Overtime, sociology has played an essential role in the aid of healthcare policies and procedures, along with playing a fundamental role in one’s understanding of health inequalities. This paper explores how sociology has played such a role in healthcare, whilst including discussions regarding the influence of social structures and inequalities in the health of an individual, their family and community, with the topic of health variations between social classes being the main focus of the discussion. A structured overview, review and evaluation of a specific health policy in the UK will also be provided within this paper.
Sociology in healthcare.
Sociology can be defined in a number of ways, due to its almost limitless scope (Denny, Earle, and Hewison, 2016). Clarke, (2010) explains that sociology is a form of social science discipline, in which a distinctive approach is taken in order to investigate society. Morrall (2001) expresses that the use of sociology in healthcare is essential, as the subject aids in highlighting the nature of health and illness, along with the social causes of the disease and death. This exposes any ethical predicaments in the production of healthcare as a whole, ultimately creating practitioners who are capable of competent and focused decision making and in turn providing the healthcare system with more individualised policies and practice.
The inclusion of sociology and nursing practice has been criticised by many since it was first introduced. Sharp (1994) was one of the first to critic the idea of the inclusion of sociology within nursing practice, arguing that nursing as a whole is a “action-orientated profession”, therefore nurses should only be concerned with the knowledge of how to perform tasks, rather than acquiring the theoretical knowledge of sociology. However, Porter (1995) was in favour of this inclusion, arguing that health not determined on the assessment of an individual’s physical state, but can in fact be determined by factors such as social and cultural, factors in which nurses should both be educated in and understand. Porter goes on to explain that in turn, this would allow nurses to care for patients in a holistic and individualised manor.
Inequalities in the UK have been researched by a number of sociologists over time. Karl Marx (1818-83) explored social class inequalities, basing his analysis around Capitalist society, expressing that “the rich get richer at the expense of the poor”. This portrayed that wage labourers (in which Marx classed as proletariats), develop a significant amount more financial profit and wealth for their employers (classed as the bourgeoisie) than they were to keep for themselves – stating that for himself, this strongly highlighted the essence of society. (Denny and Earle, 2005).
In the year 1921-2000, Social class was categorized in accordance to the ‘The Registrar General’s Classification of Social Class’ which provided an explanation stating that individuals were to be allocated to one of five social classes, based on both the occupation and income of the head of the household (Waugh and Brooker, 2013). This suggests that the structures highlighted by Marx in the year 1818-83, still existed in modern day society, as women, students, and the unemployed were excluded from this. However, in 2001 this classification was revised, with both women and the unemployed or retired being taken into account, along with seven social classes being put in place in order to help accommodate this. (Waugh and Brooker, 2013).
According to research conducted by sociologists throughout history, socioeconomic inequalities and an individual’s health status have been proven to have a strong correlation. In 1988, an analysis of socioeconomic classification inequalities in health was carried out by sociologists from both Oxford University and Nuffield College. The study suggested that individuals with a significantly higher financial income had relatively low death rates, compared to those individuals whose occupation consisted on manual labour (Kirby et al, 2000). Overall, the study displayed that university lecturer’s come out at the top of the table regarding relatively low death rates, with bricklayer’s labourers at the bottom of the table with the highest death rates recorded in the study.
Highlighting the conspicuous link between an individuals’ socioeconomic classification and their health, studies have found that between the years of 1982 and 1986, men in class one (the highest categorised class) had a life expectancy of 2.3 years greater than those in class three, and 4.9 years greater than those in class seven (the lowest categorised class) (Matthews, 2015). Present day sociology research confirms this link, as in 2002-2006 the gap between those in classes one and seven had increased to 5.8 years, whereas the that between classes one and three had declined to 1.9 years (Office for National Statistics, 2011).
In 1980, The Black Report (Black et al) exposed the extent of health inequalities in the UK and answered the question that many people had been asking; how does an individuals’ socioeconomic classification effect their health status? Findings from the report suggest that materialistic deprivation is the main cause of social inequalities in health. White (2013) agreed with The Black Report, stating that materialistic influences on health include; working conditions, diet, exposure to pollution, and housing.
The Marmot Review, published in 2010, has effectively reduced health inequalities in the UK since being released. The review has aided in the rise in commitment from health professions and service providers to reduce health inequalities and address the social determinates of health.
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