Social Determinants Of Health: Factors Affecting Health Inequality Essay.

Consider how social factors affect peoples health with reference to the work of Marmot. Critically discuss TWO examples of their interventions that have been developed in order to address inequalities at a national or local level.consider why these were introduced and evaluate their effectiveness. 

The Impact of Social Circumstances on Health

The human body needs to be part of a society, fitting in the society leads tohealthier, more content people who are healthy both mentally and physically. Nevertheless, people who are less privileged have a shorter life span than rich people do. These differences in health are health injustices (Marmot 2006). The following paper discusses the social determinants and factors that lead to differences in health within the social sphere. Furthermore, the paper critically discusses interventions developed to address inequalities at either the national or local level. In addition to that, it considers why they were introduced and evaluates their effectiveness.

The social circumstances strongly affect health of people globally. Poor social factors affect the health of people.Furthermore, the extremely poor are at a higher risk of a serious disease or premature death as opposed to the rich. Most causes of death and diseases are more prominent at the lowest level of the social hierarchy.Poor health among those people who live below the poverty level is a show of material disadvantage, effects of insecurity and lack social integration and anxiety(Marmot 2006).

People who live in the lower social gradient are more disadvantaged in various ways such as; having few assets, poor levels of education, insecure employment, poor housing anddifficulty in raising families.The more such people live in such dilapidated conditions, the more they suffer a greater psychological wear, and their chances of enjoying a healthy old age are very limited (Kelly, Sacker & Del 2011). 

Life consists of critical transitions from childhood to old age.This can affect the health of an individual because the transitions move a person either to a more disadvantaged or less advantaged path.Welfare policies offer springboards especially to the poor to offset an earlier disadvantage (Wilkinson & Marmot 2003).

Good health is achieved by reduced levels of failure in education, job security, andincome. Policy makers need interventions to ensure thatfew people are disadvantaged.Policies for employment,education, and housing affect thestandards of health.Citizens need to be fully engaged in the socio economic and cultural aspects of the society since it encourages people to be healthyinstead of leaving them exclude, insecure and deprived (Institute of Health 2011).

Stress

Socialand psychological circumstances are major causes of long-term stress. Low self- esteem, insecurity,lack of controlat work or home, and continued anxietyhas massive effects on the health of an individual. Psychological problems facilitate poor mental health. Furthermore, they also increase chances of premature death (World Health Organization 2008)

Causes of Health Inequality in Society

Stress damages any area of life; the stress that followsan emergency activates hormones, which affects the immune system and the cardiovascular system.The hormones prepare us for anything by elevating the heart rate, increasing alertness and anxiety, or diverting blood to muscles.When this biological response to stress is activated too often and for longer periods, it has multiple effects on the health of a person such as increased chances of getting infections, depression, cholesterol in blood, high blood pressure, stroke and risks of heart attack. Moreover, the lower people become in social hierarchy, the more they become susceptible to stress and resultant health problems (World Health Organization 2008).

Stress is controlled medically by the use of drugs in response to the biological changes within the body. However, attention needs to be focused on the cause of the disease. In schools, workplaces or businesses the social environment is important to the health of a person same as the physical environment (Christopher 2012).

Institutions should prevent stressful situations by giving people a sense of belonging and valuing people, this would inturn positively affect their health by reducing stress.Welfare programs from the government need to address causes of anxiety and insecurity such as psychosocial needs. Furthermore, the government needs to encourage social activities, and support people with young families andstop social isolation. This intervention would be effective on the health of the person as a stress management strategy (Institute of Health 2018).

Unemployment.

Job security increases job satisfaction, well-being, and heath.However, unemployment negatively affects health. Health risks are higher in regions with higher rates of unemployment, which leads to higher incidences of premature deaths.The health effects caused by unemployment are linked to the financial problems and the psychological consequences of unemployment such as debt. Job insecurity is detrimental to health. Job insecurity increases effects of self-reported ill health, heart disease, and mental health (Marmot 2010).

In the recent years,there have been problems in many economies thus leading to more people feeling insecure in their jobs and increasing rates of unemployment, which acts asa chronic stressor (Marmot, Friel& Bell 2008). 

The interventions on unemployment have three goals. The first goal is to prevent job insecurity and unemployment, reduce hardships in employment, and find secure jobs. Governments should manage the economies effectively to prevent highs and lows in the business environment thus improve on job security, and reduce unemployment.Working hours should be reviewed since long working hours leads to poor health.The quality of education shouldbe improvedto enable people get quality and secure jobs, this would go in a long way to curb unemployment (Marmot 2010).

The Effectiveness of Interventions to Address Health Inequality

Work.

The risk of diseases increases when the workplace is stressful. Stress has a negative impact on health. Health at the workplace is compromised when people lack the opportunity to use their skills, and they have low authority especially in decision-making (Michael & Jessica 2018)The low authority over decisions and low control over work leads toill health due to stress and cardiovascular diseases (Marmot & Bell 2012).

The next factor that affects health at the workplace is rewards. Inadequate rewards leads to low motivation hence rise of cardiovascular diseases.Rewards can take different forms such as money,self-esteem, or status. The current change in labour laws is a major hindrance togetting appropriate rewards. Therefore, the workplace psychosocial environment is a major contributor to health and it needs major interventions (Morris, Deeming & Wilkinson 2010).

A virtuous cycle needs to be established at the workplace; improving the conditions at the workplace. This will lead to improvement in productivity. Moreover, employees need to be involved in decision making at work, this is beneficial to them, and it contributes to better health. Next, practices at the workplace and offices should be redesigned to allow more control, more opportunities, and greater varieties for development at the workplace. Workers deserve rewards, as this will lead to appropriate results in term of self-esteem, money, and status. Musculosketal disorders need to be reduced at the workplace, this can be done by ensuring that the workplace is appropriate ergonomically, and work is organized properly (World Health Organisation 2008). 

Transport

Healthy transport is achieved through walking, cycling,and a better public transport system.These reduce fatal accidents, they provide exercises, reduce air pollution, and increase social contact.People need to find ways of building exercises in their lives because mechanization has reduced exercise. This can be done via cycling, walking, improving and expanding the public transport and reducing over reliance on cars.Regular exercises reduce the risks of heart diseases, limit obesity, and reduce the onset of diabetes. Furthermore, regular exercises protect the old from depression and promote a sense of well being (Wash & Jones 2010).

Planning the urban environment will help in reducing traffic byseparatingcyclists and other road user from vehicles, since accidents caused by vehicles are fatal than those caused by cyclists (Walsh & Jones 2010).

Moreover, social interaction is promoted through walking and cycling as opposed to cars that insulate people from each other.Furthermore, isolated streetscease to be social places. When people are isolated such as in suburbs, they face loneliness thus leading to ill health (Michael & Jessica 2014).

Psychological Circumstances and the Risks to Health

Reducing traffic on the roads reduces pollution from vehicle exhausts. Walking and cycling reduces the use of renewable energy that leads to global warming and effect of greenhouse gases on health (Walsh & Jones 2010). 

The use of cars is rapidly on the rise across Europe despite its effects to the environment. In contrast to this,walking or cycling is reducing across the continent.The main intervention is to reverse the trend and allow more cycling and walking (Walsh & Jones 2010).

Roads in urban areas should be designed to accommodate more cyclists and walking pedestrians. The public transport needs improvement through increased government financial support.The use of cars should be reduced by removing spaces for car parking, dedicating roads to more pedestrians and cyclists, increasing lanes for buses, reducing the growth of suburbs with fewer people, and creating supermarkets on the outskirts oftowns (Walsh & Jones 2010).

The following social determinants of health affect people’s health either negatively or positively. They include; the social gradient, stress, work, unemployment, and transport. Policy makers have formulated interventions and outlined their effectiveness in handling the inequalities that are posed by the social determinants of health 

Reference List

Christopher, W 2012, Health inequalities in primary care: time to face justice, PubMed, viewed 23 March 2018,

Institute of Health 2011, Health inequalities, a challenge for local authorities, International Journal of Epidemiology, vol. 39 no.1, p.24.

Institute of Health 2018,  Enable all people to maximize their capabilities and have control over their lives, Institute of Health, viewed 23 March 2018 , <https://www.instituteofhealth.org/resources-reports/enable-all-people-to-maximize-their-capabilities-and-have-control-over-their-lives>

Kelly , Y,  Sacker, A & Del, B 2011, What is the role of the home learning environment and parenting in reducing the socioeconomic gradient in child development? Findings from the millennium cohort study, Archives of Disease Childhood, vol. 96, no. 23, pp 832-837.

Marmort, M  2010, Fair Society, Healthy Lives .Strategic Review of the Health Inequalities in England post 2010,Institute of Health Equity, viewed 23 March 2018,   <https://https://www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review> 

Marmot, M  2006, Social Determinants of Health, Oxford University Press, London.

Marmot, M & Bell, R 2012, Fair Society, Healthy Lives, Institute of Health Equity,  viewed 23 March 2018 , <https://doir.org/10.1016/j.puhe.2012.05.014> 

Marmot, M, Friel, S & Bell, R 2008, Health equity through action on the social determinants of health,  Lancet, vol. 372, no. 57, pp. 1661 – 1669.

Michael, M & Jessica, J  2014, Social Determinants of Health Equity, PubMed, viewed on 23 March 2018, < https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151898/>

Morris, J, Deeming, C & Wilkinson, P 2010, Action towards healthy living for all,  International Journal of Epidemiology, vol. 39, no. 4, pp. 266 – 273.

Walsh, D, & Jones, R, 2010, It is not just deprivation; Why do equally deprived UK cities experience different health outcomes, Public Health, vol. 124, no. 2, pp. 487 – 495.

Wilkinson, R & Marmot, M 2003, Social Determinants of Health. The Solid fact, 2^nd edn, Oxford University Press, London.

World Health Organization 2008, Closing the gap in generation in health, Health equity through action on the social determinants of health, vol.12, no.4, p.16