Sociological Perpestives in Health and Social Care

In this assignment I am going to write a report explaining the patterns and trends of health and illness in three social groups: gender, ethnicity and social class. I am also going to explain the pattern and trends of health and illness which looks at measurement of health, morbidity rates, mortality rates, disease incidence, disease prevalence and health surveillance. Measurements of health Health is generally measured in negative terms, such as the level of disease and the number of deaths within a population, rather than by analysis of positive indicators, such as the presence of health.Epidemiology is the study of disease origins or cause and how much information about the number of people within a population. Epidemiological data provides valuable information about the number of people a population that are affected by ill health, who die as a result of particular health problems and which groups of individuals are most at risk of developing and dying from particular types of il lness or disease. This information is used to identify and plan appropriate health and social care services as well as health-promotion activities.The most commonly used indicators are morbidity (presence of illness or disease) and mortality (death). (Eleanor Landridge, 2007) Morbidity rates Morbidity is difficult to measure as the information is gathered from a range of different sources. Data is collected by the government as well as the NHS and local authority social services departments through direct surveys of the population such as specific health surveys, and as a result of administrative processes, for example, when an individual visits a GP or A&E department or has an assessment of needs.Some diseases are required to be reported, for example cancers and infectious diseases and so data is collected via this process. The problem with this information is that to some extent it reflects services that are available rather than the true picture of disease incidence. Individuals have to also express their needs through actively seeking medical or social care services. (Eleanor Landridge, 2007) The general household survey is a continuous government population survey this includes questions about peoples experience of llness both acute and chronic within the two weeks prior to the person completing the survey. The individual GHS 2002 interview includes questions regarding health and the use of health services; this provides information about the individual’s view of their health. The measurement of working days lost due to sickness can also provide a measure of morbidity for those who are in paid employment. As a measure, it is limited as it only relates to paid employment and this excludes many women who are at home caring for children or older people as well as those who are retired and unable to work through disability. Eleanor Landridge, 2007) Mortality rates The Office for national statistics is responsible for collecting and analysing data colle cted from a range of sources including the ten year national population census, the GHS and specific health information gathered through, for example, deaths and disease incidence reporting undertaken by GP’s and strategic health authorities. Mortality rates can be compared internationally because most countries hold similar information. Mortality rate are expressed in several different ways.A basis measurement is to express mortality as a number of deaths per 100 per year. However this does not allow the diversity of age within the population which varies over time and between geographical areas. For example, mortality rates in the south-east of England will appear high as there are a high percentage of older people living there. The standardised mortality ration (SMR) is the method used to compare mortality levels across different years or for different sub-populations within the same year.The SMR is useful because it can be used to identify and for comparisons. Infant mort ality rate (IMR) are also used as a measurement of health as this provides information about the number of deaths that occur in the first year of life per 1000 live births per year. The IMR is strongly associated with adult mortality rates as it is sensitive to changes in preventive medicine and improvements in health services. Gender, age, social class and cause of death are variables that can be assessed through analysis of the mortality rates. Eleanor Landridge, 2007) Disease incidence & prevalence Within epidemiology the term ‘disease incidence’ is the proportion of a group that is free of a condition but who develop it over a given period of time, such as a day, week, month, year or decade. It measures the number of new cases that occur in the population. The incidence of a disease will depends on the cause of the disease, for example, why it occurs.There might be an infectious agent which requires certain conditions for transmission, or it may be that the disease occurs due to some genetic factor, with or without certain predisposing environmental conditions. The prevalence of a disease depends not only on the incidence (how often new cases occur in a particular group of people), but also on the course of the disease, whether it can be treated, how long it would last and if people can die as a result of it.Prevalence studies therefore provide a snapshot of how many people in the given population have the specific disease being measured at a given point in time. Disease incidence and prevalence are related but measure different aspects of disease within the population. (Kelly Davis, 2010) Health surveillance Health surveillance is generally related to occupational health screening methods used to identify occupational health hazards for workers. The description has been widened to include the range of routine health screening strategies and methods which begin before birth and throughout an individuals life.Health surveillance is increasingly available, such as screening for specific cancers (breast, cervical, prostate), diabetes, high blood pressure, raised blood cholesterol levels and bone density. All of these are aimed at early detection of treatable conditions and may be targeted at specific ‘at risk’ groups within the population. In this course of carrying out this surveillance, information about the incidence and prevalence will be gathered as many of these treatable conditions may be without symptoms and so not alert the individual to the presence of a problem. Kelly Davis, 2010) 158,900 males and 156,300 females were newly diagnosed with cancer each year in the UK during 2007–09, equivalent to incidence rates of 427 per 100,000 males and 371 per 100,000 females Around 81,600 males and 74,600 females died from cancer in each of those years in the UK, corresponding to mortality rates of 209 per 100,000 males and 151 per 100,000 females Breast cancer had the highest incidence rate in females (1 24 cases per 100,000 females) and prostate cancer had the highest incidence rate for males (103 cases per 100,000 males) ttp://www. ons. gov. uk/ons/rel/cancer-unit/cancer-incidence-and-mortality/2007-2009/stb-cancer-incidence-and-mortality. html The Black report was a document published in 1980 by the Department of Health and Social Security in the United Kingdom, which was the report of the expert committee into health inequality chaired by Sir Douglas Black. It was demonstrated that although overall health had improved since the introduction of the welfare state, there were widespread health inequalities.It also found that the main cause of these inequalities was economic inequality. The result of the black report stated that risk on death increase with lower social classes. People in lower class were more likely to suffer from respiratory disease. Babies that were born to parents in social class V had a higher chance of death in the first month compared with babies of profession al class parents.The report showed that there had continued to be an improvement in health across all the classes, during the first 35 years of the National Health Service but there was still a co-relation between social class, and infant mortality rates, life expectancy and inequalities in the use of medical services The introduction of the NHS intended to present everyone with free healthcare despite of their income and social class status. The general household survey showed that patterns of morbidity were followed to a related class gradient to that of mortality.This showed that people in lower socioeconomic groups reported ill health more compared to those in higher socioeconomic groups. In addition the black report found that working class people did not use health care services often which resulted to them not receiving the care that they required, whereas middle class people used health services frequently and had better care compared to working class people (Jennie Nadioo/J ane Wills/2001) http://sonet. nottingham. ac. uk/rlos/ucel/blackinequalities/Default. html Ethnicity People from minority ethnic groups were found to self-report poor health more frequently and visit their GP more frequently.People from south Asia especially Bangladeshi and Pakistani origins have moderately higher incidence of coronary heart disease and poorer health than other ethnic groups as shown in the graph. There is also a higher prevalence of diagnosed non-insulin dependent diabetes among south Asians and people from the Caribbean, with mortality directly associated with diabetes amongst south Asia migrants around three and a half times that of the general population. Ethnicity refers to: culture, religion, language and history which are all shared by groups of people and are passed on generation by generation.Ethnicity can carry along barriers that can affect health, for example language barrier. People may find it hard to communicate and may find it difficult to explain ho w they are feeling if they are suffering from ill health, this may lead to illness and disease spreading and causing long term health problems. Language and cultural barriers can have major effect on someone’s live, as they will not be able to make full use of health care services. For example Asian women are sometime dependent to seek medical advice from male doctors or they may have problems in speaking English.Some people may be unwilling to seek medical advices as they have suffered from racism or the fear of racism is worrying to them. Diet can bring along factors that can cause health problems. For example someone people may eat food that is high in fat and cholesterol this can lead to ill health if safety measures are not taken. Lifestyle can also cause ill health for example leading an unhealthy lifestyle and not exercising can cause obesity which can lead to a number of illnesses such as coronary heart disease and diabetes. (Eleanor Landridge, 2007) – (Kelly D avis 2010) Social classEven though official statistics must be treated with care, there is overpowering evidence that health and ill-health and life expectancy vary according to social group and especially according to social class. People from higher social class are living longer and enjoying better health than the people from lower social class. (Kelly Davis/2010) The black report was mainly based around social class that middle class and upper class people have better standards of living, quality of life and health than working class and lower class people, as shown in the graph, people from lower class suffer from more illnesses than those in higher class.Today life expectancy at birth remains lower for those in the lower social classes than in the professional classes. Nearly every kind of illness is linked to class. Poverty is the major driver of ill health, and poorer people tend to get sick more often, to be ill for longer and to die younger than richer people. Those who di e younger are people who live on benefits or low wages, who work in unhealthy work places, live in poor workplaces, who live in poor quality housing, and who eat unhealthy food.In modern Britain, lung cancer and stomach cancer occur twice as often among men in manual jobs as among men in professional jobs, and death rates from heart disease and lung cancer, the two biggest causes of premature death, about twice as high for those from manual backgrounds. (Eleanor Landridge, 2007) Gender Gender is also a factor that can affect health. Men and women have different patterns of ill health but males have a higher rate of illnesses. This can be because men and women are expected to have roles which they adapt from society and because of this males are less likely to access routine screening.However women are seen as the carer of the family therefore is able to access them and other health care services. Because of this potential illnesses in women can be identified earlier. As shown in the graph women suffer from more illnesses then men do. Women are more likely to report physical and physiological problems to their GP so the studies that show that women get ill more often then men may not be accurate. The main reason women may be hospitalised is due to pregnancies, child birth, contraception, menopause and menstruation.They also constitute the majority of people suffering from neurosis. Psychosis, dementia and depressive disorders. Because women have higher life expectancy than men they are more likely to use health services longer/ more than me. Even if women do have higher morbidity rates then men or not they are more likely to suffer from cancer, arthritis and rheumatism then men, where as men are more likely to suffer from circulatory diseases and strokes. Life expectancy has gone up for both men and women in the last hundred years but has increased more for women.The main cause of death among men is heart disease, lung cancer, bronchitis, accidents and other vi olent deaths. For women the main causes of death are breast cancer, cervix cancer and uterus cancer also coronary heart disease. Although smoking prevalence has declined dramatically during the past ofur decades, men are still more likely to smoke then women across all ages. In 1974, 51% of men and 41% of women smoked whereas in 2007 these figures have dropped to 22% and 20% respectively. (office of national statistics 2006a, 2009) (Eleanor Landridge, 2007) – (Kelly Davis 2010)