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P3 + M1: Research these topics

The Black Report

The Black Report is a document published by the Department of
Health and Social Security in 1980. The DHSS demerged into the
Department of Health and the Department for Work and pensions.
It is a document which highlights the inequalities in health.

It says that even though the health of the country has improved,
now Britain is a welfare state; we still have widespread health
inequalities. It added that the main cause of these inequalities was
poverty.

Douglas Black, who wrote the report, played a huge part in shaping
the NHS. He discovered the link between social class and health. He
people in higher social classes were healthier and had higher life
expectancy rates; he compared labourers and professionals.
However, explaining why people in higher social classes don’t get
mental illnesses such as schizophrenia is difficult; as it’s not a
disease, which are easy to explain why people get them.

It is sometimes difficult to explain why the poorest regions get the

most illnesses as there are multiple answers. It’s hard to explain
why people who are employed get less illnesses.

There is evidence of 'social drift', where people with poor health

suffer a decline in socio-economic position. Where people with
schizophrenia become in a lower social class than their fathers. The
graph below is dated 1980.
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Acheson Report
The Acheson Report was published in 1998 which its real name is
“The Independent Inquiry into Inequalities in Health Report” by
Donald Acheson. Just like The Black Report, this article too
highlights the inequalities in health regarding social class.

The report finds that the mortality rate has been decreasing from
1970-1990. The upper social classes experienced a more rapid
decline. The report contains 39 policy suggestions, including
agriculture, and taxation. This report was commissioned by the
government.

A government-commissioned report on health inequalities will provide "a

key influence" on future public health policy in the UK, according to Health
Secretary Frank Dobson.

Sir Donald Acheson's report highlights a range of areas where health

inequalities can be reduced. News Online details four of these:

Benefits

The report calls for an increase in benefit levels for women of childbearing
age, expectant mothers, young children and older people.

It says poverty has a disproportionate effect on children. In the mid

1990s, around a quarter of people in the UK were living below the poverty
level.

But among children, the figure was one in three.

The report says children under two are more expensive to look after than
older children, but Income Support levels do not reflect this.
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It says benefits underestimate the cost of providing a basic standard of

living for single parents.

And it states that many people on low incomes do not have enough
money to buy the items and services necessary for good health, meaning
that money for food is often used to meet emergencies.

Mothers are sometimes forced to go without food as a result.

The report says many pregnant women on Income Support have

inadequate diets, especially single women under 25.

Education

The report calls for more funding for schools in deprived areas, better
nutrition at schools and "health promoting schools".

These promote health through the curriculum, for example, by teaching

children not just about cooking, but also about budgeting for food.

The report also proposes that schools should offer pupils free fresh fruit
and avoid putting sweet machines on the premises.

They should also promote parenting and relationship classes and

programmes on substance abuse and sex education.

It says children from disadvantaged backgrounds achieve less at school

than other children and are more likely to go on to get badly paid jobs or
be unemployed.

This leads to a vicious circle of health problems associated with low

income and a perpetuation of the poverty trap.

The report says reduced entitlement to free school meals and the selling
off of school playing fields have a bad impact on children's health.

About 15% of children in England receive a free school lunch. Entitlement

is based on whether their parents are on benefits.

Babies

The report reiterates concerns about benefit levels and education about
the need for nutritional meals as well as calling for policies for an end to
"food deserts".

These are deprived estates where access to affordable fresh food is

difficult because of poor public transport links.

The report says babies whose fathers are in lower social groups are on
average 130 grams lighter than those with fathers in the top social
groups.
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Babies whose mothers were born in south Asia are on average 200 grams
lighter than those born to mothers born in the UK.

Low-weight babies are more likely to suffer from heart disease and related
illnesses in later life.

Children of women who are overweight are also at increased rate of

coronary heart disease as adults.

The report says poor women are more likely to be obese than the rich.
Twenty-five per cent of women in lower social classes are obese compared
14% of professional women.

Smoking and drinking

The report calls for restrictions on smoking in public places, a ban on

tobacco advertising and promotion, mass educational initiatives, increases
in the price of tobacco and the prescribing of nicotine replacement therapy
on the NHS.

The poorer you are the more likely you are to

smoke, says the report.

In 1996, 29% of men and 28% of women smoked,

but only 2% of professional men and 11% of
professional women smoked, compared with 41% of
unskilled male workers and 36% of unskilled women
workers.

Richer people also smoke fewer cigarettes than the

poor, are less likely to be addicted to cigarettes and
The poor are more more able to give up smoking.
likely to smoke and
less likely to be Since 1973, the number of rich people who stop
able to quit smoking has doubled from 25% to 50%.

Around 9% of poor people gave up smoking in 1973. That figure had only
risen to around 13% in 1996.

Moreover, the number of people who smoke in the UK has fallen in recent
years, but the number of poor people who smoke has remained stable.

The report says: "Smoking is an important component of differences in

mortality between social classes."

Smoking is the highest single risk factor for cancer in the UK.

The poor are also twice as likely to have drink problems as the rich.
Seventeen per cent of poor men and 6% of poor women has an alcohol
problem, compared with 8% of rich men and 3% of rich women.
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Saving Lives: Our Healthier Nation

Our Healthier Nation is a government action plan which is aimed at
tackling poor health particularly for those who are worst off in
society. It sets targets which aims to reduce deaths caused by the
four main killers, cancer, coronary heart disease and strokes,
accidents and mental illness. It is actually a government paper

There are two editions of this paper. The 1998 version is titled “Our
Healthier Nation” and the 1999 edition is titled “Saving Lives: Our
Healthier Nation”. The 1999 edition of this paper has a forward from
Tony Blair, is much longer, and has more signatures from various
people from various government organisations.

The 1999 version is going to be talked about from hereon. The

paper seems to care too much about people and is interested in
preventing illnesses before an outbreak or epidemic happens. There
is just too much of it to sum up on one page.

It says “ “We will achieve what no previous Government has

achieve”' So we are setting new, tougher and challenging targets in
each of these priority areas. By 2010: * Cancer
reduce the death rate from cancer in people under 75 by at
least a fifth - saving 100,000 lives
* Coronary heart disease and stroke
reduce the death rate from coronary heart disease and stroke
and related diseases in people under 75 by at least two fifths -
saving 200,000 lives
* Accidents
reduce the death rate from accidents by at least a fifth and
to reduce the rate of serious injury from accidents by at least
a tenth - saving 12,000 lives
* Mental health
reduce the death rate from suicide and undetermined injury by
at least a fifth - saving 4,000 lives

1.6 These are ambitious targets. But they are achievable - and we
are committing ourselves to make steady progress towards
achieving them.

1.7 We believe we can succeed in this ambition. We believe we can

make a difference. We have the principles and programmes in place
which will achieve what no previous Government has achieved:”.

It also tackles smoking which is says is the biggest preventable

death issue. The government is very serious about tackling health
so it even has the schools involved with the initiative.
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Inequalities in Health
People with higher social classes are more likely to live longer.
Based on figures in the 1970s, men and women in the V (lowest
class) had two and a half greater chance of dying before the
retirement age than their professional counterparts (class I). These
differences can be traced down to environmental factors. Boys in
class V have a greater chance of dying from fire, falls, or drowning
from those in class I. This may be because children in the higher
classes get a better upbringing and are better looked after. Their
deaths from vehicles outweigh class by 7 to 1.

Tacking health and inequalities

It’s more likely for an unemployed person to turn to alcohol, crime

and drugs. People who are unemployed will be more interested in
getting quick money.

“As the credit crunch gets "worse" (although that's debatable),

there are more "acquisitive" crimes being committed - shoplifting,
thefts, burglaries, cars being broken into, that sort of thing, and all
the goods being sold on the black market. The people buying them
seem to think they are getting a bargain, but they are buying
someone's misery.”

The thieves therefore still have plenty of money to buy their drugs.
This is not a good thing for Britain at all.

How can health and inequalities be tacked? There are various ways
for this to be done.

Demographics let us know we have a problem, how widespread it is,

and whether our efforts have helped to tackle those problems. They
allow community groups, and government organisations to come up
with strategies and campaigns to tackle problems.

Demographics teach us that the gaps in the income and wealth

remain large. And that exam results differ by social status. All of
these things are not going to change. It seems like society likes to
put people in boxes.

If we didn’t have demographics on teenage pregnancies, we

wouldn’t be able to fully understand about tackling teenage
pregnancies and be able to solve the problem. Demographics allows
the government to produce campaigns which increase awareness
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about sexually transmitted infections, the low benefits paid to single

mothers which is below the minimum wage, and contraception.
Demographics let us know we have a problem, how widespread it is,
and whether our efforts have helped to tackle those problems. They
allow community groups, and government organisations to come up
with strategies and campaigns to tackle problems.

The reason why the amount of care centres in Birmingham are

increasing is because Birmingham is a place where people are on
benefits, unemployed, in poverty, so places like SureStart are only
going to be in places where they are needed. All because of
demographics.

Drugs are a widespread problem. How would we know that one in

three people admit to taking drugs if we didn’t collect statistics?
How would the police have an idea of how much drug users they
have to catch in the area if we didn’t collect statistics? The fact is
we wouldn’t. The government does not take statistics for the sake
of it. Their statistics have an actual purpose to it.

Below are the various ways the government tackles health issues.

We tackle issues such as smoking with NHS advertising campaigns ,

education in schools, funding, and research.
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References
http://www.ucel.ac.uk/shield/black_report/Default.html
(accessed 5th March 2009)

http://en.wikipedia.org/wiki/Black_Report
(accessed 5th March 2009)

http://www.sochealth.co.uk/history/black.htm
(accessed 5th March 2009)

http://www.guardian.co.uk/society/2002/sep/14/medicineandhealth.guardianobit
uaries
(accessed 5th March 2009)

http://news.bbc.co.uk/1/hi/health/222649.stm
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http://www.archive.official-documents.co.uk/document/doh/ih/contents.htm
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http://collections.europarchive.org/tna/search/?query=http%3A%2F
%2Fohn.gov.uk&SearchButton.x=0&SearchButton.y=0
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http://www.webarchive.org.uk/pan/11052/20050218/www.ohn.gov.uk/index.htm
l
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http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicy
AndGuidance/DH_4008701
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http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicy
AndGuidance/DH_4008701
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