Expository Essay on Health Inequalities

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Sewanee University of the South
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Inequalities in health have become a significant public health problem in many countries globally. Health inequalities refer to the measurable disparities in health outcomes and experiences between different groups within a given population based on their geographical area, socioeconomic status, gender, age, disability, or ethnic group (Scambler, 2012). On the other hand, public health is the art and science of prolonging life, preventing diseases, and promoting human health through organized efforts and informed choices of the society, individuals, and other relevant entities, (Newton et al., 2015). In this regard, Public Health England (PHE) is in charge of safeguarding and enhancing the nation’s health, as well as, addressing inequalities. Some of the fundamental causes of health inequalities include unequal dissemination of power, income, and wealth, just to mention a few (Marmot & Allen, 2014). The variances in these social determinants impact negatively on people thus limiting their ability to live longer and healthier lives (Scambler, 2012). Similarly, the inequalities are transferred from one generation to another in many instances, thus creating a continuous cycle of public health problems which in turn influences the overall productivity of the country (Martinson, 2012).It is in the light of this context that this paper identifies and discusses three ways in which public health England attempts to minimize health inequalities in the country.

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The health of individuals in England has improved remarkably over the last few decades (Bleich, Jarlenski, Bell, & LaVeist, 2012). Research has pointed out that the life expectancy of men in 1841 was 40.2 years while that of women was 42.2 years (Newton et al., 2015). Similar studies conducted in 2000 revealed that the life expectancy of men had improved to 75.6 years and that of women to 80.3 years (Newton et al., 2015). Moreover, the infant mortality rates have decreased significantly throughout the 20th century in response to proper nutrition and improved living conditions, among other factors (Deaton, 2013). However, there is still a huge gap between the rich and poor in terms of their overall health outcomes, life expectancy, and access to healthcare despite the notable improvement in public health in the country (Pickett & Wilkinson, 2015). As a result, more effective steps and policies need to be implemented to address these inequalities in public health.

Steps Taken by Public Health England to Minimize Health Inequalities

The Sure Start Program

The sure start program is an initiative sponsored by the government to support children, mothers, and families living in disadvantaged areas across England. It was introduced in 1998 as a multi-departmental project for early intervention of children under the age of four years (Eyal et al., 2013). The program was intended to bring together a range of services including family support, childcare, education, as well as, support for special needs, just to mention a few (WHO, 2017). The initiative began with 60 Sure Start trailblazer districts which were composed of voluntary bodies, health services, and the local authorities (Eyal et al., 2013). In 2000, the government committed 948 million to double the number of Sure Start Local Programmes (SSLP) to 500 with an intention to cover the majority of the poorest children under the age of four. The facilities were later converted into Sure Start Children Centers( SSCC) in 2003 and represented the mainstreaming of Sure Start as a universal service (WHO, 2017). In this regard, the SSCC made it possible for the government to reach out to families and children who had not been previously covered by the SSP.

The implementation of the Sure Start Centres ( SSC) has considerably improved the health of women and children across the country. In this regard, the SCCs provide a wide range of services for parents, children, and families with an aim of ensuring their emotional, social, and economic well-being (Ingleby, 2012). The centers support pregnant mothers and offer them ante-natal and post-natal care, as well as informed advice on how to bring up healthy children. The program receives full funding from the government amounting to almost 4 million per year (Barr, Bambra & Whitehead, 2014). It has been able to cater to the health needs of many children and families living in underserved areas and thus contributing to the government's efforts of minimizing health differences in the country (Bartley, 2016). However, studies have pointed out that there has been a continuous shut down of many Sure Start centers, particularly, in areas where they are needed the most (Eyal et al., 2013). For example, a poll conducted recently revealed that the centers had decreased from 3,632 in 2010 to 2,677 in 2015 (WHO, 2017). In this case, the reduction in the number of the Sure Start centers in underserved regions has negatively impacted the health of many residents thus contributing to the existing health inequalities in England. As a result, policymakers and the government should design and implement efficient policies to address this problem

The Sure Start Program, facilitating healthy living standards, and the resource allocation/funding project have had a significant impact on the health and well-being of the population in England (Carey & Crammond, 2015). For instance, longitudinal studies conducted to evaluate the effects of the Sure Start program have shown that children living in the local areas covered by the program exhibited greater self-regulation and positive social behavior compared to their counterparts living in regions not covered by the initiative (WHO, 2017). There were also fewer cases of childhood illnesses and malnutrition in the Sure Start Local Programme areas (Marmot, 2015). Similarly, steps taken to improve the living standards of the majority of the population in England have minimized the number of chronic and lifestyle diseases such as diabetes, heart problems, and obesity (Mackenbach, 2012). It has also decreased the number of deaths in children caused by malnutrition (WHO, 2017). Moreover, the funding and resource allocation project has been able to address the health needs of the underserved population. However, there are still cases of health inequalities in the country that need to be addressed efficiently.

Ensuring a Healthy Living Standard For Everyone

Public health England has taken various steps to promote healthy living standards for everyone in the society. First, it has been on the front row in sensitizing the population about the importance of adopting healthy lifestyles through public education and training programs. Studies have shown that most of the deaths and chronic diseases in the nation are caused by unhealthy behaviors such as poor nutrition, excessive alcohol consumption, and inactivity, among other contributing factors (Scambler, 2012). As a result, empowering individuals to make healthy choices is vital in minimizing health inequalities. Secondly, the organization has been working closely with the government to advocate and execute policies to reduce the social gradient in the standard of living through proper taxation and other fiscal policies (Eyal et al., 2013). This initiative is meant to reduce the gap between the rich and poor and minimize the disparities in health, especially, those caused by social-economic factors such as unequal distribution of wealth. Thirdly, PHE has partnered with various organizations and the government to resolve the rampant unemployment problem in the country by improving access to jobs for persons living in underprivileged areas(Scambler, 2012). In this regard, creating employment opportunities for everyone will enable them to cater to the needs of their families thus improving their living standards. Lastly, efforts have been made towards improving healthcare delivery by promoting quality and timely treatment and increasing the number of care providers in underprivileged regions.

Another area that PHE focuses on with the aim of reducing health inequalities is prevention, which consequentially helps it ensure that people have healthy living standards (Beckfield, Olafsdottir & Bakhtiari, 2013). According to the National Health Service (2016), PHE uses prevention by investing in programs that address the determinants of health, particularly in social and environmental circles. Another key action undertaken by PHE is proactively advocating for policies that encourage people to adopt behaviors that are healthy. For instance, policies may be enacted to increase the price or reduce the availability of consumer products that have adverse health effects. Lastly, PHE ensures that in areas where universal services are provided, more investment of the services is channeled towards groups that are vulnerable (National Health Service, 2016).

The National Health Service (2016) further shares that another example of a prime area for reducing health inequalities is smoking. The reason is that smoking is prevalent in populations that are deprived. Hence, it becomes prudent to prevent deprived populations from smoking so as to reduce health inequalities associate with smoking. Thus, PHE has previously worked in cooperation with England’s legislature to initiate smoking cessation. The assertion can be evidenced in the way over the years taxes have been progressively increasing on tobacco products so as to make them expensive and thus reduce their purchase volumes by the deprived population (National Health Service, 2016).

Resource Allocation/ Funding

The government has set aside resources to fund projects and policies aimed at minimizing and mitigating the effects of health disparities in the country. For instance, it provides funds to local and state governments to develop affordable and high-quality homes for all members of the community. Additionally, it provides grants to different entities to ensure the creation of fair employment and working conditions for individuals in lower-income areas (WHO, 2017). The department of health is in charge of allocating resources to the National Health Service (NHS), which ensures the proper planning, budgeting, and utilization of funds meant to address the health needs of different groups in the society. The funding formula ensures that there is an adequate redistribution of funds, especially, to the neediest group in the population (Scambler, 2012). The allocations are made to the PCTs based on the relative needs of their populations, which are evaluated through a weighted capitation formula, which is continuously overseen by the Independent Advisory Committee on Resource Allocation (ACRA). In this regard, the ACRA makes recommendations to government representatives and policymakers on potential changes to the formula before each round of revenue allocation (Martinson, 2012). Research has, however, shown that not all areas are currently receiving the amount of money they should receive based on their needs. As a result, there is still a huge gap between the rich and poor in terms of their health outcomes, life expectancy, and mortality rates. It is in this respect that the government should identify effective ways of dealing with these issues and thus minimize the disparities in health between the rich and poor (Fish and Karban, 2014).

Another way through which the public health system of England reduces health inequality through resource allocation is by offering free school meals. In England, families who have children that go to a state school are entitled to receive a free meal. However, for the children to be eligible for the free meal, their...

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