The magnitude of the relationship between income level and poor health is not appreciated enough (Woolf & Braveman, 2011). Regardless of individual characteristics, education and neighborhoods in which people live have a considerable impact on their health (Donatelle, 2014). Even though disparities in housing and transportation have been substantially reduced over the last decades, discrepancies in the health of minority groups and the poor have persisted (Woolf & Braveman, 2011). Health disparities affecting ethnical and racial groups, as well as people with low income, operate through the social environments, access to healthcare services, and attitudes toward healthy behaviors (Woolf & Braveman, 2011).
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Overview of the Problem
The life expectancies of the households in the low-income bracket are significantly shorter than those of people who are better off even for the most affluent societies (Wilkinson & Marmot, 2003). The risk of developing serious illnesses for the residents of poor neighborhoods is twice as high in comparison to those living in affluent neighborhoods (Wilkinson & Marmot, 2003). Cultural differences, along with discrepancies in socioeconomic status play a pivotal role in the management of health outcomes of socially disadvantaged groups. The first substantial step toward narrowing the health disparities was made in 2003 by the Institute of Medicine, which issued the report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (Woolf & Braveman, 2011). It drew the necessary attention of policymakers, which resulted in the standardization of treatment of disadvantaged groups (Woolf & Braveman, 2011).
The theory of “social disorganization” can account for the link between health disparities and life in disadvantaged neighborhoods (Bak, Andersen, & Dokkedal, 2015). According to it, characteristics of some community structures such as poverty, low employment opportunities, and residential uncertainties lead to the deficiency in the health-promoting infrastructure and resources (Bak et al., 2015). Poor infrastructure and a lack of necessary social services that are inherent to deprived neighborhoods also result in increased levels of stress. A recent study suggests that the residents of those communities usually rate their health as bad or poor more often than people living in affluent neighborhoods (Bak et al., 2015). Therefore, it is safe to conclude that social determinants are the best predictors of health outcomes.
Other Factors Contributing to Health Disparities
Education is a very significant social determinant that greatly influences health. Disparities in health can be explained by different levels of education that greatly contribute to people’s health behaviors (Woolf & Braveman, 2011). Data from extensive literature reveals that there is a three-fold difference in the likelihood to die before reaching the age of 65 between those adults who have and do not have a high school diploma or its equivalent (Woolf & Braveman, 2011). The data also suggests that six years difference in education can account for the seven-year difference in life expectancy (Woolf & Braveman, 2011).
Culture also has a considerable influence on health literacy. Cultural beliefs contribute greatly to the inability or lack of desire to act on instructions of health care providers (Shaw, Huebner, Armin, Orzech, & Vivian, 2008). Low health literacy levels among some minority groups are related to the morbidity and mortality rates among them (Shaw et al., 2008). The problem is exacerbated by the lack of medical interpreters in public hospitals. According to Baker et al, a high number of Latino patients visiting the emergency department of a community hospital “had poor knowledge of their diagnosis and recommended treatment” (as cited in Shaw et al., 2008).
There is a correlation between Intimate Partner Violence (IPV) exposure and annual household income (Larsen, 2016). A poor self-assessment of health among socially disadvantaged women is related to the higher likelihood of experiencing IPV (Larsen, 2016). There is also a significant link between prolonged IPV exposure and a frequency of mental health complaints (Larsen, 2016). Moreover, high IPV exposure among racial and ethnic minorities can account for large numbers of chronic diseases (Larsen, 2016).
The government has to address the issues affecting the health of socially disadvantaged people. The important thing that has to be realized by policymakers is that negative effects on the health of people with low socioeconomic status tend to accumulate during life (Wilkinson & Marmot, 2003). Therefore, if social circumstances and economic constraints of those groups will not be changed they will have lower chances to enjoy good health in old age (Wilkinson & Marmot, 2003).
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The government can significantly reduce the number of poor people by regulating taxes, benefits, access to services, housing, and education, thus reducing the negative health effects of poverty. Policymakers must issue legislation aimed at the protection of vulnerable groups from deprivation and discrimination (Wilkinson & Marmot, 2003). It is a public duty to provide minimum income guarantees as a protection for people from disadvantaged backgrounds. Moreover, all existing impediments that limit their access to health care and social services have to be removed
Health disparities negatively influence ethnical and racial groups, as well as people living in neighborhoods affected by deprivation, operate through the social environments, access to healthcare services, and attitudes toward healthy behaviors. The government must take drastic and consistent measures aimed at reducing social exclusion and stratification, unemployment, and limited access to healthcare for people from disadvantaged backgrounds. Legislation guarantying free education and minimum wages can also significantly influence the economic status of residents of poor neighborhoods and minority groups, thus improving their health.
Bak, C., Andersen, P., & Dokkedal, U. (2015). The association between social position and self-rated health in 10 deprived neighbourhoods. BMC Public Health, 15(1), 14.
Donatelle, R. (2014). Health: The basics (11th ed.). San Francisco, SF: Benjamin Cummings.
Larsen, M. (2016). First Insights into the Relationships Between Social Position, IPV Exposure, and Health Outcomes. Health Inequities Related To Intimate Partner Violence Against Women, 133-153.
Shaw, S., Huebner, C., Armin, J., Orzech, K., & Vivian, J. (2008). The Role of Culture in Health Literacy and Chronic Disease Screening and Management. Journal of Immigrant and Minority Health, 11(6), 460-467.
Wilkinson, R., & Marmot, M. (2003). Social determinants of health: the solid facts. Denmark, Copenhagen: WHO Publishing.
Woolf, S. & Braveman, P. (2011). Where Health Disparities Begin: The Role of Social And Economic Determinants–Why Current Policies May Make Matters Worse. Health Affairs, 30(10), 1852-1859.