Inequalities In Health

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INEQUALITIES IN HEALTH

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Inequalities in Health

Introduction

According to a study by Treanor, M. (2016), globally up to 23% of children between the

age of 2 and 9 years might be at risk of having disabilities- highlighting the increasing global

burden of developmental vulnerability. The main reason for the developmental vulnerability has

been shown by strong evidence to result from children’s suboptimal start due to lack of the basic

requirements for healthy development and well-being due to poverty (Malqvist, M. et al. 2013,

6). As a result, the children underperform in various areas of development such as motor,

language, socio-emotional, cognitive or even behavioral. While this problem can happen to any

child, Woolfenden et al. (2013, 23) notes that those with lower social-economic status have been

shown to have a higher prevalence of the problem which correlates with other numerous studies

that prove poverty to have a devastating effect on the health of a child. This highlights one of the

many challenges of health inequalities among the children groups living in poverty.

By simple definition, the term inequality refers to the differences that occur between

different groups within a population. For instance, health inequalities are evident in the presence

of disadvantaged groups not benefitting from a country’s or population’s health development in

equal measures with the privileged groups (Rashbrooke, M. 2013, 42). Numerous reasons lead to

the health inequalities with one of the primary causes being poverty. According to a 2014 UK

study report, up to two-thirds of the respondents (child doctors) believed that poverty, as well as

low income, massively contributed to the ill health of the children that they worked with (Pickett,

K.E. 2015). There are a myriad of reasons why poverty leads to inequalities in children’s health

including the fact that; it restricts the parents ability to access the best quality of care, causes

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food insecurity, housing problems, increases chances of parents’ involvement in unhealthy

lifestyles such as smoking during pregnancy leading to poor children’s health. In addressing this

issue, different strategies must, therefore, be developed. As such, this paper analyzes health

inequalities of children living in poverty, exploring the reasons, and their impacts as well as

highlighting strategies that may be used in improving the health of these groups.

Health Inequalities in Children Living in Poverty

The children living in poverty are those who are born to parents who are in the lower

socio-economic classes. Ideally, these parents have lower incomes, do not afford good or

standard housing, notwithstanding being food secure among other challenges (McFadden, A. et

al. 2013). As a result, the children are exposed to unfavorable conditions that may be detrimental

to their health beginning prior to their birth as well as many more years following the same.

Furthermore, Malqvist, M. et al. (2013) states that parents and families in the lower socio-

economic status sometimes lack the ability to control their own lives due to overreliance on

others such as charity organizations of governmental assistance. According to these research

work, these kinds of problems may deprive the happiness and satisfaction of the affected people

leading to stress and depression. Also, as Treanor, M. (2016) notes, such kind of stress not only

affects the parents’ ways of living but also causes physical problems like high blood pressure and

may also lead to premature births low weight births.

Further research also shows that the children born by parents living in poverty may also

be subjected to problems such as abuse as a result of misuse of drugs or even neglect

(Rashbrooke, M. 2013). This is following a body of evidence that shows that people struggling

with adversities like unfavorable economic status have high chances of engaging in unhealthy

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lifestyles such as drug and alcohol abuse. For instance, for the mothers who smoke during

pregnancy Black, R.E. et al. (2013) indicate that the probability of having a stillbirth is as high as

20-30% and that of infant mortality is even higher with 40%. Furthermore, parents abusing drugs

are more prone to neglecting their children or even assaulting them in a number of ways. This

may cause tremendous problems to the health of the children- who entirely rely on their parents

to provide for them. According to (WHO, 2017), children exposed to such environments may be

at risk of diverse chronic problems such as developmental delays, mental health issues, as well as

increased adult mortality and morbidity.

The children from poor background sometimes do not get the appropriate food required

for their body’s healthy growth and development (Black, R.E. et al. 2013, 33). This is because

their parents do not afford some crucial food materials important for healthy growth. It is evident

that food shortages affect the health of children living in poverty, especially drawing from a

study conducted in 2012 where 60% of the pediatricians involved in the survey believed that

food insecurity contributed to poor health (McFadden, A. et al. 2013). The children having bad

diets may have numerous and diverse disease conditions such as diabetes and obesity (Reiss, F.

2013, 9). For example, a study conducted in the UK showed that as a result of unfavorable

economic conditions in one of the towns in London, cases of rickets had started to rise in certain

groups. Following further research, it was identified that the people in these groups were not

eating a balanced diet which negatively affected their kids.

The children living in poverty also suffer numerous ill-health problems as a result of the

poor housing conditions at their homes (Braveman, P. & Gottlieb, L. 2014). This may be due to

their parents’ inability to afford a standard quality house that would guarantee their good health.

For example, some families live in overcrowded, damp houses that are unsuitable for young and

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vulnerable children (WHO, 2013). Such conditions may be liable for causing a myriad of adverse

health problems due to associated diseases like pneumonia. A 2014 UK report also showed that

for the families who had fuel challenges where they were unable to pay for heating throughout

the year, their children were 30% more likely to be presented to the primary care due to adverse

health conditions (Pickett, K.E. 2015, 38). Also, according to a report by WHO, (2017), the

children from the poorest 20% households have almost a two times probability to die before the

age of 5 years compared to children from the 20% of the wealthiest families. Ideally, these

statistics illustrate the consequences of poor housing with regard to the health of the children

living in poverty.

Major Reasons for Health Inequality

Ideally, many factors lead to health inequality. Most of the problems result from the

socio-economic factors affecting the individuals or groups in a particular population. While

economic factors play an enormous role in generating inequality, other social determinants e.g.,

ethnicity and education play even a bigger role (Malqvist, M. et al. 2013). This is because, for

example, a lack of education may lead to a cycle of poverty in the family in that with the lack of

quality education, every generation may be deprived of the necessary qualifications for a well-

paying job, thus leading to a consistent low income. As such, the children born to that family

also lack quality education or training owing to their parents’ inability to afford it. As a result,

this problem becomes like a vicious circle within the family whereby it affects their ways of lives

a great deal including their health status. It is worth noting, however, that the poor education may

be as a result of ethnicity among other social factors which may make a particular ethnic group

marginalized thus negatively affecting their living conditions. As such, the problems of health

inequality, similar to any other inequalities, is based on the social constructs of a population.

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According to a conceptual framework that was produced by the Commission on Social

Determinants of Health (CSDH), the social position is noted as the primary determinant of

inequity (Jayasinghe, S. 2015, 9). In addition, Jayasinghe, S. (2015) also notes that inequity is a

term that is usually utilized interchangeably with inequality though it is a more specific term

referring to inequality occurring as a result of the social construct. The concept of social position

according to Treanor, M. (2016) refers to how the various productive resources are owned or

held in control. The social positioning as this study further explains, can be illustrated through a

myriad of social markers like ethnicity, people’s income, aspects of gender, as well as education.

According to (Malqvist, M. et al. 2013, 12), the various social positions are given value or

relevance by factors such as the socioeconomic as well as the political context. Ideally, these

social, economic and political factors include the governmental policies, cultural and traditional

values, as well as the microeconomic conditions. For example, inequalities in health may be as a

result of a government policy that favors the provision of resources to a particular ethnic group

while discriminating another minority group. The minority group, therefore, may not have the

resources needed for growth and development thus being left behind in terms of income

generation, education, or even healthcare facilities (Rashbrooke, M. 2013). As a result, this group

becomes poor, lacks crucial information, etc. which is reflected by its members who are unable

to afford similar benefits which the privileged groups afford. Among these benefits include

health benefits thus leading to inequalities in health.

The CSDH conceptual model, further suggests that the social determinants of health

Inequalities (SDHI) are made up of three main components; context, structural mechanisms as

well as the individuals’ socio-economic positions (Shokouh, S.M. et al. 2017). For instance,

according to the model the ‘context’ component may have a number of roles in aspects such as;

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the social systems, in areas like the education system, in culture, e.g. tribalism or racism, well as

the political systems. On the other hand, concepts of structural mechanisms are based on ways in

which the state is structured with regard to the welfare as well as the distribution of its resources,

as the dominant institution (Jayasinghe, S. 2015). It is then the institutions and processes- the

foundation of structural mechanisms- that within unique contexts lead to the generation of social

stratification. This is based on the different social and economic positions, income, the

educational achievements, one’s occupation, race, among other dimensions. For instance,

following this social stratification the groups in the top of the hierarchy- due to certain privileges,

such as skin color, race or religious background, develop more wealth or acquires more resources

enhancing their abilities to afford quality health among other benefits. Consequently, children in

this kind of groups do not bear the brunt of health disparities like the disadvantaged groups.

Drawing from this CSDH conceptual model, it is evident that the SDHI are numerous and

varied. They are also integrated in such a way that their impacts are as a result of the interplay

among a number of aspects. The government policy, for example, plays a major role in the

development of various institution as well as processes that may be crucial to the success or the

downfall of a community’s socio-economic position. As the socio-economic statuses within a

certain group deteriorate with respect to ‘context,’ the health of that group starts declining as the

poverty levels sets in. The children born to this kind of society, therefore, bears the brutal force

of the health inequality due to poverty whereby chances of affording quality food, housing,

health care, among other facilities become limited.

Strategies for Addressing Health Inequality Issues

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There are numerous and diverse strategies that can be used in addressing the issue of

health inequality in children living in poverty. Essentially, according to Rashbrooke, M. (2013), the

solution lies in assisting the parents of these children to come out of the entrapment of poverty.

This is because the children do not make any choices of their own but rather relies on their

parents to make provisions for them. As such, a boost to their parents and families has a direct

impact on the children themselves. As already discussed, poverty is a huge contributor to health

inequalities among different groups within a population. As such, addressing the various issues

leading to poverty could have a huge impact on health inequalities within the said groups (Reiss,

F. 2013). Such factors that must be addressed include employment, cost of living, e.g., housing,

the social security benefits such as credits, and education attainment among other factors.

The government has the primary responsibility for addressing health inequality problems

regarding poverty. As noted from the conceptual model, the governments are responsible for

creating social structures through the development of institutions as well as processes that lead

the distribution of wealth or resources across the society. It is, therefore, the task of the

government to ensure that these resources are equally and indiscriminately distributed within the

society (Rashbrooke, M. 2013). As such, the government must ensure that structural changes to the

economic, tax as well as benefit systems are made. For instance, the government may make

changes intended for maximizing the household income as well as resources. According to Reiss,

F. (2013), the government can also offer incentives for supporting the people experiencing

different types of socio-economic problems. For instance, introducing a Child Poverty Acts

could help in the reduction of the prevalence and impacts of poverty and subsequently the

reduction of health inequalities.

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Just as the conceptual model indicates, due to social stratification- whereby some people

have a higher socio-economic position (i.e. are more affluent)- it is possible for others to be

disadvantaged lacking access to resources, information as well as environments enabling the

betterment of their health outcomes. Therefore, the government must ensure that, other than

developing the necessary infrastructure, ways are devised for preventing a possible barriers to its

success i.e. social factors barriers including any type of discrimination on the basis of ethnicity,

tribe, color, age, gender, among others.

The government may also use other avenues like creating Health Care Funds to help the

disadvantaged groups in a myriad of ways. For example, the government may set up

comprehensive health care facilities for the poor individuals or groups or develop policies that

enable them to acquire health insurance cards. Such initiatives would be crucial in bringing

health boosters close to the people regardless of their socio-economic status. In essence, this

would have a huge impact on the health of the disadvantaged groups- especially the children-

who may be the most vulnerable (Poverty, C. 2014, 29). In addition, producing policies that

promote the development of social capital within the society may help in eliminating some of the

health inequality problems that result from issues such as institutional discriminations within a

society (Turnbull, A. 2015). Ideally, this is because such a society becomes aware of the vices of

such discrimination thus leading to the development of a system where each member looks after

the other.

Conclusion

Poverty is among the leading causes of health inequalities among the children groups.

According to a study conducted in the UK in 2014, up to two-thirds pediatricians in the survey

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believed that poverty, as well as low income, massively contributed to the ill health of the

children that they worked with. There are a myriad of reasons why poverty leads to inequalities

in children’s health including the fact that; it restricts the parents ability to access the best quality

of care, causes food insecurity, housing problems, increases chances of parents’ involvement in

unhealthy lifestyles such as smoking during pregnancy leading to poor children’s health (Uphoff

et al. 2013, 31). In addressing this issue, different strategies must, therefore, be developed. This

paper has highlighted the various theoretical frameworks on causes of health inequalities

especially with regard to socio-economic status. Among these models is the CDSH conceptual

models that describe the various social determinants of health inequalities. In addition, several

strategies for addressing the issue have been thoroughly explained whereby the main role lies in

the government’s interventions.

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References

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