The social determinants of healthcare are situations in which people grow, work, born or live and age. The circumstances are created by power, money and resources distribution at the local, national and global level. The social determinants of health are in most cases responsible for the inequalities in health. This report will identify, discuss, analyse social determinant of health and public health and its relationship to health inequality in Sutton. Moreover, it will discuss the current social and health policies and explain an example of contemporary public health provision in Sutton.
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Social Determinants of Health in Sutton
Sutton is situated in south London with a population of 191,123 of whom 51% are female and 49% male (Sutton 1990). According to (Sutton 1990), under 5 year olds account for 6.7%, working age 20–64 accounts 60.8% compared to 64.4% in London. Sutton’s residents aged 65 years and above forms 13.4%. This is higher when compared to the 11.2% that is of average in London. Moreover, minority ethnic population accounts for 21%.
According to Mann (1966: 169), the Borough of Sutton continued being much healthy. However, there existed an unacceptable wide range of death rates and life expectancy in some of the major death causes. These inequalities are shown in teenage pregnancies, low birth weight babies and prevalence of smoking, which are key wellbeing and health predictors. The life expectancy for men is 79.4 years, and women are 83, compared with the national average of 78.3 and 82.3 years respectively. The three main causes of death in Sutton are Heart disease, stroke and cancer (Royal College of Physicians Of London 2011)
According to Marmot & Wilkinson (1999), health is a basic human right and a necessity. There exist wider determinants of health and wellbeing of Sutton as observed by (Glasby & Dickinson (2008). Therefore, innovative ways of working and strong partnerships are significant in reduction of health inequalities. Barnard et al (2008) pointed that 16.7% of children are living in poverty compared to 28.0% in London. Furthermore, there are 31,816 people who are not in employment, education or training and are of 18 year of age. Pitkin & Varda (2009: 272-306) further observed that in Sutton the children with special educational needs are approximately 1,087. The economic activity rate is 78.3% among working age people in Sutton, and this is higher than75.1%, the average in London. 70.6% of council housing met the Government’s housing standard. There are about 80,000 homes and approximately 250 households in Sutton that will be affected by the total welfare benefit cap in 2013. Over 5,000 households currently on social housing waiting list and 168 households statutorily homeless during 2011/12 (Cox et al 2007).
The government has invested in health researchers to determine the factors that impact health. These factors are also known as health determinants. Complex interactions of life’s every stage between physical environments, the individual behavior, social and economic factors determine health. It is the combined influence of the determinants of health that determines health status and does not exist in isolation from each other. These determinants impact the collective and personal well-being of the people in Sutton (Baggott 2004: 78).
The health inequalities between rich and poor exist in the Borough of Sutton. This poses a great challenge in the field of health related areas which needs to be overcome for the valid progress of any society. These inequalities prevail when the poor are discriminated and not treated with equality. This can be injurious to the health of society as a whole. The discrimination defines the validity of equality in rights to health among people and gives rise in numerous health care related problems (Jerome 1983).
According to McKenzie, et al (2008), some health status indicators and determinants include:
- Social Support Networks.
- Social Environments.
- Physical Environments.
- Personal Health Practices and Coping Skills.
- Income and Social Status.
- Healthy Child Development.
- Health Services.
- Employment/Working Conditions.
- Education and Literacy.
- Life choices.
- Biology and Genetic Endowment.
Some people have the genetic tendency to health status, and it is drawn from their biological background and ancestors. This can be thought as an endowment or course. Similarly, Royal College of Physicians of London (2011) adds that health also corresponds to culture. For example, obesity is viewed as a point of embarrassment in some cultures. Thus, the norms in culture demand an idealistic perspective of health. This also tends to vary in different genders. Men are supposed to be strong and active, whereas females are stereotyped as curvy in response to perfection (Marmot & Wilkinson 1999). This perception is the outcome of culture shock upon arriving in the United States. These students must understand the cultural beliefs and customs.
The education and literacy also play a significant role in health status as determinant. The educational background differentiates the favorable or hazardous conditions regarding health. The working conditions should be according to the safety measures provided for workers in the organisation. These working conditions are also considered as determinants of health because of their influence in the conditions (Glasby & Dickinson 2008). Health services provided by the medical institutions such as hospitals and clinics are the participants in the health concerns and thus regarded as health determinants. Similarly, institutions such as insurance foundations that provide policies for health concerns are the developing phenomenon these days. They also contribute in the health status of the people. However, this depends on the income and social status of the individual up to some extent. Financially stable people tend to enjoy better health benefits than the less privileged; therefore, it is also counted under the broad category of health status determinants (Barnard et al 2008). The personal health is also a matter of an individual and practiced on a daily scale. People have a propensity to take care of themselves. They have reflexes to respond to physical and social environment in undertaking such practices considering their own health. Thus, they are themselves viewed as determinants of health within the category on a personal level.
According to Pitkin et al (2009: 272-306), many conditions affect the health, and they include poverty, drugs provision among others. Health and social care policies prevent deviations from the health related concerns and misconduct of procedures. Moreover, the health and social care policies depend on factors related to health. The opportunity to enjoy the rights to health requires advancements in health care, community planning, childcare, education, law, media and housing.
According to Cox et al (2007), there is differential access to the services of the public including health services due to health inequalities in Sutton. The white paper “Our Health, Our Care, Our Say” gave a policy direction focusing on personalized responsive services and change to early intervention and prevention. Moreover, subsequent policy documents “NHS Next Stage Review,” “Putting People First,” and “Equity and Excellence- Liberating the NHS,” focused on personalized and individualisation in both health and social care (Baggott 2004).
Jerome (1983) observed that the white paper of Equity and Excellence-Liberating the NHS provided the framework for NHS radical reforms. The main theme in the government’s policy was to integrate the health and social care services, develop with health the resilient communities, and place the user of the services at the centre of all service design with the health choices and wellbeing of local people. The target is delivering to every individual an improved health outcome, reducing dependency on welfare and health provisions and ensuring the delivered services are affordable and of high quality.
According to McKenzie et al (2008), Case study and instructor’s guide created by: Jeanette K. Stehr-Green, MD, public health services formerly provided by the NHS SW London have been transferred to local councils. At the local level in Sutton, some of the current health and social policies include:
Barnard et al (2008) observed that NHS patients currently can choose their hospital they are referred to or GP, in most circumstances. Furthermore, personal budgets allow the flexibility of making choices and control their support and social care arrangements. This has made services and information be more responsive and available to the needs of the people.
Observing dignity, respect and compassion when treating patients
The skilled staff should observe dignity, respect and compassion when attending to every person using the paper will examine the systems of heath care in United States and Canada and try to make comparisons. In United States, the health care services. The council wants compassion to be incorporated in the health and social care services. This means quality care being part of quality treatment. This is implemented by providing information to people about their services to help them in making informed choices, using personal health budgets (Barnard et al 2008)
This aims to improve the health of the people that require support and care, encouraging residents to live as independently as possible, ensuring people are happy with the support they receive, and protecting adults. The point of focus for Sutton is to maintain the policy in line with the dynamic environment and adjust its flexibility (Barnard et al 2008).
The national statistics shows that the number of people with health problems is increasing, and require both social and health care. This shows that people with complex health needs are probably many. This calls for of the social and health care services integration. The council of Sutton ensures that the policy of integration of the health of social services is implemented by:
- Collaborating with healthcare organisations to provide integrated health care.
- Allowing people make decisions on the best services that are best for them such as providing personal health budgets.
- Removing integrated health care barriers.
- Coordinating the people’s care.
- Provision of information on health care needs of people.
- Giving support to the people transferring from one service need to the next.
Quality of life improvement for people with long term conditions
Long term conditions are incurable health problems that can be controlled by therapies and medication. They include dementia, depression, high blood pressure and arthritis. According to Royal College of Physicians Of London (2011), the borough of Sutton has a large population of its citizens having long term conditions and the number is projected to rise over the next ten years. The care to people with the condition accounts for 70% of the total health and social care money in England (Glasby et al 2008). The council of Sutton plans to better the life of people suffering from the long term conditions by:
- Consulting them on the best care plan for them based on their individual needs
- Helping them acquire skills for management of their own health.
- Ensuring their care is well coordinated.
The council also uses technology in curbing this condition. Telecare and Telehealth services that encompass blood pressure alarms and monitors are examples. Pitkin et al (2009: 272-306) observed that technology used correctly reduces:
- Visits to emergency and accidents departments by 15%
- Rates of death by 45%
- Hospital emergency admissions by 20%
The Contemporary Public Health Provision In Relation To the Organisation of Health and Social Care
The contemporary public health provisions are nowadays highly regarded by the government agencies. The government is investing heavily on these issues but also realised that investing in them is only a part of the solution. The research on health is done by the government on a broader scale for the welfare of people. According to Sutton (2009), In Sutton, the adults who receive support from Adult Social Services are approximately 2,500. In addition, the number receiving support through voluntary sector funded prevention services are nearly 1,000 people. Therefore, a total of 3,500 adults received care and support funded by Sutton Council (Sutton 2009).
Cox et al (2007) asserted that Adult Social Services consider social and community context including family structure, social cohesion, perceptions of equity and discrimination, civic participation, institutionalisation. The family structure of the person is highly noticed for the health issues. Like any organisation, this service is impacted by the economic conditions in carrying out its task. Therefore, it is bound to comply with such uncertain conditions. They have to examine the access to employment, employment status, poverty, and housing stability of the individuals in order to take proper actions. The education background is also observed. This comprises of enrolment in higher education, school policies that support health promotion, graduation rates, and school environments that are safe and conducive to learning.
The health provisions services in Sutton consider the health care as comprising of several components. These components include access to health services along with access to primary care with community-based health promotion and wellness programs, clinical and preventive care, and the technological establishments in health care programs. The neighborhood and environment of any area is judged by access to healthy foods, environmental conditions, crime and violence, and quality of housing. This organising framework has been used to develop in relation to the organisation of health and social care. Adult Social Services in Sutton have also been utilizing the same framework of social determinants of health for the purpose of better understanding and contribution of work in Sutton’s health care (Baggott 2004).
The government and other voluntary organisations strive for the successful provisions of health and social provisions to the public regarding safety and health concerns. This is essential for the public these days due to the increasing pollution in the fast-pace and dynamic environment. Health considerations are the basic right of every person by the world health organisation. The prevailing problem is the successful delivery of these rights to the public in different settings (Jerome 1983).
The increase in the awareness of people as a result of advancements and accessibility to technology at personal levels has made them more conscious to the related issues of health. Therefore, it is not only the organisation’s responsibility to cope with the health issues, but has inclined towards a relatively personal level, as well.
According to McKenzie et al (2008), the social determinants of health have indicated the several factors impacting the health and social care aspects. The overall promotion and maintenance of health is achieved through different combination of mental, physical, and social well-being. This means that health is not specifically or entirely related to the physical factors, but also the mental satisfaction is also correlated. Similarly, environment can also be considered as an important factor contributing in the social health determinants. This includes characteristics of the social environment, the built environment, and the natural environment. Resources such as adequate housing, clean water and air and safe communities and roads all have been found to contribute to good health, especially to the health of infants and children (Marmot et al 1999).
The health and social care provisions are faced by many discriminations and health inequalities. Financially stable people tend to enjoy better health benefits than the less privileged people. There are clear inequalities in terms of Coronary Heart Disease, stroke, diabetes, respiratory disease (COPD) and cancer across the borough and between genders. The linking factors are smoking and obesity. Inequalities exist in accessing services with those most at risk and not accessing services as much as those least at risk. Therefore, it is also counted under the broad category of health status determinants. The personal health is also a matter of an individual and should be practiced on a daily scale. People have a propensity to take care of themselves. They have reflexes to respond to physical and social environment in undertaking such practices considering their own health. Therefore, they are themselves viewed as determinants of health within the category on a personal level.
Glasby et al (2008) suggested that the equality must be developed to ensure the proper and indistinctive medical treatment to each social class and individuals regardless of the social constraints. This is usually backed by the establishment of better health related programs and introduction of policies supporting the resolutions of these restrictions based on underlying factors. Resources are scarcely available to poor people who lead low life and unhealthy living. Examples of these resources include dirty activities that result to physical healthiness. For example, proper diet, ensuring that all meals are balanced and taking a lot of water, pollution, and other factors.
In conclusion, there exist many social determinants of health in the borough of Sutton. These varies from physical, health, social, health care, cultural factors have a strong influence on patients’ and families” decisions. Some cultural, environmental and educational determinants .The settings in the borough include the improvement of the lives of people that need care and support, encouraging residents to live as independently as possible, ensuring people are happy with the support they receive, and protecting adults. Their policies are aligned with these points to serve the adult people and to take care of them. These policies are maintained according to the dynamic environment and adjust flexibly. Lastly, the contemporary health provision in Sutton addresses the current health interventions. These are steered by the government and the voluntary organisations.
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