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How Could You Close "Needs" and "Wants" Gap in Low Socioeconomic Populations?

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Recent evidence suggests that the health of the population in the United Kingdom continues to improve. However, despite this many people will experience an inequality in terms of their health and the chance of living in good health is unequally distributed within society. Socio-economic status is one of the most important determinants of health and the link between this and health is widely accepted. Differences in health by social class was examined by the Black Report, which investigated the problem of health inequalities in the UK and found that people of lower economic status were far more likely to experience ill-health and premature death than those of higher socio-economic status.

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Socioeconomic status, whether assessed by income, education, or occupation, is linked to a wide range of health problems, including low birthweight, cardiovascular disease, hypertension, arthritis, diabetes, and cancer. Lower socioeconomic status is associated with higher mortality, and the greatest disparities occur in middle adulthood (ages 45–65). J. Michael McGinnis and William Foege have provided an incisive analysis of the “actual causes” of death in which they estimated the number of U.S

deaths caused by factors such as tobacco, diet and lack of activity, and toxic agents. They noted the mismatch between the importance of these factors and allocation of health care resources, with most resources going to treat diseases and relatively few to modifying the predisposing factors. To modify these risk factors, one needs to look even further upstream to consider their “actual determinants.” Socioeconomic status is a key underlying factor. In this paper we examine multiple pathways through which it can influence health, and we consider the implications of these pathways for policy. While socioeconomic status is clearly linked to morbidity and mortality, the mechanisms responsible for the association are not well understood. Identifying these mechanisms provides more options for policy remedies. Given the pervasive effects of socioeconomic status, no single policy, or even one domain of policy, can eliminate health disparities. The Acheson Commission in the United Kingdom, which was charged with providing policy suggestions for reducing health disparities in that country, made thirty-nine recommendations, organized around key populations (such as children, older people, and ethnic minorities) and domains (such as income and tax benefits, education, and employment). If a U.S. equivalent of the Acheson Commission were convened, what policies should it consider on the basis of the empirical data? Below we consider policies addressing several areas for which the empirical evidence is strongest regarding the links between socioeconomic status and health.

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Socioeconomic indicators of income, wealth, and employment predetermine the insurance coverage level. Although rates of uninsured individuals have reduced significantly in the United States since the implementation of the ACA in 2014, there are still 12% of Americans without insurance within various social groups (Chen, Vargas-Bustamante, Mortensen, & Ortega, 2016, p. 140). Moreover, the enrollment in health-insurance exchanges varies across the United States because some states opted out of the Medicaid expansion (Griffith et al., 2017). In accordance with more recent research conducted by Griffith et al. (2017), 35% of low-income residents of nonexpansion states are uninsured, and 21% of poor individuals are uninsured in expansion states (p. 1508). Persistently high rates of uninsured Americans are mainly a reflection of their low economic status and inadequate incomes. Aggravating racial and ethnic disparities in health care, inappropriate insurance coverage is apparent in low-income individuals from ethnic minorities. The lowest rates of insurance are identified in Latinos “compared with all other racial/ethnic groups” (Chen et al., 2016, p. 141). Although to improve ethnic minorities’ access to high-quality health care and insurance, under the ACA adopted in 2014, the U. S. Health Resources and Services Administration (HRSA) expanded the Community Health Centers Program and the National Health Service Corps. Income is considered a significant barrier to their insurance coverage (Chen et al., 2016). Poor Latinos, African Americans, Asians, and Native Americans are less likely to receive efficient care for their health needs than insured individuals with a higher income are. Inadequate access to health care is one of the major social inequalities experienced by the United States’ low-income populations. Differences in welfare and living conditions generate reduced opportunities for needy individuals and decrease their abilities to cope with physical and emotional disorders. Approximately 20% of low-income people avoid care due to its cost (Griffith et al., 2017, p. 1506). The cross-sectional study pursued by Berkowitz, Traore, Singer, and Atlas (2015) has revealed that Americans living in poverty experience worse access to health care, including chronic disease management, “preventive service provision, resource utilization, and patient-centeredness of care” (p. 403). According to the research findings, economically vulnerable populations annually visit hospitals 5.4 times, while annual rates of visits of median-income individuals comprise 9.3 times (Berkowitz et al., 2015, p. 408)

These statistical indicators testify to income-caused disparities in health care access. Thus, inequalities in welfare and living standards predetermine disparities in using effective methods of completing emerging health care needs.

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To summarize, the importance of learning good health behaviours and coping mechanisms from birth has been explained in order to have a better future health when becoming an adult. In relation to this the essay has also shown the NHS plans to reduce health inequalities by creating more easy reachable services for families and by promoting health campaigns targeting children and youngsters. Moreover, as it was explained, there are also social factors adhered to ill-health. By reviewing nowadays problems faced by society, the essay discussed the local authorities polices to improve their communities, and highlighted their future repercussion in health improvement. Through the presentation and analysis of the more relevant reports that have been published in Britain during the last 30 years, the actual social strategies and their implementation in health have been reviewed and analyzed, in order to highlight the importance of partnership between agencies when tackling inequalities.

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Berkowitz, S., Traore, C., Singer, D., & Atlas, S. (2015). Evaluating area‐based socioeconomic status indicators for monitoring disparities within health care systems: Results from a primary care network. Health Services Research, 50(2), 398–417.

Braveman, P., & Gottlieb, L. (2014). The social determinants of health: It’s time to consider the causes of the causes. Public Health Reports, 129(1), 19–31.

Chen, J., Vargas-Bustamante, A., Mortensen, K., & Ortega, A. (2016). Racial and ethnic disparities in health care access and utilization under the Affordable Care Act. Medical Care, 54(2), 140–146.

Chetty, R., Stepner, M., Abraham, S., Lin, S., Scuderi, B., Turner, N.,… Cutler, D. (2016). The association between income and life expectancy in the United States, 2001-2014. Journal of the American Medical Association, 315(16), 1750–1766.

Griffith, K., Evans, L., & Bor, J. (2017). The Affordable Care Act reduced socioeconomic disparities in health care access. Health Affairs, 36(8), 1503–1510.

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