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Poverty levels in the last decade has been said to be rising sharply. It has become quite a controversial subject amongst politicians and social scientists alike. ? Poverty? and?
the poor? are quite controversial terms that are frequently used but are shaped by our beliefs and current opinion about the whys and wherefores? of poverty. The effects of high unemployment, low pay and changes in the health and social system have forced the issue of poverty into the forefront of political agendas and media attention. Poverty and health are definitely linked and not only are the? poor more likely to suffer from ill health and premature death, but poor health and disability are themselves recognised as causes of poverty? . (Blackburn 1991 pg 7) Theorists and social scientists have looked at all aspects of poverty and their research has proven that poor health is related to social class and obvious ill health inequalities are found between the different classes, with the poor suffering most.
Firstly we need to understand poverty. One of the first people who tried to establish a standard for measuring poverty was Charles Booth, who looked at basic requirements needed to maintain a physically healthy existence, which is sufficient food and shelter to make possible the physically efficient functioning of the body. (Giddens 1989 pg 270). There are two ways in which poverty is still defined; absolute and relative poverty, these are based on different ways of seeing peoples need. Absolute poverty refers to those without the basic necessities to sustain human life. These people don? t have their basic needs met in relation to food, warmth, water and shelter. ?
Families are in poverty when their incomes are insufficient to obtain the minimum necessity for the maintenance of physical efficiency. ? (Rowntree 1941 in Blackburn 1991 pg 9) Relative poverty uses the standard of living enjoyed by or taken for granted by most people as the base line from which poverty can be measured. Poverty relative to the kind of society we live in has been developed by Townsend in that poverty can be assessed in terms of the customs and standards of a previous era. People are in poverty when they? lack the resources to obtain the type of diet, participate in the activities and have the living conditions and amenities which are customary, or at least widely encouraged or approved in the society in which they belong. ? (Townsend 1979 in Blackburn 1991 pg 10). Here poverty is concerned with social needs as well as physical needs. Poverty is generally understood to be the level at which deprivation is inevitable.
In Townsend? s study of poverty in Britain in 1960? s he calculated that in order to avoid relative poverty a certain income level was needed. ? It is possible to define income levels that are sufficient to enable people to live in varying degrees of discomfort and to indicate a level of income that permits social participation. ? (Townsend 1979 in Ackers 038; Abbott 1996). The most common way to measure poverty is by household income. There is no official poverty line in the U.
K. , but where we draw the line depends on what we view as a minimum level of income and standard of living for family and individuals. Poverty in most British studies has been defined as anyone with an income on or below the level of income supplement (100 % benefit) is defined as living in poverty. Anyone with an income of 100 %- 140 % of income support is defined as? on the margins of poverty? . Surveys have shown that the majority of people regard the poor as being responsible for their own poverty and are suspicious of those who live? for free?
on government handouts. Many people believe that those on welfare could find work if they were determined to. These views are out of line with the reality of poverty whose numbers are made up of the over 65? s, under 14?
s, ill and disabled the low paid and single parents. Income is a key resource for families and the ones with low incomes are least able to afford or have access to good housing, generally live in poor areas with no play facilities for children and have poor access to health, education and leisure services. Poor incomes don? t enable these families to buy the correct foods thought to be important to health (e. g. fresh fruit and vegetables) or to be able to keep their homes dry and warm. ?
Poverty is an experience of doing without that touches every part of life and family health? (Blackburn 1991 pg 12). Official statistics reveal class inequalities when looking at health, with some groups obviously more disadvantaged than others. These statistics were initially revealed in? The Black Report? 1980, which looked at inequalities in health. Nearly every kind of illness and disease is linked to social class, with poorer people tending to die young and become ill more often than the richer people. Other reliable measures of health came from medical models which suggest that health is related to a host of social factors including income, education, housing and environmental conditions. ?
Differences in health experiences and life expectancy between the social classes, between ethnic groups and the genders are the most distinctive form of health inequality in Britain today (Blackburn 1991). ? Social class is the most widely used indication of a person? s social and economic circumstance. Occupation is also used as the best indicator of socio-economic status and is the basis for The Registrar Generals social class classification. Social class and poverty affects the health of people from birth to old age. ? At almost every age, people in the poorer social classes have higher rates of illness and death then people in the wealthier social classes. ? (Whitehead 1988).
Studies of child mortality clearly show a difference in causes of death between the social classes. Low birth weight in babies is associated with social class and thought to be associated with parental poverty and poor maternal environment rather than the quality of medical care. Childhood death rates from accidents (the largest single cause of death in childhood) are a clear example of how living in a poor area, without safe play areas has a serious consequence on the health of children. (Blackburn 1991). Class inequalities in health are narrower in adulthood than childhood and statistics tell us that death rates are far higher for the lower classes compared with the higher ones. (Whitehead 1988) The poorer social classes are ill more than their richer counterparts and use the health services more often. Almost all major killer diseases affect manual classes more than non-manual classes and in some instances are twice as high in class V, than in class I. According to Browne and Bottrill (1998) there are two main explanations for this, which can be seen, as cultural and material.
Cultural explanations look at how health inequalities are rooted in the behaviour and lifestyles of the individual and that those suffering poor health have different attitudes, values and lifestyles which mean they don? t look after themselves. Inadequate diet, smoking, drinking and lack of exercise all have direct effects on the health of a person. Low income confines the type of food that poor people can buy and therefore the amount of nutrients an individual can eat. (Blackburn 1991) These adults in low-income families continue to smoke excessively and the female is more likely to deprive herself of a sufficient diet to enable her to afford the cigarettes. Even though these adults know the adverse affects it will have on their health, they continue with this lifestyle because to them it is a way of coping with the everyday stress that living in poverty has on them. According to Ackers 038; Abbott (1996) Material explanations enforce the idea that those with poor health can?
t afford to have a healthy diet, live in poor housing with poor working conditions etc. Our Healthier Nation recognised this link and the government has now set targets for improvement of living conditions and aims to address inequality which arises from poverty, low pay and poor housing. By looking at poor health from a social class perspective we can see there is a link between poverty and health. It has been agreed that social class inequalities are products of society and these social and economic factors have major influences on patterns of illness and health. ? The link between poverty and ill health is clear. In nearly every case the highest incidence of illness is experienced by the worse off social classes. ? (Whitehead 1988).
The Black report discussed a number of explanations to try to explain why health inequalities exist in relation to the poor. The? artefact? explanation argues that the method of measuring occupational class used by the Registrar General increases the size and importance of health differences.
That the apparent differences in health between lower occupational groups and those in higher occupational groups are the result of statistical inaccuracies, in relation to the size of the groups measured. Another view is that of? social selection? , which argues that people in poor health tend to move down the social scale and become concentrated in the lower socio-economic groups, whilst those in good health experience upward mobility. In other words it is health status that determines social class and not social class that determines health status and that it is inevitable there will be a gap between the higher and lower classes. The third explanation looks at the? behaviour?
of people in lower classes and stresses the differences in the ways some social groups choose to live; the behavioural and voluntary lifestyles they adopt. ? Inequalities in health evolve because lower social groups have adopted more dangerous and health damaging behaviour than higher social groups, and may have less interest in protecting their health in the future? (Whitehead 1987 in Akers 038; Abbott 1996). It has been noted that people in lower groups tend to smoke more, drink more, take less exercise etc, than those in higher groups. The final view looks at the? structural? explanations of the causes of inequality.
This stresses that those in lower occupational groups are more exposed to poverty and deprivation and that these are the main causes of ill health and early death. That these social circumstances are outside the control of the individuals and emphasise that external environment and conditions in which people live and work play a great part in their health. The Black Report and Healthier Nation, both noted that class differences in health remained and that it could not be blamed on lifestyle choices, as some of the poorer classes don? t have the freedom of choice others have and because of their circumstances they can? t always choose to have a healthy lifestyle. Therefore when looking at inequalities in health we must recognise that cultural, material and behavioural factors do play a part and that poverty does affect the health choices of an individual.
The present view is more in keeping with the structural explanation and the present government, because of the obvious strong links is trying to address both issues of poverty and health. Bibliography Ackers, L 038; Abbott, P. 1996 Social Policy for Nurses and the Caring Professions. Open University Press. Browne, K 038; Bottrill, I 1998. Our Unequal Unhealthy Nation. Sociology Review Nov. 1998.
Blackburn, C. 1991 Poverty 038; Health. Open University Press. Giddens, A. 1989 Sociology. Polity Press. Rowntree, B. S. 1941 in Blackburn C. 1991 Poverty 038; Health.
Open University Press. Townsend, P. 1979 in Blackburn C. 1991 Poverty 038; health. Open University Press. Townsend, P. 1979 in Ackers, L. 038; Abbott, P. 1996 Social Policy for Nurses and the Caring Professions. Open University Press. Whitehead, M. 1988 The Health Divide.
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