Introduction
The area of public health has been one of the most significant yet underrated areas of public administrative jurisdiction in the UK. Successive governments have tried to enforce progressive Reform measures in this area to reduce anomalies, but with limited success. Despite enjoying a high GDP and income levels for the people, the standards of health care available to citizens are much below that available to people belonging to other countries of the European Union ( EU).
This study is mainly intended to throw light on the impact of social and other classes upon public health systems in the country.
The general area of study
This study is mainly intended to analyze aspects of the various implications of class on health, not only individual health but also public health. The class that is denoted in this study relates to the occupational or working class, or even social classes when related to non-working or young people. As is well known, the gradient of occupation is found in income, and consequently in health- related problems. It is common knowledge that people in the lower socio- economic or lower classes are more susceptible to poor health, or diseases, as compared with high income or affluent groups. Moreover, these segments of society are not always have access to high quality medical attention and care, which exacerbates their conditions and renders them unfit for gainful employment or productive work. The effects of class also affects mortality and lifespan of people in lower strata is of society, since chronic poor health and disease cuts down the life span and accelerates mortality
Rationale
The right to good health and hygienic working conditions is a need that is fundamental to civilized society and could be, in a wider sense, considered a prerogative of free society to which human beings belong. Conducive working and living conditions foster a sense of well- being and vitality that is intrinsic for good health and personal welfare. The hypothesis of this study is based on the premise that occupation and social class defines the health of society, since occupation is directly linked with income generation. People who are highly educated are in a position to earn higher incomes and generate more wealth than people with little, or no education, and who consequently have to resort to menial or frugal occupations to tend to themselves and their families. Their lack of education have resulted in lower incomes and thus lesser generation of wealth for well-being. While rich people could afford to have substantial savings and higher propensity to generate wealth, this is not possible in the case of poorer and underprovided sections of society, who thus have to resort to lower jobs with lower pays.
People who are from lower classes of society have lower incomes, and are thus not able to access high quality medical treatment in private settings. Moreover, they are not also always covered by private Health Insurance Covers, unlike wealthy and privileged people, and have to resort to public health care systems.
People who are from lower classes, generally have lower wealth generation, as a result of which they are not able to afford quality treatment for their morbid health conditions, as a result of which their sickness and mortality rates may be higher than that of higher classed and wealthier strata’s of society.
This study needs to be seen in the context of reducing the differentiations between the health conditions prevalent among people in society. A person need not be marginalized or provided a lower standard of health care or treatment, just because they happen to belong to the lower strata of society, since the gravity of their health problems are more important and not their income generating capacities.
However, it is indeed sad but true, that good health care facilities and treatment in today’s scenario is mainly concentrated on the rich and privileged classes of society, to the disadvantage of poorer sections of society who have to seek lower and compromising levels of health care treatment and interventions. Moreover, the true state of present conditions can be gauged if one were to consider the fact that HIV/AIDS, coronary diseases, cancers and other serious health conditions are more prevalent among poorer and less literate sections of society.
Sense of problem
The true sense of the problem is found in the fact that class determines the level oflving of people in today’s global environment, save under exceptional situations.
This stems from the simple fact that poorer patients cannot afford the high cost of treatment, which could be afforded by wealthier patients from higher social backgrounds.
In today’s health conscious society, medical intervention could mean long stays in health care settings with professional health care services being provided by the institution, diet regimen, exercises, physical therapy and ambient lifestyle with controlled food habits. This could not be possibility to be indulged in by a poorer patient who needs to keep himself occupied, in order to financially support himself and his dependents. Although health care insurance may be available to lower stratas of society, they may not be always adequate to cover the full course of treatment and convalescing period of the patient. Most of the treatment may be done in public health settings, which may thus deny the high quality care and treatment that could be gained in private nursing centres.
What is perceived is a circle of inadequacy stemming from poor education, which leads to lower employability, which in turns leads to lower incomes but high occupational stress leading to poor heath and disease. Under conditions when employability becomes doubtful, the patient has to be without work even after he is discharged from hospital and thus has to depend upon State Aid for livelihood.
The various methods in which health care services discrimination among lower classes of society could be seen in terms of the following:
- Medical discrimination in terms of longer waiting time.
- Lack of equal access to emergency medical care and medical intervention.
- Need for placing money deposits before treatment is commenced and also, lack of continuity in treatment for patients.
- Refusal to treat patients belonging to lower stratas of society on non-recommendation from privileged medical practitioners.
Identification of theoretical conceptual framework
It is intended to carry out the research based on the longitudinal cohort study of around 250 men and same number of women in the age group of 25- 55 working in various capacities working in a corporate setting.
They were medically screened for various types of communicable diseases and found acceptable for the purpose of the research study. Since the purpose of the research is to establish or nullify the hypothesis through qualitative analysis, it is believed that the respondents were of moderate health conditions, the effects of which would be known after the survey had been taken up and the analysis made.
The matters that would be discussed during the course of this study would be in terms of their lifestyles, smoking, drinking and private lives and their relationships with peers, superiors and subordinates as well as family members and friends. All these aspects are believed to be significant and needs to be explored during the course of the study in order to arrive at a correct evaluation of the study and its rigour.
During the course of this research it is necessary to provide unbiased and authenticated questions to be put forth to the respondents in order to elicit correct responses from them. It is also necessary to ask open-ended question since this is one of the basis of qualitative surveys to which this survey belong. Through the use of open-ended questionnaires it is possible to gain insight into the various aspects of different classes of respondents and their perceived impact of clases on health and well being.
In a qualitative analysis as this one, it is essential that the sourcing of the data be according to the needs of the study and in consonance with their objectives. It is also necessary that the methods are patterned, standardized and follow scientific rigour.
In this qualitative survey, it is necessary that the respondents be able to source and evaluate choices of the survey and data and realize the limits of such survey methods.
It is necessary that this survey should use appropriate methods of analysis, and demonstrate an understanding of the implications of the results with reference to the existing literature in the field and how this survey contributes to the induction of new aspects into this study.
The theoretical aspects of this survey should consider the empirical implications of the results of the survey in an attempt to reduce the gap and bridge the guilt between the theoretical and practical aspects of this survey method.
The findings of this survey should be amenable to further research skills, healthy criticism and the ability to infer conclusions and offer recommendations within the particular aspect of the subject matter of this research study.
Literature review
Although the subject of class interference in public health is a large and significant area for public welfare research, the literature available does not seem to be suggestive of this truth.
The Whitehall survey conducted in two parts consisted of study of 18,000 men in the Civil Service, set up in 1967.The first Whitehall study showed that men in the lowest employment grades were much more likely to die
Prematurely than men in the highest grades. The Whitehall II study was set up to determine what underlies this grade or social gradient in death and disease and to include women in the scope of its survey. (Work, Stress and Health: The Whitehall II study: 2004).
During the year 1980, the Thatcher Government in its bid to promote the cause of Britons caused the release of the Black Report. The Report stresses the need, interalia that achieving a high standard of health among its entire people represents one of the highest of society’s aspirations. Present social inequalities in health in a country with substantial resources like Britain are unacceptable, and deserve so to be declared by every section of public opinion. “ (Socialist Health Association: The Black Report).
Another significant work in this direction has been by Sarah Earthy in her book entitled social class & Health Inequalities, in which it has been explained that there are many causes for health and social class. They could be attributed to social selecting, whether direct or indirect, the cultural behaviour could be seen in terms of particular cohorts indulging in health harming conduct and the material aspects could be in terms of social class or income disparities that could lead to health differences.( Sarah Earthy : Social Class and Health inequalities: Sociology of Contemporary societies).
The UK Government had commissioned Sir Donald Acheson to study the health conditions through an independt inquiry and submit a report, which he did. In 1998.
This was entitled the Independent inquiry into inequalities in Health Care Report.
It conduced in the following crucial areas that “all policies likely to have an impact on health should be evaluated in terms of their impact on health inequalities; secondly, a high priority should be given to the health of families with children; and thirdly, further steps should be taken to reduce income inequalities and improve the living standards of poor households “(Independent inquiry into inequalities in Health Care Report 1998).
Methodology
- Objective: The main objective of this study is a qualitative analysis to determine whether occupational or social class influences public health. Of people.
- Design: Cross sectional, qualitative cohort study working in various capacities – from clerk to company manager.
- Settings: Corporate setting of large industrial house in southern London, UK.
- Participants: Involving 250 men and women in the age group of 25- 55 years with more or less similar backgrounds and primary health assessments.
- Main outcome measure: The study seeks to confirm or nullify the research hypothesis whether class plays a dominant role in the determination of public health or not.
- Results: Considering the overwhelming responses to the interviews, which had a response rate of more than 76% (for men) and 67% (for women), it was seen that the hypothesis was carried unanimously
Conclusions
Although the survey validates the hypothesis that class cultures influences public health , there needs to be further research studies on how class divides could be reduced and a higher standards of health care in commensuration with the available resources could be made easily accessible to underprivileged and economically weaker sections of the society.
This would ensure that in future there would be more productive and better use of human resources in the country.
Works Cited
Work, Stress and Health: The Whitehall II study: 2004: Introduction: P 3. Web.
Socialist Health Association: The Black Report 1980: 2008. Web.
Sarah Earthy : Social Class and Health inequalities : Sociology of Contemporary societies: 2008. Web.
Independent inquiry into inequalities in Health Care Report 1998: Synopsis: 2008. Web.