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Health Inequalities

Within this short essay I intend to talk about health inequalities in Britain today, and how pioneers

from the past have helped shape our NHS as we know it today. I will looks at the NHS how

and why it came about, and what changes are about to happen today. I will look at the black

report, the marmot review and the Acheson report.

The Beverage report (1944) was commissioned by parliament on the best ways to help those

on low incomes, and also to tackle growing health inequalities. Its main aims were to put in

place the following measures. All working age people to pay a contribution from their wages,

In return benefits would be paid to the sick or unemployed, and Retired people and widows

helped.

The Second World War provided a step towards a better, healthier society; it resulted in the

Beverage report of 1942. This had five main aims to help overcome, want, disease,

ignorance, squalor and idleness. This was the establishment of the welfare state by a post war

labour government. The main component of this were as follows: A national health service to

provide free health care for all, nationalized hospitals, A new national insurance scheme for

all adults, to provide sickness, unemployment, maternity benefit for all and pensions for the

over 60s. The national assistance act (to provide help for those not already covered e.g.

unmarried mothers and the handicapped. The national industrial injuries act. Child

allowances.

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The NHS was the first of its kind to be implemented by a government and even today it

remains unique. However when the NHS introduced in 1944, it was assumed that it would

eradicate or reduce Britain’s heath inequalities.

Labour set up a welfare state based on the principle of universality: the services

provided by the state should be provided for rich and poor alike, since services

provided for the poor alone would be second rate. [ CITATION mic01 \l 2057 ]

The determinants of health and health promotion will incorporate a number of strategies,

which were first developed within the Ottawa charter November 1986. These strategies

included developing personal skills and knowledge, the strengthening of our communities

and the creation of supportive environments for health. These would be backed by a healthy

approach to public policy. Paying special attention to make sure health services use, health

promotion as a tool, to create better health and lifestyles.

The charter stated that the main resources and fundamental conditions for good health are

shelter, income, education, food, a stable ecosystem, sustainable resources, social justice and

equality and peace. It states that individuals, communities, social groups and health personal

to take responsibility in the pursuit of better health. The conference was held in Ottawa

Canada on the 21st November 1986, it was the first of its kind, in the world. This is where

health promotion as we know it originated from, it was a spring board to other models, and

how health promotion is intended to be used.

Health is a complete state of physical, mental and social wellbeing, not merely the absence of

disease or infirmity’’http://www.health.vic.gov.au/healthpromotion/what_is/determinants.htm

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In 1977 an American psychiatrist George Engel developed a new and major theory in

medicine. This become known as the Bio psychosocial model of health (BPS), the model

took into account the biological, psychological and sociological factors which effect health. It

was a dramatic shift from just recognizing disease and health. To looking at other factors

such as relationships, stress and beliefs and how these factors can have an effect both

physically and psychologically on the body.

Engel said that the basis for understanding the determinants of disease and these treatments

for diseases the medical modal must take into account the individual, his social and

environmental living conditions. How society, the physician’s role and the health care system

as a whole responds to that individual this is the bio psychosocial model

The Black report was published in 1980 by the Douglas Black, the purpose of the report was

address growing health inequalities. The report stated that overall health had improved since

the introduction of the NHS; however it found widespread inequalities in health. This was

largely due to the socio-economic status of the population. The report showed that there were

class differences within healthcare and in the distribution of medical services. It stated that

there were higher rates of infant mortality, and premature death in the poorer areas.

The Acheson report (1998) stated that health inequalities exist and could be categorised by

ethnic group, gender or socioeconomic status. It states that poverty is associated with poor

health. It also states that mortality rates have fallen among both sexes in all social classes,

however differences between the top and the bottom of the social classes have widened. He

states that an indicator of ill health is hypertension. He says that there are social differences

among women from higher to lower social classes. In relation to health related behaviour

Acheson, says that there is a higher amount of men in unskilled jobs who smoke, compared to

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professional men. He also says that people in poorer social groups tend to eat less healthily,

compared to those in higher socioeconomic groups.

Marmot (2005) in his journal wrote that there are widening health inequalities despite the

emergence of the NHS and the Black report. He stated that poverty is at the root of a lot of

health problems and infectious diseases. He says that income poverty could provide could

provide an explanation, to the differences between mortality rates. He made these

assumptions based on various countries and populations in that country. In other words

poorer populations have increased health problems and greater incidences of infectious

diseases.

A white paper published by the government in 2010 is intended to outline a major shift in

how the NHS tackles public health challenges. It states that health behaviour lifestyles have

increased at an alarming rate. The paper intends to empower the population to make healthier

lifestyle choices, and put local communities at the centre of public health. The paper intends

to reorganise the NHS and create a new public health service. It intends to put greater control

in the hands of local communities and GPs. Whether these changes are for the better remain

to be seen, we are entering a new age in public health and the NHS.

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Refrences

HM Government (2010). Healthy Lives, Healthy People: Our strategy for public health in
England. London: Crown. 1,2,3,4

MMWR weekly. (1999). achievements in public health, 1900- 1999:. control of infectious
diseases, 621-629.

Michael Marmot. (2005). Social determinants of health inequalities. Public Health. 365
(1), 1099-1102.

scaife, m. (2001). history: modern british and european. cambridge: hart mcleod.

Sir Douglas Black (1980). The Black Report, Inequalities in health. London: DOH. 1, 20.

Sir Donald Acheson (1998). Independent Inquiry into Inequalities in Health Report.

London: The Stationary Office. 1-9.

Thrower, P. (1996). Investigating, health welfare and poverty 2nd ed. london: Harper &
Colins LTD .

http://www.who.int/healthpromotion/conferences/previous/ottawa/en/index.html 20.12.2010

http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/ottawa_charter_for_health_pr
omotion?opendocument 15.12.2010