Inequalities in Health

Evidence of a link between socio-economic position and health dates back to ancient China, Greece and Egypt and is apparent today in all societies (Graham 2000). Inequalities in health and the risks of premature death have been recorded since the 19th century (Graham 2000). In the mid-nineteenth century the United Kingdom was undergoing rapid industrialisation. This was supported by adults and children labouring long hours in factories and mines. They lived in unsanitary and cramped housing which contributed to the low life expectancy.

Since the 19th century death rates have fallen by half. Chronic disease in later life such as coronary heart disease and cancer dominate the mortality statistics (Graham 2000). Despite this ill health continues to follow the contours of disadvantage. This is a continuing cause for concern in the 21st century, especially when it is linked to maternity care. Therefore this essay will attempt to demonstrate how inequalities can adversely affect the health of the whole family in the scenario by examining relevant research into the health and social aspect that this family will encounter.

It will also examine how the maternity services can provide adequate help and information to Mary during her pregnancy. It will cover housing, education, the environment and health. One in four people in the UK live below the EC poverty line; this takes a heavy toll on health (DSS 1998, cited by Graham 2000). People’s lifestyles and behaviour are recognised as causes to health problems. Smoking has been identified as the major preventable cause of premature death and is a habit with a sharp socio-economic gradient among both women and men.

However, when looking back in history to the nineteenth century when manufactured cigarettes were not yet invented infectious diseases such as measles, whooping cough and diarrhoea were the major causes of death (Graham 2000). Another cause of health problems is diet, stress, housing, alcohol and substance misuse and exercise (Alderman et al 2000). In April 1977 the then secretary of State assembled a Working Group to address the inequalities in health. Their objectives were to assemble all available information regarding the difference between the health status among the social classes.

The Black Report (1980) was produced under the Chairmanship of Sir Douglas Black, it looked at the possible causes and the implications for policy, and to suggest further research. It suggested that the causes of health inequalities were so deep rooted that only major public expenditure would be capable of altering the pattern (Jenkin 1980). The evidence showed that there was a large gap in mortality between the social classes, and that instead of getting better the gap was widening.

It documented that poor families are locked into poverty including educational, environmental and social disadvantage for a lifetime and sometimes generations. This showed huge implications on their health. The financial implications on the Health Service are immense. It showed that there were large numbers of young women among the working class that suffered from depressive illness, and that this in turn had a profound effect on family life and child-rearing.

It also found that twice as many babies born into the social class of unskilled people die within the first month, than babies born to the social class of professionals. Approximately three times as many infants born to parents in the unskilled class die in their first year compared to infants born into the professional social class. Although attempts were made to suppress this report it was made more newsworthy by these actions and became to some the most important medical report since the war. With the election of the Labour government in 1997 a new inquiry was commissioned.

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In July 1997, the then Secretary of State for Health commissioned Sir Donald Acheson to review and summarise inequality in health in England and to identify and prioritise areas for development of policies to reduce them. His report, “Independent Inquiry …

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