Insights from the Case Study of Brook Road

Introduction

Health inequalities are referred to unjust and avoidable differences in health and healthcare opportunities for the people across the population and specific population groups. It impacts to take action against social justice for the people leading them to face avoidable deteriorated health consequences and increased mortality. In this study, the factors, patterns and sources of health inequalities are to be discussed in reference to the case study of Brook Road. Thereafter, relation between health theories and welfare inequalities along with health policy impact on health inequalities are to be evaluated.

In the UK, it is reported that after the Brexit vote the racial discrimination was increased to 71% among people of minor ethnicity which was 58% in 2016 (Booth, 2019). The social development of increased racism in the UK societies have affected to create health change among minority ethnic individuals by leading them to face higher health-related morbidities. It is evident as the case study mentioned that due to the rise in racial incidence in the locality of Brook Road, the Khans who belong from minority communities in the UK has developed increased stress that is worsening their health condition. This is because racist incidents involve violence against minority communities which makes the minority individuals feel unprotected and fear of unnecessary harm leading to raise their stress level out of hindered mental health created by the unsafe condition (Massoumi et al., 2017).

The economic development in the UK has caused increased income inequality that led to changes in raising the mortality and morbidity of UK individuals. This is because income inequality makes people unable to have adequate finances in supporting their enhanced health and avail adequate care required for health improvement. It leads the people suffering from diseases to face drastic health consequences as they are unable to avail the healthcare services and protection needed to lower their morbidity and it eventually leads them to face morality relate to the disease (Dewan et al., 2019). This is evident from the case study where it is mentioned that the Bradleys have poor income due to which they are forced to buy cheap and unhealthy foods even though one of them is suffering from Type-2 diabetes for which healthy diet is required to lower the morbidity rate of the disease in the individual. On the contrary, the Huntleys has adequate income which they use for availing adequate food and recreational drugs which are not needed as compulsory factors for leading a healthy lifestyle.

In regard to environmental development in the UK, the UK Sustainable Development Strategy mentions that it is the right of all in the UK to have healthy, clean and safe environment for living. This is to be achieved through reduction of poverty, pollution, unemployment and poor housing condition (Ganzleben and Kazmierczak, 2020). However, the case study regarding Brook Road mentions that the environment development in the area included noisy and congested places to live for the poor whereas the benefit of clam and green places was offered to the rich. This nature of deteriorated environment development for the poor leads to cause higher morbidity and mortality rates in them because without a healthy living environment, the people are unable to breathe fresh air, remain emotionally calm and access healthcare services which are basic needs for their improving deteriorated health condition (Brailsford et al., 2019). It is evident from the case study where it is mentioned that Khans who are family of 6 and among them one of the children is facing severe asthma. The severity may have been raised due to increased pollution created by congested traffic in the area that causes increased air pollution. Moreover, the Bradleys who are an elderly couple are seen to avoid accessing effective healthcare as the healthcare services are far from their living place which they are unable to attend effectively.

In the UK, it is reported that the bottom 20% of the population has average disposable income of £12,798 while the top 20% of individuals have average income of £69,126 (equalitytrust.org.uk, 2018). Thus, it indicates huge income inequality is present in the UK and it is one of the patterned inequalities in health and illness. This is because inequality in income makes the rich and poor to have differential access to care opportunities which has adverse impact on their health (Lahtinen et al., 2017). It is evident from the case study where (the Bradleys) Bret who is suffering from memory problems and arthritis and Iris who is suffering from overweight and type-2 diabetes are seen to depend on having cheap unhealthy foods as they do not have adequate money or income to buy healthy food. The inequalities in education and health awareness is one of the patterned inequalities seen in health and illness. This is evident from the case study where the Bradleys were seen to avail over-the-counter drugs without considering the way they may create side-effects on their health and way it would deteriorate their current health condition.

The differences in education and health awareness lead to create inequality in healthcare because the educated people are found to be aware and concerned as well as perceived of the impact of the disease they are suffering along with the need for taking immediate care services which the uneducated people fail to understand to avail care at the right time (Heymann et al., 2019). It is evident while comparing the Bradleys with the Khans, where the Khans being educated and aware of their health avails necessary healthcare such as support from the midwives, clinic visit fir serve asthma control and others which is not seen in case of the Bradleys.

The working hours and job security are seen to act as pattern of inequality faced in health and illness. This is because people involved in long working are seen to lack time in maintaining healthy activities or having job security issues are found to be mentally stressed and anxious out of their instability regarding work status (Shields et al., 2020). In contrast, the people with job security and legible working hours are seen to have enhanced health as they have time for taking care of their health and maintain work-life balance required for their stable emotional health (Lam and Ambrey, 2019). In the case study, it is seen Mr Huntley is facing increased job insecurity due to continuous lay off at his office and trying to work over hours to ensure his job security which has led him less time to eat healthy food and have stable mental state. In contrast, Mr Khan has job security and is seen to overtime according to his capability without taking any pressure to ensure the security of his job. This has led him to have a stable mental state unlike Mr Huntley, in turn, showing inequality in health exists with respect to work nature.

The Equality Act 2010 mentions nine key protected characteristics of health that are age, disability, gender, marital status, pregnancy, race, religion, sex and sexual orientation (legislation.gov.uk, 2010). The Act does not protect the group of people from discrimination who are single, widowed, divorced or have dissolved civil partnership (legislation.gov.uk, 2010). Age indicates that with aging, the elderly required active support from the family and non-discriminative opportunity to avail healthcare services to ensure their well-being (Talarska et al., 2018). However, discriminative health support to the elderly leads them to face delay in care and increased exacerbation of the disease (Liu et al., 2020). In case of the Bradleys, who are elderly couple, discriminative healthcare support created out of inequalities in health in respect to low education, hindered availability of transportation and poor income is responsible in deteriorating their health. This is evident as active healthcare support that promote intake of healthy food and prescribed medication in type-2 diabetes elderly is seen to avoid worsening the impact of the disease and damage to other organs of the body (Tan et al., 2018). However, in the case of Mrs Bradley, the lack of active healthcare support led her to face exacerbation of type-2 diabetes which damaged her eyes and kidney along with muscles in the feet to make worsen health consequences.

The gender mentions that vulnerability of certain health condition may be more for women or men. This is because of the physical development and working ability of the body along with differential involvement in care by women and men (Zayed and Jansen, 2018). In the current case study, it is seen that since Mrs Khan is a female, she is responsible to take care of the house and her children as her husband goes to work who is responsible in take care of ensuring income for the family. The condition of increased responsibility of care to be provided to the children and managing household by Mrs Khan has led her develop high blood pressure with no healthcare changes been seen in Mr Khan. The ethnicity of individuals is another protected characteristic in health as the minority ethnic communities due to their lower status are often deprived of basic healthcare and fear of living improved life without violence from the higher cultural communities (Sutton et al., 2017). It is evident as fear of increased racist incidence and discrimination is seen to make the Khans feel stressed regarding their ability to live a safe and healthy life.

The Health Belief Model (HBM) is referred to as the theoretical model which can be used in guiding the health promotion and prevention of disease (Sheppard and Thomas, 2021). Thus, the aim of creating welfare state of the mentioned patients is to use HBM in changing their current behaviour and lifestyle. The HBM mentions that by making individuals to understand their risk of facing health issues due to their current behaviour (perceived susceptibility) and severity along with its potential consequences to be faced due to their careless management of the health issue (perceived severity) is able to create changes in their behaviour and resolve welfare inequalities for them (Costa, 2020). This indicates that making the Bradleys understand the risk of their current health symptoms and diseases along with the severe consequences to be faced of their current healthcare behaviour of ignoring care services and taking over-the counter medication would help in change their behaviour to create enhanced welfare by overcoming health inequalities caused by lack of education and awareness in them. This aspect of the theory also impacts the health policies to be developed in such a way so that it mentions guidance regarding the way severity and susceptibility of the disease is to be perceived among population.

The HBM informs the barriers of making behaviour change and prevention in controlling any disease (perceived barriers) and benefits of the changed behaviour or prevention strategies (perceived) are to be identified and informed to target population for improved their health (Mercadante and Law, 2021). This is because it helps in overcoming welfare inequalities which are created out of lack of knowledge regarding the factors leading to inequality in health. The aspect of the model is to be used in framing healthcare policies which should mention strategies to overcome barriers of health promotion regarding any disease and provide education regarding the importance of following suggested behaviour change in the polices. The allocation of low budget impact policy development by reducing availability of finances to buy and arrange resources in effective development and establishment of the policy (Penno et al., 2013). The research bias is to be reduced by training the researchers to have better skills in framing the policies and crowdfunding is to be implemented for additional funding in framing care policies.

Conclusion

The above discussion mentions that wider inequalities of health related to income, education, work, transportation, housing facility and others are present in the Brook Road area which is adversely affecting the health of the people living in the area. The use of the Health Belief Model as theoretical construct is to be made in resolving welfare inequalities and develop policies regarding health.

Recommendation

The recommendation is that effective action and policies are to be implemented to avoid racist incidence and discrimination in the society so that people of all communities irrespective of their status are able to live their life without stress and anxiety from social condition. Further, it is recommended clean and safe housing facility with enhanced healthy environments is to be support for all individuals irrespective of their social and income status to create equality towards living with enhanced health. The other recommendation is that income support is to be provided to the elderly to help them avoid financial instability which forces them to have limited scope in accessing and managing enhanced health support.

References

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Dewan, P., Rørth, R., Jhund, P.S., Ferreira, J.P., Zannad, F., Shen, L., Køber, L., Abraham, W.T., Desai, A.S., Dickstein, K. and Packer, M., 2019. Income inequality and outcomes in heart failure: a global between-country analysis. JACC: Heart Failure, 7(4), pp.336-346.

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Lahtinen, H., Mattila, M., Wass, H. and Martikainen, P., 2017. Explaining social class inequality in voter turnout: the contribution of income and health. Scandinavian Political Studies, 40(4), pp.388-410.

Lam, J. and Ambrey, C.L., 2019. The scarring effects of father’s unemployment? Job-security satisfaction and mental health at midlife. The Journals of Gerontology: Series B, 74(1), pp.105-112.

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legislation.gov.uk 2010, Equality Act 2010, Available at: https://www.legislation.gov.uk/ukpga/2010/15/contents [Accessed on: 6 August 2021]

Massoumi, N., Mills, T. and Miller, D., 2017. What is Islamophobia? Racism, social movements and the state. Pluto Press.

Mercadante, A.R. and Law, A.V., 2021. Will they, or Won't they? Examining patients' vaccine intention for flu and COVID-19 using the Health Belief Model. Research in Social and Administrative Pharmacy, 17(9), pp.1596-1605.

Penno, E., Gauld, R. and Audas, R., 2013. How are population-based funding formulae for healthcare composed? A comparative analysis of seven models. BMC health services research, 13(1), pp.1-13.

Sheppard, J. and Thomas, C.B., 2021. Community pharmacists and communication in the time of COVID-19: Applying the health belief model. Research in Social and Administrative Pharmacy, 17(1), pp.1984-1987.

Shields, M., Johnston, D.W. and Suziedelyte, A., 2020. Macroeconomic Shocks, Job Security and Health: Evidence from the Mining Industry. American Journal of Health Economics, 6(3).pp.45-78.

Sutton, C.X., Carpenter, D.A., Sumida, W. and Taira, D., 2017. 2016 Writing Contest Undergraduate Winner: The Relationship Between Medication Adherence and Total Healthcare Expenditures by Race/Ethnicity in Patients with Diabetes in Hawai ‘i. Hawai'i Journal of Medicine & Public Health, 76(7), p.183.

Talarska, D., Tobis, S., Kotkowiak, M., Strugała, M., Stanisławska, J. and Wieczorowska-Tobis, K., 2018. Determinants of quality of life and the need for support for the elderly with good physical and mental functioning. Medical science monitor: international medical journal of experimental and clinical research, 24, p.1604.

Tan, C.C.L., Cheng, K.K.F., Sum, C.F., Shew, J.S.H., Holydard, E. and Wenru, W.A.N.G., 2018. Perceptions of diabetes self-care management among older Singaporeans with type 2 diabetes: A qualitative study. Journal of Nursing Research, 26(4), pp.242-249.

Zayed, K. and Jansen, P., 2018. Gender differences and the relationship of motor, cognitive and academic achievement in omani primary school-aged children. Frontiers in psychology, 9, p.2477.

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Mercadante, A.R. and Law, A.V., 2021. Will they, or Won't they? Examining patients' vaccine intention for flu and COVID-19 using the Health Belief Model. Research in Social and Administrative Pharmacy, 17(9), pp.1596-1605.

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Shields, M., Johnston, D.W. and Suziedelyte, A., 2020. Macroeconomic Shocks, Job Security and Health: Evidence from the Mining Industry. American Journal of Health Economics, 6(3).pp.45-78.

Sutton, C.X., Carpenter, D.A., Sumida, W. and Taira, D., 2017. 2016 Writing Contest Undergraduate Winner: The Relationship Between Medication Adherence and Total Healthcare Expenditures by Race/Ethnicity in Patients with Diabetes in Hawai ‘i. Hawai'i Journal of Medicine & Public Health, 76(7), p.183.

Talarska, D., Tobis, S., Kotkowiak, M., Strugała, M., Stanisławska, J. and Wieczorowska-Tobis, K., 2018. Determinants of quality of life and the need for support for the elderly with good physical and mental functioning. Medical science monitor: international medical journal of experimental and clinical research, 24, p.1604.

Tan, C.C.L., Cheng, K.K.F., Sum, C.F., Shew, J.S.H., Holydard, E. and Wenru, W.A.N.G., 2018. Perceptions of diabetes self-care management among older Singaporeans with type 2 diabetes: A qualitative study. Journal of Nursing Research, 26(4), pp.242-249.

Zayed, K. and Jansen, P., 2018. Gender differences and the relationship of motor, cognitive and academic achievement in omani primary school-aged children. Frontiers in psychology, 9, p.2477.