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Higher Pupil Conference
April 2008
Wealth and Health
Presented by Heather Fulton
Areas of the course that can be examined are limited
Causes of inequalities in wealth and health
Consequences of inequalities in wealth and health
Government strategies to deal with these inequalities
Success of these strategies
Extent of wealth and health inequalities
The extent to which the founding principles of the NHS are being met
Collectivist v Individualist v Third Way debate
In 2007 the 2 questions in the Social Issues section were
Causes of inequalities in wealth and health
Consequences of inequalities in wealth and health
Government strategies to deal with these inequalities
Success of these strategies
Extent of wealth and health inequalities
The extent to which the founding principles of the NHS are being met
Collectivist v Individualist v Third Way debate
This workshop will therefore concentrate on
Causes of inequalities in wealth and health
Government strategies to deal with these inequalities
Success of these strategies
Causes of inequalities in
wealth and health
Unemployment
& Low Income
Government
policies
agegender
Glass ceiling Career
breaks
Types of job
race
Economic policies which encourage or restrict growth
Burden of taxation
Employment law
Level of benefits
Spending on
healthHealth education
Poor education
Trade cycle
Illness & disability
Lone parents
race
gender
Social class and health
Pension levels
Complexity of the benefits system
Means- testing
Illness and age
Health provision
Discrimination and harassment
education Habits
and health
Government Strategies to overcome inequalities in Wealth and Health
Wealth inequalities have an enormous impact on health inequalities
Coronary heart diseaseCoronary heart disease
StrokesStrokes
Lung cancerLung cancer
Accidents & suicidesAccidents & suicides
Respiratory diseasesRespiratory diseases
Risk in
creas
es
Social Social class Iclass I
Social class Social class VV
The Acheson Report (1998)Findings
Poor men are 68% more likely to die in middle age than richer men.
Poor women are 55% more likely to die young.
Health inequalities start before birth
– A key factor in low weight babies is the mother’s birth weight and her pre-pregnant weight.
Therefore a major Governmentstrategy to overcome health inequalities is to tackle wealth inequalities.
Government strategies to tackle Wealth and Health
inequalities
Social Inclusion
reconnecting people with
work
education
health
community
Government strategies to tackle Health inequalities
A major theme of the strategies of successive Labour Governments since 1997 is to promote more individual responsibility for health and wealth through.
EDUCATION
Individual responsibility for health is promoted through education in schools, GP surgeries, clinics and hospitals and through advertising campaigns.
Individual responsibility for wealth is encouraged through persuading people to get off welfare and into work.
Government strategies to tackle Health inequalities
Anti -smoking
Obesity and exercise
Alcohol abuse
Smoking bans
in Scotland
in EnglandMake more use of private sector
GP practices to provide more education and preventative services
Reduce waiting lists
Measures to tackle wealth
inequalities
Healthy Living Centres
To promote good health in disadvantaged areas
Health promoting schools – encourage healthy eating and exercise
“Working together for a healthier
Scotland”
Campaigns on TV in press and through NHS
Laws
NHS
Sure Start
Help children and carers overcome social exclusion
Government strategies to tackle Wealth inequalities
Welfare to Work Programme to
tackle unemployment Low
Income
As above but also equal
opportunity laws
Gender and Race
Pension Credit
Winter Fuel Allowance
Employment Equality (Age) Regulations 2006
New Deal, NMW etc to improve family income
Uprating Child Benefit
Sure Start programme
New Deal
National Minimum Wage
Working Tax Credit
Jobcentre Plus
Children
Old Age
Extent of success of current government policies to end wealth and health inequalities
The main government policies
get more people back into work
reduce and eventually eliminate the number of children living in poverty
reduce the number of elderly people living in poverty
reduce the differences in health caused by social class
increase the the proportion of GDP spent on health in the UK and bring it up to the level of our European neighbours.
reduce waiting lists and waiting times
Modernise the NHS.
Extent of success of current government policies to end wealth and health inequalities
TARGET – to get more people back into work
SUCCESS
In February 2008
• 5.2% were unemployed - down from 7.2% in 1997
• 29.4 million people in work – highest number on record
• Claimant count was 794,000 – lowest in 32 yearsHOWEVER
• Unemployment rate up from 4.7% in 2004
• Is lower unemployment more to do with a strong economy and not government policies?
• Two-fifths of those getting work are out-of-work again within six months.
Extent of success of current government policies to end wealth and health inequalities
TARGET – reduce number of people on low pay
SUCCESS
• The proportion of workers aged 22+ who are low paid (£7 an hour in 2007) fell between 2002 to 2005
• The pay gap between low paid men and low paid women has narrowed.
HOWEVER
• The proportion of low paid workers has not fallen between 2005 and 2008
•There is still a substantial gap between low paid men and low paid women
• 50% of children living on a low income are in households where at least one adult is working
Extent of success of current government policies to end wealth and health inequalities
TARGET – reduce and eliminate children living in poverty
SUCCESS
• The number of children in low income households fell from 4.4 million in 1999 to 3.8 million in 2006
HOWEVER
• The number of children in poverty is still 3.8 million
• The government target was to reduce child poverty by 25% by 2006. They are 500,000 short of their target
• 50% of children living on a low income are in households where at least one adult is working
Extent of success of current government policies to end wealth and health inequalities
TARGET – reduce the number of elderly people living in poverty
SUCCESS
• The proportion of pensioners living in low income households fell from 29% in 1997 to 17% in 2006.
• Among single pensioners, the rate has halved over the period, from 40% to 20%.
HOWEVER
• 17% of pensioners still live in poverty
• a third of pensioner households entitled to Pension Credit are not claiming it.
Extent of success of current government policies to end wealth and health inequalities
TARGET – reduce the differences in health caused by social classSUCCESS
• There is some evidence to show that mortality rates from cancer and heart disease are falling.
HOWEVER
•The reduction in mortality rates from heart disease and cancer is across all social classes
• There is no evidence to suggest any progress in reducing health inequalities caused by social class in areas
such as infant death and low birthweight
Extent of success of current government policies to end wealth and health inequalities
TARGET – increase the the proportion of GDP spent on health in the UK
SUCCESS
• The government has raised spending on health to 9% of GDP which is similar to our European neighbours.
HOWEVER
• Much of the extra spending went on increases in pay and other cost pressures such as the cost of drugs. Therefore the extra money available for extra patient services is only 2.4%.
Extent of success of current government policies to end wealth and health inequalities
TARGET – reduce waiting lists and waiting times
SUCCESS
• Since 2000, the waiting lists have been shortened significantly and waiting times of more than 12 months have been eliminated.
HOWEVER
• Some of the improvement has been the result of the way in which waiting times are calculated. For example counting the waiting time for each stage in a diagnosis and treatment not the overall wait time.
Extent of success of current government policies to end wealth and health inequalities
TARGET – Modernise the NHS
SUCCESS
• In 1997, the average age of NHS buildings was older than the NHS (ie over 50 years old). In 2005, less than 25% are that old.
•By 2005, the NHS had 68 new hospitals built or being built out of the planned target of 100 new hospitals
HOWEVER
• Critics argue that PFI will cost the NHS more in the medium to long term which will cut services in the future and that many of these new hospitals reduce bed numbers and deliver poor quality buildings which will cost more.
Extent of success of current government policies to end wealth and health inequalities
TARGET – Reduce ill-health by banning smoking in public places
SUCCESS
• Researchers found a 17% drop in the number of people admitted for heart attacks in the year since the ban came into force, compared with an average 3%
reduction a year over the previous decade. The reduction was most marked among non-smokers, with a 20% fall, compared with a 14% drop among smokers.
• Other research published by the British Medical Journal, found a 39% reduction in second-hand smoke
exposure among primary school children in Scotland, and a 49% reduction among adult non-smokers
•The number of all heart attack admissions in 9 Scottish hospitals fell by more than 550, from 3,235 in the year to March 2006, to 2,684 in the year to March 2007. Among non-smokers, the reduction was from 1,630 to 1,306.
SummaryCauses of inequalities in wealth and health• Government policies• Unemployment and low income• Age – old people and children• Gender and race
Wealth inequalities have an enormous impact on health inequalitiesGovernment strategies to reduce inequalities
The government has had mixed success in meeting its targets but overall it is more positive than negative.
Legislation eg NMW or Smoking Bans
Directing resources towards the old and children
Advertising campaigns and health promoting schools and NHS
Welfare to work
Emphasis on people taking individual responsibility through education and incentives
Social inclusion