Poverty And Health Inequalities Health And Social Care Essay

Poverty And Health Inequalities Health And Social Care Essay Sociologists define social class as the grouping of people by occupations. The different positions represent different levels of power, influence and money1, 2. In the UK society was divided into 5 main groups of classes however the Office of National Statistics (ONS) produced a new socio-economic classification in 2001 (Table 1)3, 4. Social Class Up to 2001 From 2002 I 1-4 High Low II IIIN IIIM 5-8 IV V Table 1- Classification of Social class4 The Black Report and the Acheson Report In August 1980 the Department of Health (DOH) published the Black Report, also known as the Working Group on Inequalities in Health. The Report showed the extent to which ill-health and death are unequally distributed among the population of Britain, and suggested that these inequalities have been widening rather than decreasing since the formation of the National Health Service (NHS) in 19485. The Report concluded that these inequalities were not caused due to failings in the NHS, but because of many other social inequalities influencing health: income, education, housing, diet, employment, and conditions of work. In consequence, the Report recommended a wide strategy of social policy measures to reduce inequalities in health; however these recommendations were ignored not implemented 6. In 1998 The Acheson Report, also known as the Independent Inquiry into Inequalities in Health Report was published, this was 18 years after the Black Report, both reports showed similarities in thei r finding. The Acheson report showed a widening gap between different social groups (Figure 1)7. Figure 1-Number of deaths per 1000 by all causes for men aged 20-64 between 1991-19937 The report also noted that, while social determinants (Figure 2) affect peoples health across their lives, the early years are a particularly important stage of life, where poor socio economic circumstances have lasting effects. The Report recommended policies and interventions to reduce inequalities in access to the determinants of good health among parents, particularly mothers and children8, 9. The Main Determinants of Health Figure 2- The Main Determinants of Health10 The Situation in the UK- Income and Poverty The main point that both the Black and Acheson report identified was the association between poverty, social class and health inequalities. This applied to all aspects of health including life expectancy, infant mortality and general level of health8. Poverty isolates people, reducing their ability to engage in social and community life. In a study comparing the poorest and richest fifth of households, poorer children had fewer opportunities for activities and socialising. Poverty is measured by looking at the low-income threshold. This is 60% of the median UK income 4, 11. In 2007/08, 13 ½ million people in the UK (Table 2) were living in households below the low-income threshold, an increase of 1  ½ million compared with the 2004/05 figures. This is around a fifth (22%) of the population. The number of people on low incomes is lower than it was during the early 1990s but is much greater than in the early 1980s11, 12. Country Number of people England 11,500,000 Scotland 900,000 Wales 70,000 Northern Ireland 40,000 Total 13,500,000 Table 2- Distribution of people living below the poverty line in the UK, 13.5 million of the total population of approx 61 million13 Health of the UK Population- Link between Poverty and Health The health of people in the more wealthy areas of the UK is better than those living in the deprived areas. Those people living in poorer communities die younger and experience poorer physical and mental health throughout their life than those living in wealthier communities12, 13. There is a link between life expectancy at birth and social class in the UK. Those from social class I and II have a higher life expectancy at birth than those from social class IV and V .Professional men are expected to live to around 80 years and unskilled manual men to 72.7 years and for women, the figures are 85.1 and 78.1 years (Figure 3)14 Figure 3- Life expectancy of men and women at birth by social class UK, 1992-200515 This can be linked to death by major diseases in the UK, those from social class IV and V have a higher death rate compared to those form social class I and II (Figure 4).14, 15. Figure 4- Major causes of death 2003: Death rate for men aged 25-64 are 50-100% higher among those from manual backgrounds compared to those form non-manual backgrounds4, 12, 13. Infant Mortality in the UK The general association between poverty and health can be seen by looking at different diseases and mortality rates in the UK however one area which shows this association very clearly is child health. This is measured by looking at the rate of infant mortality. Infant mortality rate is the number of deaths of infants per 1000 live births16. There were 9,954 infant deaths overall in the period 2006-08, giving an overall infant mortality rate of 4.8 deaths per 1,000 live births (Table 3). Of those with a valid socio-economic group (8,709), the rate was 4.7 deaths per 1,000. Out of the 8,709 deaths in this category, 43% of these deaths (3,744) were in the Routine and Manual (RM) Social group, giving a rate of 5.4 deaths per 1,000 live births in this group 17, 18. Year Number of Deaths Infant Mortality Rate 2006 3321 5.9 2007 3264 4.7 2008 3369 4.8 Total 9954 Table 3- Infant deaths and mortality: babies born in 2006-200819 Poverty and Infant Mortality Infant death rates among both those from manual backgrounds (social class 1-4) and those from non-manual backgrounds, (social class 5-8) have fallen by around a fifth over the last decade but the gap between them has not reduced.   Infant deaths are still 50% more common among poor children in lower social groups (manual backgrounds) than among those from non-manual backgrounds.   In the lower social groups infant mortality is 20% higher than the average 4.8 per 1,000 (Figure 5)20, 21, 22.http://www.poverty.org.uk/21/a.png Figure 5- Annual number of deaths per 1000 live births between 1997-2007, it also shows the social class of the infants4, 15. When looking at different regions of the UK; it is clear that there is a significant difference in infant death rates. The rate of infant deaths in the West Midlands is one-and-a-half times more than that in the South East (Figure 6)23, 24, 25.http://www.poverty.org.uk/21/b.png Figure 6- Graph showing how the number of infant deaths per 1000 live births varies by region (West midlands, Yorkshire and the Humber, North West, Northern Ireland, East Midlands, North East, London, Scotland, Wales, South West, East, South East) 4,24. Infant death by region also has an association with poverty. The region with the highest proportion of households below the average income is the North East and West Midlands and it is the West midlands which has the highest infant death rate. The regions with the lowest portion of households below the average income, is the East and South East and it is the South East with the lowest number of infant deaths (Figure 7) 26, 27, 28. Figure 7- Graph showing low-income households by region (North East, West midlands, Wales, North West, Yorkshire and the Humber, East Midlands, Scotland, South West, Northern Ireland, East, South East)4, 15, 27 There are many conditions that cause infant death. The leading causes of infant death include congenital abnormalities, Sudden Infant Death Syndrome (SIDS), problems related to complications of pregnancy, and infant respiratory distress syndrome (Table 4)19, 29. Cause of Death Number of Deaths Congenital anomalies 920 Antepartum infections 59 Immaturity related conditions 1550 Asphyxia, anoxia or trauma (intrapartum) 205 External conditions 47 Infant respiratory distress syndrome 122 Other specific conditions 26 Sudden infant deaths 158 Other conditions 282 All causes 3369 Table 4- Infant deaths by cause of death: babies born in 200811, 15, 19 Other Risk Factors Increasing Infant Mortality There are other risk factors which increase the rate of infant deaths. These factors are associated with income and poverty. The main three factors are low birth weight, smoking during pregnancy and ethnicity27. Low birth weight Babies birth weights are key indicators of the outcome of pregnancy, even though there can be considerable differences between the health and well-being of babies born at the same stage of pregnancy. Babies born with a low birth weight are at greatest risk of having immediate and long-term health problems. The smallest babies are the most likely to die in the first weeks and months of life. Babies born to parents from manual backgrounds (Social class 5-8) tend to be more likely to have low birth weight than those born to parents form non-manual social backgrounds (Social class 1-4) these differences continue throughout the decade (Figure 8)31. Figure 8- Graph shows the proportion of babies born each year who are classed as having low birth weight (less than 2.5 kilograms, 5  ½ lbs), between 1996-2006. It also shows the social class of the infants4. Smoking during pregnancy Smoking in pregnancy causes devastating outcomes; these are increased risk of miscarriage, still birth and death. If parents continue to smoke after pregnancy, there is an increased rate of sudden infant death syndrome32. In the UK in 2006, 33% of mothers from social class 5-8 (manual) smoked throughout pregnancy compared with only 22% of mothers from social class 1-4 (non manual) (Figure 9) 33. Figure 9- Smoking prevelance overall and by social class. England 1998-2006 34 Exposure to passive smoking during pregnancy is associated with still birth, death and increase risk of lower respiratory tract infection in infants. One study found that in households where both parents smoke, young children have a 72 per cent increased risk of respiratory illnesses35. In 2006, 21% of non smoking pregnant women were exposed to the smoke of someone else usually a partner, throughout their pregnancy. Also 40% of mothers aged under 20 smoked throughout pregnancy compared with 13% of mothers aged 35 and over 33, 34. Ethnicity There are large differences in the infant mortality rates of ethnic groups in the UK, for babies born in 2005. Asian and Black ethnic groups accounted for over 11% of live births and 17% of infant deaths. Babies in the Pakistani and Caribbean groups had particularly high infant mortality rates, 9.6 and 9.8 deaths per 1,000 live births this was double the rate in the White British group of 4.5 deaths per 1,000 live births (Table 5)36 Ethnic Group Number of deaths Infant mortality rate Bangladeshi (Asian/Asian British) 34 4.2 Indian (Asian/Asian British) 93 5.8 Pakistani (Asian/Asian British) 231 9.6 African (Black/Black British) 118 6.0 Caribbean (Black/Black British) 73 9.8 White British 1859 4.5 White other 142 4.3 All other ethnic groups 271 5.4 Not stated 357 5.1 Total Number of deaths 3,200 Table 5- Infant deaths and infant mortality rates by ethnic group of babies born in 2005 11, 27, 30, Mortality in the Pakistani group was high throughout the first year of life whilst mortality in the Caribbean group was especially high in the first month of life. Half of all infant deaths in the Pakistani group were due to congenital anomalies, compared with only a quarter of deaths in the White British group. There is a general trend between income of ethnic groups and infant mortality rates. Those groups that have a high infant mortality rate such as the Pakistani and African groups tend to live in low income households compared to white groups (Figure 10)25,30,. http://www.poverty.org.uk/06/b.png Figure 10-Graph showing how the proportion of people living in low-income households varies by different ethnic groups4, 15, 30, Conclusion- Policies in place to address the issues It can be seen that health inequalities are present in the UK and therefore the Government has put in place many programmes and policies to tackle this problem. Tackling Health Inequalities-A Programme for Action The Tacking Health Inequalities: A Programme for Action was launched in July 2003 by the Secretary of State for Health, its aim is to meet the governments targets to reduce the health gap on infant mortality and life expectancy by 2010. The Programme has a clear strategy to work on the following four delivery themes: Supporting families, mothers and children Engaging Communities and Individuals Preventing Illness and providing effective treatment and care Addressing the underlying determinants of health37 National Service Framework for Children, Young People and Maternity Services The National Service Framework for Children, Young People and Maternity Services (Childrens National Service Framework) is a 10 year programme aiming to improve childrens health, social care and promote high quality health care for women and their families. The standards set by this framework require services to: Promote healthy lifestyles. Tackle health inequalities Ensure that pregnant women receive high quality care throughout their pregnancy38 Infant Mortality National Support Team The Infant Mortality National Support Team (IMNST) was launched in autumn 2008. It supports the 43 areas with the highest infant mortality rate in the routine and manual group. The IMNST has 4 main aims (Figure.11)39. Figure 11- The aims of The Infant Mortality National Support Team39. Tackling health inequalities is a top priority for the Government and the main focus is on narrowing the health gap between disadvantaged groups, communities and the rest of the country and on improving health overall. The policies, programmes and strategies in place are helping to reduce the health gap however there is a long way to go before there is significant change in health inequalities. This can be seen by looking at one of the Health Inequalities Public Service Agreement (PSA) targets (Box 1) and the progression of this target40. PSA Target on Infant Mortality By 2010 to reduce by at least 10% the gap in mortality between routine and manual groups and the population as a whole. Box 1- PSA target on reducing mortality in the UK by 10% by 201040. There is a decrease of infant mortality amongst the routine and manual groups however to narrow the gap by at least 10% by 2010 is still a challenge (Table 6)41. Year Percentage Gap 2004-2006 17% 2003-2005 18% 2002-2004 19% Table 6- Percentage gap in mortality between routine and manual groups and the population as a whole41. This shows that the Government needs to do more to reduce health inequalities by concentrating on wider social determinants of health. WORD COUNT-1650

The Uncertainty of Happiness in Anton Chekhovs About Love Essay

In Anton Chekov's "About Love" Alekhin also known as Pavel Konstantinovich shares a story within a story about his one true love Anna Alekeevna with Burkin, the high school teacher and Ivan Inanovich, the veterinary surgeon. The story shares how he and Anna grew to share an unconditional love for each other. The two sacrificed their love for each other for the happiness of others since Anna was already married and had two children. Later on in his life, Alekhin realizes that he had missed his one chance of true love, when he had the chance they should have sacrificed everything and attempted to live a happy life together. Although Alehin's tone while telling his story seems to doubt the possibility of true happiness, it is not until after he is finished that he seems to understand that by not sacrificing and taking chances in life, you hinder your chance of ever-attaining true contentment. Living in his own form of futliarnost, Alekhin enforces the idea that ones own happiness is set upon the ideal they have envisioned for themselves. I an educated man with a knowledge of languages, should, instead of devoting myself to science or literary work, live in the country, rush around like a squirrel in a cage, work hard with never a penny to show for it (198). The term "futliarnost" is used to explain one who encasts himself physically, psychologically or morally in order to reduce the contact between oneself and the rest of the world. Alekhin's state of affairs with Anna comes in the form of a rejection of love, forcing him to keep busy with daily routines to keep his mind from pondering upon hi... ...hat he had the chance to be in love was a taste of happiness. One must take chances and make sacrifices in order to obtain such a passionate emotion; if that person refuses to change their ways they may be pushing away a chance of happiness that may only come once. It is not until Alekhin is finished telling his story that he comes to realize many things about the situation and himself. Others may look upon happiness as a state of mind you create for yourself, a state of contentment. Alekhin was able to reach this state by occupying himself and achieving good in his life. One can look upon this story as one of irreverence or a lesson in life. Happiness is relative; a person can create happiness or unhappiness depending on how they choose to act upon chances life and loved ones present to them.

Acts of congress summary

Politics First Chapter Nine continues with an examination of Barney Frank, the Democrat who served as the senior leader of the House Financial Services Committee that was responsible with researching, marking up, rewriting, and passing proposed legislation that would prohibit another financial crisis from developing in the future.However, while waiting for the release the administration's white paper, which helped inform and educate members of Congress about White House proposals, Frank found himself in the midst of a potential political rebellion from in Congress, nd even from within his own party. Many moderates balked at Franks more aggressive reform proposals, while liberals found it treasonous that he was collaborating with banks, the very institutions that they held responsible for the onset of the financial crisis and the beneficiaries of TARP†Troubled Asset Relief Program.One such critic was Senator Dick Durban, who rejected the idea ofa bank bail-out, and was disappoin ted that banks were still in a position to politic in Washington. Frank disagreed, asserting that the big banks were losing steam in Washington and the evidence was simple: they could not prohibit the passage of redit card legislation that protected consumers. In an effort to gain support and educate members of Congress, Franks staff put on a serious of workshops and work sessions for members.In addition to his efforts to placate liberals, Frank threw his support behind provisions that would ultimately become the Consumer Financial Protection Bureau†an idea first presented by Elizabeth Warren in an article for the journal Democracy. The legislation became important but the â€Å"blues and news,† the old and new moderate factions of the Democratic party of each party, were already rowning in health care legislation, breaking Franks declaration that the new legislation would pass before Congress' summer vacation.Key Points/Details Big banks were largely to blame, but coll ateral damage of the bank fallout could be small banks and credit unions – The press was largely to blame, in Franks mind, for overstating the political clout that big banks and Wall Street had What would their influence be in the process of writing new legislation – Frank recruited the Democratic members of the House Committee on Financial Services (Banking Committee) who he held in highest esteem to work on issues for the reform bill –Frank favored three hallmarks for reform that might relieve liberals who were nervous that banks were not bearing the brunt of responsibility for the crisis o Credit card bill – more transparency from issuers of credit cards o Subprime mortgage bill – bill that banned many subprime mortgages and required that lenders would require companies to give stockholders a chance to give feedback about Though Frank had originally been hesitant to support such a executive pay – provision, White House backing, growing su pport from among popular and powerful Democrats (Clinton, Edwards, etc. polling numbers that seemed to indicate that the public favored it, and convincing arguments from Harvard law professor – and current US Senator from Massachusetts – Elizabeth Warren, persuaded Frank to throw his support behind the creation of a new regulatory agency (CFPA/b). Agency would regulate American financial firms and the services and products that they offer to the public –> Independent agency under the Federal Reserve Board o Frank felt pressure from both sides – the administration as well as hesitant, moderate â€Å"news and blues† – of his own party Many were worried that supporting the creation of he agency would leave them vulnerable in upcoming elections in vulnerable districts o Proposed health care and â€Å"cap and trade† legislation distracted both Congress and the public –Frank began to recognize that he had to do more to reassure his c olleagues that this agency was a good idea Worked to cajole them and gain their support o By the end of the chapter, Frank is convinced that he is right and that he will be able to get such legislation passed Terms: derivatives rating agencies systemic risk regulator subprime mortgages consumer protection â€Å"say on pay' Elizabeth Warren Price gouging Payday lender Office of Legislative Council CFPA / CFPB Chapter 10 – An Impotent Minority Chapter 10 focuses on the struggles of Rep. Spencer Bachus (R-AL) and the rest of his party to reconcile their desire to reform the financial sector but not seem to bow to the desires of the Democrats. Rep. Bachus, a moderate Republican who before the crash had proposed legislation regulating subprime mortgages only to be rebuffed by his more conservative colleagues, favored bipartisan efforts.He was up against an increasingly conservative House Republican caucus, who were led by radicals who ere emboldened by redistricting in their stat es that left them with little need to proposal for financial reform, undercutting the release of the administration white paper by a week. This proposal overwhelmingly focused on the principle that they would not stand for future â€Å"bailouts† of the Wall Street institutions that were responsible for the financial crisis. Though the plan garnered little media attention, and did not include many of the provisions laid out in the White House bill, it did indicate that Congressional Republicans recognized the reality that comprehensive financial reform was necessary. TARP Republican Study Committee

Boiling Point Elevation Definition and Process

Boiling point elevation occurs when the boiling point of a solution becomes higher than the boiling point of a pure solvent. The temperature at which the solvent boils is increased by adding any non-volatile solute. A common example of boiling point elevation can be observed by adding salt to water. The boiling point of the water is increased (although in this case, not enough to affect the cooking rate of food). Boiling point elevation, like freezing point depression, is a colligative property of matter. This means it depends on the number of particles present in a solution and not on the type of particles or their mass. In other words, increasing the concentration of the particles increases the temperature at which the solution boils. How Boiling Point Elevation Works In a nutshell, boiling point increases because most of the solute particles remain in the liquid phase rather than enter the gas phase. In order for a liquid to boil, its vapor pressure needs to exceed ambient pressure, which is harder to achieve once you add a nonvolatile component. If you like, you could think of adding a solute as diluting the solvent. It doesnt matter whether the solute is an electrolyte or not. For example, boiling point elevation of water occurs whether you add salt (an electrolyte) or sugar (not an electrolyte). Boiling Point Elevation Equation The amount of boiling point elevation can be calculated using the Clausius-Clapeyron equation and Raoults law. For an ideal dilute solution: Boiling Pointtotal Boiling Pointsolvent ΔTb where ΔTb molality * Kb * i with Kb ebullioscopic constant (0.52Â °C kg/mol for water) and i Vant Hoff factor The equation is also commonly written as: ΔT Kbm The boiling point elevation constant depends on the solvent. For example, here are constants for some common solvents: Solvent Normal Boiling Point, oC Kb, oC m-1 water 100.0 0.512 benzene 80.1 2.53 chloroform 61.3 3.63 acetic acid 118.1 3.07 nitrobenzene 210.9 5.24