The world health organizations definition of health is a complete physical, mental and social well-being and not merely the absence of disease and infirmity However, this WHO definition does not allow for variations in levels of health. A person’s wellbeing is not always constant, it fluctuates throughout their lives. They can be perfectly healthy at one time then suddenly or gradually become unwell or worse. When considering a person’s health most attention is focused on people’s behaviour and lifestyle choices such as smoking, drinking and exercise etc. This behaviour is also influenced by circumstances and events may not be under that persons control e.g. friends/family, education, social and economic environment and even living arrangements.
Factors that influence ill health
Sex and gender display significant differences in both physical and social response to illness. Sex, physical differences between men and women, was previously considered to be the contributing factor when it comes to healthiness. For example, women who smoke are 20% more likely to develop lung cancer than men that smoke, though coronary heart disease appears ten years later in women than in men, due to the protective effect of high oestrogen levels before menopause.2 In 1971 the age gap between life expectancy between sexes was 6.2 years, in favour of females3. However, in 2010 the gap had decreased to 2.54, this change challenges the theory that women have a biological advantage. Gender, the social differences between men and women, is now thought to be the major determinant of health. Women have higher consultation rates than their male counterparts, men tend to be more apathetic when it comes to their health5. This then allows for diseases etc. to be caught earlier and treated before they become fatal. Men also tend to work in more unsafe occupations e.g. Miners and fire-fighters. Men are also more likely to take part in hazardous behaviour6.
One factor that seriously affects health and illness is age, ageing is out of an individual’s control and cannot be properly prevented. Health is often portrayed to decline significantly with age and in many cases this is true. Nevertheless, ailments that are seen as “a part of growing old” are usually treatable and actually are treated when a younger person displays them. A study that was carried out on urinary incontinence found that the condition could be remedied in younger generations, but was perceived as inevitable in older people and thus was not taken care of.7 Despite the findings of this study, many bodily functions do decline with age. The immune system grows weaker, meaning recovery from other illnesses becomes harder and nerves deteriorate leading to balance problems and thus falling which can cause further problems. Problems caused by falls were witnessed in P3, falling didn’t just affect physical ability but mental and social wellbeing too. The patients had reduced confidence and were therefore afraid to leave their homes for too long, if at all. This societal change then brought about mental health worries such as depression as they noticed the breakdown in communication with friends and family.
Lifestyle and behaviour are a large part of a person’s condition, though the choices people make may be for social reasons rather than individual motives. Within lifestyle and behaviour there are countless activities that contribute to one’s health. Diet and physical activity tend to be important issues, a poor diet and lack of physical activity have caused the UK to be “one of the most obese nations in Europe”8. Obesity is a risk factor for further illnesses such as heart disease and diabetes. Overeating can be a result of many social matters such as stress from work or from relationships. Other behaviours are important as well, such as smoking, drinking alcohol and drug abuse. Relating back to sex, women tend to drink over the daily limit of alcohol, more often than men. This result is actually due to social background, such as a history of abuse, parents/partners/siblings that have alcohol issues or a history of depression.9 Any of these factors can increase the chance of someone having a drinking problem, particularly females. Men are more likely to smoke at a younger age than women, 40% of men surveyed started smoking before 16 years of age and continued to do it regularly.10 These statistics come about as males are more likely to be pressured by peers into carrying out activities such as smoking or drug taking.
How somebody is educated typically shapes a person’s future, if they receive better education then they will be pushed toward going on to further education and getting a good job. Poor education can give someone a negative view on schooling and they may wish to drop out as soon as they can because of their negative interpretation. Social capital is important in influencing health, social capital is described as “the aggregate of the actual or potential resources which are linked to possession of a durable network of more or less institutionalized relationships of mutual acquaintance or recognition – or in other words to membership of a group” 11 This social capital can be used to acquire better goods and services and may also be passed from one generation to the next. This seems to be a standard in middle class society, however within the working class a lack of involvement tends to be the norm. Bio-psychosocial approaches emphasise how important relational networking is in the aim for good health. For example, religion has been found to increase a sense of belonging, through that and related activities, like volunteering, good health is promoted.12 It is important to consider peoples living and working conditions. People under constant stress, such as bringing up children alone and in poverty, are likely to carry out health damaging behaviours13. Research on women and smoking, showed low-income lone parents were the most likely to smoke and that it was used as a coping strategy for stress and social exclusion.13
Mental health is another important factor that must be considered in a person’s overall health and wellbeing. Mental health itself has many determinants. Isolation and alienation as found in elderly who have had falls can cause a deterioration in mental health. A similar scenario that could lead to poor mental health is peer rejection, teenagers who have not smoked or drank alcohol when enticed by peers. They may be deemed “uncool” or seen as different and thus are not accepted into social groups. Possibly violence and crime in the local area may lead to mental issues, just being in a poorer area can decrease a someone’s optimism. Poor nutrition can lead to poor mood, as of yet it is not fully understood but a lack of Vitamin D directly correlates with an increase in depression.14 A difficult upbringing is known to have adverse effects when older, as witnessed in P2. Patients who were abused as children and then heard about similar stories in the news had mental breakdowns or found daily life harder to cope with.
Inequalities in health
Those with the greatest need for healthcare are those that are the working class, those that are “socially excluded”. It seems though, that those with the greatest need actually have the least access to good quality services15. The areas with the worst levels of health have the lowest number of healthcare workers living and working in them. Places with the highest level of young people leaving school with no qualifications are also the same areas that have the lowest availability of teaching staff per population16. In areas with high employment figures, those with jobs seem to work long hours that may affect their wellbeing. In high unemployment areas those who do have jobs do not work for as long. Unfortunately those areas with greater unemployment are associated with higher levels of mental health problems such as depression. Some inequalities in health can be seen as racist, such as research not being done into sickle cell disease. Sickle cell disease is more prevalent in black and ethnic minority groups and services for the disease fall far behind the number of cases in the UK17.
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A wide range of factors exist that have to be considered in order judge a person’s overall health and wellbeing. Each factor in itself has many contributing elements that have to be acknowledged to find the root of each problem. Most factors that do influence health also interact or accumulate, for example age can affect the choices we make in life, and the choices that one makes and the behaviours they carry out can determine how long that person may live. The health service are also accountable for influencing factors of health and illness. Even in today’s society, healthcare is not equally accessible to all but in years to come this is set to change.
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