Thread to discuss issues around health and social inequalities

[StealthPolarBear]

I would like to just read more about this, but specifically I'd like a discussion about how these are impacted by politics / social policy

Personally, I would reckon that the businessman is more likely to die of a heart attack!

An unemployed benefit scrounger who drinks like a fish, smokes like a chimney, and eats nothing but greasy kebabs is more likely to die from a heart attack than either of them.

Health provision should be based on need (with some provision for personal responsibility). Anyone who has a heart attack should obviously get emergency treatment, and there is no excuse for that emergency treatment to take 10 minutes in one urban area, and 20 minutes in another.

If benefit scroungers happen to choose to buy cigarettes and Sky TV with their dole money than fruit and veg, that is their own fault. Society will suffer the extra health costs, so maybe it is worth slashing many benefits by 50% or more, and instead handing out food vouchers which can only be redeemed for healthy food.

Ah the counter argument to that is that these "benefit scroungers" who spend all their money on sky and fags are doing that because of their circumstances, and we should be focussing on them for that reason

lfn I can't talk about specifics, but low socio economic status is directly related to poor health - and as you move up the 'ladder', health improves

longfingernails if they drink and smoke themselves into an early grave, aren't they saving society the cost of their pensions and geriatric care?

I think vouchers instead of money would be a good idea in general (for non-disabled welfare). Benefits are meant to be a hand-up, not a hand-out. By using vouchers, you solve many of the public health issues too.

In general, I believe in personal choice when it comes to how people spend their money - however, if it isn't their money at all, but ours, then I have no objection to "us" in the form of the State being much more intrusive with how they use it.

StuckinTheMiddlewithYou Maybe. I don't know.

Actually, I do vaguely remember hearing that the smoking ban costs the Exchequer several billion a year, so there may be some truth in that.

It would cost more to administer than the current system. A black market for the food stamps would also become a problem.

Yes, you are probably right on the practical implications, Stuck. But as a matter of principle, I think I am right.

I don't. What right has the state got to dictate where people shop for food?

If you want people to look after their health, give them hope for the future, give them a life genuinely worth living and then you won't need to treat them like children.

exactly
tackle the root of the problem not the symptoms

The State has no right to tell people what to do with their own hard earned money.

We, as taxpayers, via the agency of the State, have every right to restrict what people on benefits do with other peoples' hard earned tax money.

It isn't their money. They might be "entitled" to it in law (no doubt, a stupid Labour law looking after their client vote) but morally, it isn't theirs. It's ours.

I'm not interested in morals.

Government should be utilitarian not moralistic.

What is the point in being morally "right" if what you do doesn't help the situation?

(I think was Lloyd George's Liberal government who introduced the dole btw)

Well, my Mum has certainly started drinking and smoking more sonce her income dropped. It seems to be stress and boredom. If you are at work all day you have to wait for a break and go outside to have a cigarette you are aren't as able to smoke as many cigarettes as if you at home. With alcohol, you can drink more at night because you dont have to worry about getting up and driving and going to work with a hangover the next day. Free time gives people the opportunity to indulge in bad habits. Even if you didn't increase people's income if you kept them busy I think there would be health improvements. Take the obesity epidemic- some of that is caused by sedentary office jobs but they may still burn more calories than someone at home all day. Unemployment is also often a cause of depression, which then can lead to these other probelms above.

However a lot of health problems have their seeds sown in utero. Parents need healthy lifestyles so they can pass these good habits onto their DCs. I think that, at the extreme end, education has a lot to do with it. In some deprived areas 25% of adults are functionally illiterate. They cannot read health education posters or leaflets. They cant read newspapers. They have never used the internet. They cannot read the ingredients or nuitritional information on food packaging. They have never heard of BMI, or know how to calculate units of alcohol, or know what vitamins and minerals are in what foods and what each does. They dont know what causes heart attacks or cancer or strokes or diabetes. They dont have the numeracy skills to calculate a food budget.

I think it is difficult for middle-class well-educated policy makers to understand this. They assume 'everyone knows this stuff' but sadly they dont.

There are also geographical issues at play here. Lots of children are very sedentary, which is a health timebomb. But poorer children's opportunities for activity can be much more limited than their middle income counterparts. Eg- They may live up a tower block and not have their own garden. Their parents may be too depressed/obese/drunk to take them to the park. They cant afford to go to soft plays/after school sport clubs or a bike. Their parents may feel that the area they live in isn't safe enough to allow them to play outside. Some health problems (like asthma) are directly linked to some of the dreadfully poor housing stock that some families still live in. Damp is still a problem in many buildings. Some buildings have very thin walls, making it easy to be disturbed by noisy neighbours late at night, disturbing sleep, which is essential for good health. There are 1000s of families living in overcrowded conditions which causes stress, which is often behind lots of physical health problems. In some neighbourhoods there are no shops selling fruit or vegetables. They are an expensive bus journey away.

Then there's the insecurity of a low income lifestyle. If people are stuck in the private renatl sector they are likely to get moved on every 6 months. This may limit their ability to stay on local waiting lists for servies like dentistry, physiotherapy etc. If someone has found themselves homeless and has to start from scratch with no possessions they are going to find it difficult to prepare a proper meal with no or few utensils or basic kitchen equipment. This also applies if they dont have suitable clothing for exercising in.

Oops, didn't mean for that to turn into an essay.

It was a good one :)

My mum chain smoked and drank her life away after she lost her job (and her sister). She now has throat cancer (main risk factor being a smoker who drinks heavily) and I doubt she'll be here in 12 months time.

That was how she dealt with life in the absence of knowing how else to cope.

We were poor for a time but that changed later on though the damage had been done by then.

What struck me was the absence of help. You get written off at a certain point. Especially when mental health problems are involved. Really there are not that many people who are interested - especially the impact on the wider family (children/partner etc.).

That's a sad story fox.

It is repeated hundreds of times over but policy-makers keep making the same mistakes. I have often wondered why there isn't more funding to treat the medical conditions/ill health/addictions/disabilities that keep some people out of employment.

You'd get the impression form the DM that people want to be written off on benefits forever rather than getting help to cure them, when possible. This would be much cheaper, in the long run as well as being better for the people concerned.

Stealth- Thanks

The dental saga: it was v difficult to get NHs dentist for years.Govt shut down/reduced the Dental Estimates board where nhs dentists put in their claims for work done so they had to go for private patients.Thousands have just not gone to the dentist as afraid of expense etc and winging it that nothing will go wrong Our dentist just switched us to Denplan -you pay a monthly fee depending on how bad dentist thinks you teeth are. It covers all the routine stuff but of course if you want implants you still have to pay. These plans include hygienist so idea of this is preventative care etc Good but the hygienist only does 1 day aweek and fully booked ...

Denplan quoted me £14 a month, a few years ago. I was a single parent & didn't have that money spare. I would have been paying that for just check ups as I was unlikely to need work(still hVent )

longfingernails - have you read 'The Spirit Level'. Or is that a stupid question?!

These discussions always focus on the lifestyles of the poor, but the most interesting thing about the new evidence on inequalities is what it shows us about how unequal societies affect the health and wellbeing of everyone in them, rich or poor. Rich but unequal countries - like the US - have far worse health outcomes than poorer but more equal countries - like Greece. That is because of the corrosive effects of inequality on social cohestion, stress, safety etc.

In the decade after the fall of communism in the USSR, life expectancy fell by TEN YEARS. That's really fascinating, isn't it?

So it's not just about raising the incomes/reducing the bad habits of the poor (desirable though that may be), it's about creating a more healthy society for everybody. You can only have a more healthy society by having a more equal society. So reducing the gap between rich and poor isn't just a moral or political choice, it's one that will benefit us all.

Income tax isn't the only form of tax. People on benefits pay tax too.

Just to change tack for a moment, if I was trying to rewrite policy in this area I would be seeking out people who buck the trend and asking them how they did it. People like my mum, for example. Brought up in what can only be described as a slum in a broken by an abusive family with zero money and very low standards, she could have been expected to end up the same way - but didn't. Her brothers and sisters, despite having exactly the same start in life and exactly the same chances, have struggled with marriage break-ups, alcoholism, unemployment, criminality.

I think if we could understand the success stories better it might spark more constructive resolutions.

I know a success story. Born with a chronic disability to teenage parents in one of the poorest areas of the country. Father unemployed for long periods. Now a leader in their field earning £160,000 pa.

I think the group most at risk of heart attacks is actually GPs- hardly known for their lack of income...

Access to dentistry is very difficult in our authority- all the dentists went private a few years ago. DH's denplan is £11 a month, but as HarrietJones says- even that is out of reach for many people, especially as you have to pay for children too.

I think housing has a huge impact on health- many many local authority homes are simply no longer fit to live in. Houses riddled with damp, mould, etc have serious effects on people's health. Lung/chest problems impact on the whole body.

Chil, there has been research done on those people who have resilience and drive that helps them overcome early deprivation. The Department of Health has developed a model for health promotion that segments people using socioeconomic status, life stage etc, but also differentiates those like your mum who not only raise themselves, but can be fantastic leaders and role models for others. They are usually the ones you find running community groups, self-help networks etc. We're not quite sure where that spark comes from, or how it can best be developed and supported, but it is a fantastic and neglected resource.

Your mum sounds just like mine, btw.