cannot be held responsible for ill health. This paper provides an insightful study on the causes of ill health in the society as pertinent to environmental and structural factors along with the elaboration the notion of individual responsibility as emphasised as the sole cause of growing ill health in the society. The discussion focuses on the extent to which the overemphasis on individual responsibility leads to diverting the attention from major structural and environmental causes for unhealthy practices that should otherwise be dealt with immediately. Environmental and Structural Causes of Ill Health The deterioration of health conditions among individuals tend to be a consequence of several factors, or in other words, it can be stated there happen to be several causes of ill-health encountered in a society. To elaborate this point, a consideration of people dwelling in a society is required, which tend to be divided into several groups and sub-groups on the basis of their lifestyles, living conditions, housing, income level, and class etc. Because these factors determine an individual's ability to access prompt healthcare facilities and live a healthy lifestyle, all of these do have a significant impact on health conditions prevalent in a society. The more the variation in the health status of individuals in a nation, the more likely is the prevalence of inequality in it. Historically, people had been assigning the major causes of ill health to the lifestyles of individuals. For instance, people were regarded to stay cautious in opting for a lifestyle posing risk to their health, as it was their responsibility and within their spectrum of control to stop themselves from unhealthy practices. This trend however changed as people started to develop an understanding of the factors beyond their control and distinctive health conditions prevailing in various sections of the society shed light on the environmental and structural factors as eminent causes of ill health in individuals. Hodgetts and Chamberlain (2000, p328) put forward that, "people today do not just assign responsibility to the 'immoral individual', but renegotiate this explanation and extend it by assigning cause to an 'immoral' and inequitable social system". Social inequality and discrimination among the members of society on the basis of income, class and living conditions play a very important role in the determination of health status of individuals. Allison (1991) emphasises that structural factors relating to social inequality and class distinctions tend to have severe impact upon the health status of individuals. People having access to healthcare facilities on the basis of their income and social condition, lead to the concept of inequitable or unjust society where poor people become easy prey to even minor and avoidable diseases. The unavailability of proper health and safety conditions, poor information regarding the spread of diseases, lack of preventive measures, and inattentiveness of government officials and policy makers towards the provision of healthcare facilities also pose significant threats to the health status of people. In a society where people do not have access to health facilities and are ill informed regarding the adoption of healthy lifestyles, or if substantial differences prevail among individuals concerning these factors, people are likely to confront a vulnerability to diseases and deteriorating health conditions. Cohen (2002) regards environmental and structural problems such as social inequality, poverty, discrimination and deprivation as the root causes of health problems faced by people. These factors also tend to play a significant role in determining an individual's approach to curing diseases and the extent of medical consultation. The social group forced to live with poor employment and housing conditions and deprived of the easy availability of basic health care facilities tend to have lower health status than the people with sufficient job and housing conditions along with easy access to medical services. The study carried out by Hodgetts and Chamberlain (2000) also shows that the "factors such as poor employment, housing conditions and an inability to access services contribute to accidents, illness and premature death" (p331). For instance, people in low-income social group tend to avert medical consultation on time until the condition becomes severe with a view to avoid paying a sum of their earning on health facilities. Hence, the environmental and structural factors should be considered important in contributing towards poor health status or variations in the health condition of people in a society. It should also be noticed that these factors are either uncontrollable or individuals are unintentionally exposed to them. This conception sets foundation for further discussion in the paper concerning the focus on individual responsibility for poor health status and its consequence in terms of neglecting and blurring the important environmental and structural causes behind the prevalence of ill health in a society. Focus On Individual Responsibility- Leading To Obscurity Of Environmental And Structural Causes Of Ill Health There has remained a tendency on the part of government officials and policy makers to regard the health conditions of individuals as their personal responsibility regardless of other uncontrollable factors influencing upon their health. It, in essence, is a notion in which according to Minkler (1999, p123), "the individual is seen as the appropriate focus for intervention to control risk factors, with those interventions typically consisting of providing knowledge and skills for changing unhealthy behaviours". The basis for this perception is that individuals are more able to control themselves to avoid unhealthy practices than others and hence, if they fall prey of diseases, it is due to negligence and adoption of unhealthy lifestyles. So, the responsibility for living a healthy life and adopting healthy practices tend to rest on the shoulders of individuals rather than on state or society. For instance, a smoker is responsible for his poor health conditions due to the adoption of unhealthy living conditions on his part and so on. Brown (2005, p23) asserts that, "it is argued that individuals should save for the future, rely on their own hard work to satisfy their needs and adjust their personal ends to the shares of resources they can reasonably expect to receive over the course of their lives". It is, however, argued that while assigning the responsibility of poor health conditions to the individuals, one remains negligent of various causes of ill health beyond the control of individuals, such as several environmental and structural factors. To hold the individuals responsible for taking care of their health does not tend to be practical in the broader picture. Allison (1991, p146) "there are limitations on the degree to which individuals can control their lives and, specifically, their health". People become helpless in situations when they face discrimination with regard to the conditions they have not chosen for themselves. Hence, individual responsibility tends to blindly blame people for their health problems and does not take into considerations the human limitations. Minkler (1999, p126) says that, "an overriding emphasis on personal responsibility blames the victim, by ignoring the social context in which individual decision making and health-related action takes place". This is true, because if individuals are to be regarded as personally responsible, they will be unjustly blamed for their health status regardless of an investigation of social and other factors that might be contributing to illness. For instance, there could be elements in the environment leading to health problems. In such a situation, it would be unfair for an individual to be held responsible for contracting diseases while he might not even be aware of its existence. Here, the government becomes severely responsible to investigate into the causes of illness and educate people so as to avoid its occurrence. Such a supposition will integrate further discriminations among the members of a society. Minkler (1999 p128) says that, "an overemphasis on individual responsibility for the state of one's body or health may inadvertently contribute to messages that reinforce ageism, prejudice against people with disabilities, and other stigmatising attitudes". If this notion gains acceptance, this certainly would lead to the development of a biased attitude in the society leading people to blame individuals for their health problems for instance cancer, tumour, HIV etc. Leichter (2003) propounds that much of the emphasis, on the part of politicians, government, and several scholars has remained entirely on the health problems caused by individual's careless attitude towards healthy living, however there happen to be conditions that do apply to an individual's ability to lead healthier lives. This refers to differences between individuals within the society in the form of education, living condition and income level. Individuals also tend to know less regarding many diseases existing in the world. Furthermore, this conception focuses on the adoption of unhealthy lifestyle on the part of individuals, without giving any consideration as to what leads them to adopt such a behaviour concerning their health. The determinants of the intensity of healthcare and healthy living in a society not only happen to be individual, but also collective and social. Minkler (1999, p126) elaborates that, "holding the individual responsible for health choices is particularly problematic in the case of the poor, since poverty itself is now widely accepted as among the most significant risk factors for illness and premature death". A society having a higher poverty and unemployment rate is very likely to be suffering greatly from various health problems. The notion of individual responsibility, on the other hand, tends to obscure the significance of these factors by merely emphasising the poor health conditions adopted by people. Similarly, affluent people who are satisfied with their employment and income level are more likely to adopt healthful lifestyle and consult a doctor for even minor problems as compared to the poor ones. Brown (2005, p27) comments that, "the mere fact that some people face social oppression or lack access to the capabilities necessary to function as human beings and equal citizens may provide sufficient reason not to enforce consequential responsibility". Hence, the individual responsibility phenomenon ignores the important aspects of human behaviour with regard to their living conditions and the relevant factors that undermine the chances for them to adopt a healthful lifestyle. It is also argued that this stance is usually taken by the government to get off its responsibility and assuming people to take care of their health for themselves. Minkler (1999, p128) "such a perspective lets government off the hook by assigning blame for premature morbidity and mortality and the like to the individual". Although it is true to some extent that individuals can exert better control on themselves rather than other people and thus are responsible to take care of their health status to some extent. But they should not be treated as solely responsible because their heath condition also reflects the state of factors contributing to the health of society as a whole. The government, on the other hand, endeavours to free itself from this responsibility, as it will require a lot of efforts on its part to identify and combat these environmental and structural imbalances in the society. The focus on individual responsibility obscures the structural and environmental causes of ill health to the extent of ignoring these factors albeit they prevail to a great extent in the society. While the state tries getting off the responsibility it should otherwise assume, the threat keeps on growing causing great loss to the health status among individuals. Its not basically about who is responsible to bring about health problems in society, rather it is concerning the measures and policies that should be adopted to save people from sufferings and health woes. If real and extant causes are persistently kept concealed, the situation is likely to worse off and the government would never be able to take relevant steps to mitigate these threats to individual health. Allison (1991, p150) suggests that, if the government wants to educate people concerning the threats approaching to their health, it should promote "health education programs attempting to enhance individual control and individual responsibility for health should focus specifically on those conditions in which control is possible and for which individual behaviour is efficacious". In this way, the government will able to draw participation from individuals to promote healthful living conditions and thus ensure better prospects for health of the society. In order to realise the significance of structural causes of health problems prevailing in the society and to identify the extent to which these affect people's health, the "effort is needed to reduce inequality and to ensure the social provision of resources to provide health for all" (Hodgetts and Chamberlain, 2000, p333). This effort, as evident, can be undertaken most effectively on the state level rather than on the individual one. Hence, the mere focus on individual responsibility for the dispersion of illness tends to minify the attention that should be given to the true causes of ill health in the society by making the government ignorant and negligent of important determinants of health. Conclusion This paper elaborates and evaluates the notion of individual responsibility for ill health within the context of environmental and structural causes that actually lead to unhealthy practices on the part of people. Assigning this responsibility to the individuals leads to obscurity and negligence of these causes that further enhances the threats confronting the members of a society. Individuals do tend to adopt irresponsible behaviour towards their health, but this should serve to be the reason for blaming them for their poor health conditions. There are certainly factors that are beyond the control of human beings and thus the individual behaviour and approach towards health is significantly driven by these environmental and structural factors. It is also the responsibility of government to educate the people concerning the environmental effects on health patterns, as many unhealthy practices undertaken by individuals is due to ignorance. Apart from that, a consideration needs to be given to the structural forces affecting the society in terms of class discrimination, income levels, employment conditions, deprivation and inequality. The focus on individual responsibility diverts attention from major environmental and structural causes leading to the ill health of individuals and obscures them rather than improving the health conditions in the society. Reference List Allison (1991), "Theoretical Issues Concerning The Relationship Between Perceived Control And Preventive Health Behaviour" Health Education Research: Theory & Practice, 6(2): pp. 141-151 Brown, Alexander (2005), "If We Value Individual Responsibility, Which Policies Should We Favour", Journal of Applied Philosophy, 22(1): pp. 23-44 Cohen, Carl (2002), "Social Inequality and Health: Will Psychiatry Assume Center Stage", Psychiatric Services, 53(8), pp. 937-939 Hodgetts, Darrin and Chamberlain, Kerry (2000), "The Social Negotiation of People's Views on the Causes of Illness", Journal of Health Psychology, 5(3): pp. 325-336 Leichter, Howard (2003), " 'Evil Habits' And 'Personal Choices': Assigning Responsibility For Health In The 20th Century", The Milbank Quarterly, 81(4): pp. 603-626 Minkler, Meredith (1999), "Personal Responsibility for Health A Review of the Arguments and the Evidence at Century's End", Health Education & Behaviour, 26(1): pp. 121-140 Read More