Social Determinants of Health Affecting Canadian Women and Children, Essay Example

Abstract

Social determinants of health relate to the socio-economic conditions influencing distribution of health care services within a community. It exposes the individual and group disparities in health status due to apparent inequities.  Risk factors associated with social determinants of health include one’s living and working conditions, distribution of income, wealth, influence, gender, age and power. This research seeks to examine how these determinants affect Canadian women and children. More importantly, a critique of the Canadian government’s influence in the resolution of this crisis will also be embraced.

Health Care: Social determinants of health affecting Canadian women and children access to quality health care services

Introduction

David and Elaine Coburn (2007) argue that health and health inequities are common discrepancies of health care polices across the world. However, the issue among developed nations such as Canada is too obvious to ignore. This has been greatly influenced by the fact that these governments have reduced budget spending on health care to the disadvantage of minorities in the society. The minorities most affected are women and children (Coburn, 2007).

Other theorists contend that biological factors play a great role in determinants of health. They cite endogenous and exogenous agents that influence health. Specific references were made to genetic heritage, the body’s immune system; the physical environment, metabolic abnormalities; type of blood group and blood cell characteristic as in sickle cell anemia (Ewald, 2007).

While this may be true my proposition is that individual biological factors do not influence social determinants of health; rather it is a person’s access to quality health care services along with government’s failure to appropriately intervene that makes the remarkable difference in health determination factors. The critical question is how should Canadian government address the social determinants of health?  The obvious answer is by designing more equitablehealth care policies and increase budget funding towards improving health care services.

What is the issue?

The issue at hand involves Canada Health care policies and how theyinfluence health disparities among minorities. In this discussion minorities are women and children. As it exists health care in Canada is a mix model of public funding and private execution of services. The tradition is universal health insurance coverage for Canadian citizens and legal residents. Public sector health care is not responsible for delivery and does not monitor service accessibility to every citizen or legal resident. Therefore, even though services might be available with private sector intervention, for many minorities quality health care is inaccessible even though it is free.

History

Charles Larson (2007) contends that in a society where there is universal health insurance coverage 100,000 children are born yearly in poverty being given birth by women who cannot afford excellent health care for themselves and the infants they bring into the world. This precedes; lone-mother teenage pregnancies; overcrowded polluted physical environments over which they have no power to control (Larson, 2007).

Statistics show that in 1996, the poverty rate in Canada was elevated to18%. Convincingly, child poverty escalated towards a 17-year peak of 21%. This caused governments to acknowledge deficiencies in policy regulations making this their focus in ensuing years. During that period 1.5 million Canadian children lived in poverty extending for a significantly 10 year period prior to the discovery. In the absence of more recent figures 1996 census reports reveal that provincial child poverty rates ranged from a low of 18.5% in Prince Edward Island to a high of 26.2% in Manitoba, Ontario (Raphael, 2000).

More importantly, to the dismay of researchers some of the wealthiest Canadian provinces according to the gross personal product experienced an increase in child poverty from 11% in 1989 to 20.3% in 1996. According to the researcher these data were advertised for public scrutiny. Still there is no evidence that this issue has been addressed professionally from a public health policy intervention or mere moral integrity (Raphael, 2000).

Raphael (2000) further cited the Health of Canada’s Children Report documenting differences in Canadian children’s health well-being from the perspective of poor and not-poor. From these studies poor was defined as those who were receiving social assistance or below the

Canadian low income statistical cut-off point.  Notable health differences were observed as incidence illness; death, hospitalizations, accidental injuries, mental health issues; well-being, school achievement; school drop-out, family violence and child abuse. Obvious differences were reflected between poor and not poor. Poor children were affected by significantly more health conditions than not poor ones.

Who does the issue involve?

From the foregoing history, children and women are most vulnerable minority group affected by the social determinants of health care services in Canada. This is clearly due to fact that while public health care sector administration ensures that Canadians have access to health care there are no polices predicting the probability that equitable distribution of such services are likely.  McMillian and Davies ( 2012)  contend that social class has a very strong influence on determinant of health care producing health inequality, especially, in countries with a universal health care system as Canada ( McMillian and Davies, 2012).

Private hospital management operates as a for-profit entity with public fundsPublic sector funding agencies allow private sector health care to charge according to their budget demands rather than what an individuals can afford. Hence, this vulnerable group is placed at a disadvantage where there is insufficient income to cover their health care costs.

Relevance

The for-profit component of Canada health Care whereby private hospitals can charge copayments has placed a burden on the underprivileged since public sector intervention is minimal. This issue is relevant because many poor Canadian women and children cannot access quality health care due to policy implications. Besides, public sector negligence in assessing inequities of service delivery creates disparities among social classes such as women and children compounding the problem.

Stakeholders

Stakeholders involved in this process of redesigning polices for narrowing gaps of health inequities are public sector health administration; public health, social services and interest groups in the society that represent women and children issues.

Evidence of Argument

It cannot be overemphasized that individual biological factors do not influence social determinants of health; rather it is a person’s access to quality health care services along with government’s failure to appropriately intervene that makes the remarkable difference in health determination factors. By designing more equitable health care policies and increase budget funding towards improving services are likely solutions to this dysfunction if Canadian government takes active control of the dysfunction.

Larson (2007) advocate that there is supporting evidence to prove that by designing sound policies and programs disparities can be greatly minimized among poor women and children. Further the researcher posits that delinquent health care policies put the role of health practitioners at jeopardy when they are faced with these inequities in their clinical practice. Criticisms were leveled at Canadian health care policeswhereby interventions or programs aimed at enhancing health care accessibility to the poor are not adequately evaluated or critically appraised for modifications (Larson, 2007).

The jeopardy emerges as early child health consequences manifesting as preterm births; intrauterine growth retardation; neonatal and infant deaths. It is quite clear that these factors have nothing to do with the woman’s genetics; physical history, but are directly related to poverty and access to quality health care services. Consequently, the researcher concluded that this creates life long course of disparities in health outcomes (Larson, 2007).

Coburn (2004) contends that global and national socio-political-economic trends have increased the power of business classes and lowered working class participation in the social structure. Hence, there is a significant income inequality accompanied by unequal access to health care service. If gaps are to beare to be narrowed or closed these disparities ought to be addressed by Canadian social services department (Coburn, 2004)

Precisely, Coburn (2004) approached the issue of Canadian government‘s impotence in addressing health inequities through policy making interventions from a sociological perspective rather than epidemiological. The focus was turned away from consequences of income and socio economic status on health towards a deeper understanding as it relates to the grass root emergence of the issue. Class-based production of inequities influenced by policies took precedence over merely a superficial evaluation of the consequences of health disparities among minorities.

A political economy theoretical perspective emerged from the analysis. This linkedhealth effects of income inequality to social class along and the spread of neo- liberalism philosophy. Neo -liberalist philosophy is associated with reduction in welfare services provided for citizens. Precisely, it is decline of the welfare State.  Controversies regarding application of this welfare theory have gained momentum across developed countries according to Coburn (2004) (Coburn, 2004).

More importantly, studies have shown where social welfare during 1975-1995 reduced gaps between inequities and health. While Canada when compared to United States of America and United Kingdom rated much lower in health disparities than these two developed nations neo-liberalism is taking its toll on this nation as well.Policy makers are asking for budget cuts on healthcare in a system designed to close inequities among classes.

My contention is obvious that biological factors have very little impact on social determinants of health. Class based production of inequities influenced by decline in welfare state philosophy embedded in neo-liberalistic polices undermine women and children access to quality health care in Canada. Undergirding this disparity are policies fostering them. Policy reform is the evident solution

David Coburn (2007) further linked forces with Elaine Coburn (2007) on the subject of neo-liberalistic polices exposing its effects on Canada health care system as it relates to minorities’ such as women and children. The researchers reiterated that neoliberal doctrines influence social inequalities relevant to health inequities.  However, this should initiate action towards resolving these inequities in society. Ironically, they are not addressed in the Canadian social services arena. The question remains how government should intervene?(Coburn& Coburn, 2007).

These analysts embrace a sociological paradigm of viewing existing Canadian health care policyto say that it is in a moral crisis when comparison to developing and developed world typologies are drawn. Canada health care inequity among women and children has been identified as a policy crisis influenced by neo-liberalistic political attitudes towards health care intervention in the nation. It was cited that the rich live longer healthier lives than the poor. The poor happen to be minorities inclusive of single low income women and their children (Coburn & Coburn, 2007).

The Coburns (2007) advance that the much‘proclaimed solution to human problems, neo-liberal economics producing financial growth and improved human wellbeing through market fundamentalism, has proven a failure’ (Coburn& Coburn, 2007 pp. 13). Unedited applications of neoliberal doctrines immensely create more difficulties widening social inequality gaps evolving into varieties of health inequities existing among Canadian minorities; significantly low income women and children (Coburn& Coburn, 2007).

Raphael (2000) undertook an analysis of Canadian Health care system to contend

as previous studies prove that the consequences of increasing inequality among Canadians and effects on their health status ought to be recognized and addressed. The analyst acknowledged that the subject has become a Canadian tradition still to be adequately hypothesized and resolved as a public health issue. Public health as an institution he citedis limited in its response to the dilemma. In concluding the analyst cited misinformation or lack of it as being a major factor for silence on the issue (Raphael, 2000).

Further deliberations on the misinformation criterion point towards organized attempts to undermine exposure of the misery-go-round crisis contained in economic inequality, poverty and poor health status. For the writer on principle, this is unacceptable to Canadians. When health promotion polices are explored from a public health perspective the author regrets that despite influence of public health consultants in policy making the situation of increasing disparities continue to converge (Raphael, 2000).

He contends that ‘ poverty increases as economic inequality increases’  (Raphael, 2000).The researcher expressed how convinced he was concerning a relationship between degrees of economic inequality and the emergence of child poverty from studies conducted on 16 industrialized Western nations. There was a strong, positive, and reliable relationship between the two variables (Raphael, 2000).

The twenty-first century dilemma is that disparities have become insurmountable. In projecting the lack of information or misinformation strategy in recent years Raphael (2000)admitted that insufficient evidence is available to identify a precise relationship between socio-economic status and health. Data collection regarding socio-economic determinants of health care is non-existent in Canada. The researcher further cited that the limited evidence, which is available, was retrieved from a variety of analyses regarding differences between residents of selected neighborhoods, children who were receiving social assistance and those not eligible as well as current data from longitudinal studies on children’s health (Raphael, 2000).

Raphael (2000) advances conclusively that Canada health care policy makers and social service administration must take immediate action in designinglegislations to close existing gaps of inequities reducing its influence of quality of health and well-being, especially, among women and children (Raphael, 2000).

Raphael (2000) concludes his argument to foretell that social health is being challenged. The assumptions for these predictions are measured in concepts that show where symptoms of societal disintegration occur in societies where inequalities persist. These are depicted by   increase in alcoholism, crime, road accidents and deaths; infectious diseases, illiteracy; drug abuse and offences, family dysfunctions, and decreased voter turnout ( Raphael, 2000).

Reacting specifically to the Canadian scenario Raphael (2000) cited that very little attention is paid to economic inequality. Research regarding its associating health consequences does not go beyond the boundaries of documenting the lower health status of people, living in poverty. Tragically, this is happening despite startling evidence of its long term far reaching effects (Raphael, 2000).

As this argument pertaining to health care policy intervention being a solution to health inequities among women and children continues it is important to embrace a study exemplifying the role nurses play in narrowing health inequalities in their respective communities and functions. It is clear that nurses can influence policy makers to improve accessibility to health care for children and women(Muntaner & Chung, 2012).

Muntaner and Chung (2012) conducted a scoping review to assess the empirical associations connecting social determinants and health outcomes as it relates to policy interventions. This was a deliberate attempt to expose public polices implicit in political activities aimed at influencing health inequality within the Canadian Health Care system (Muntaner & Chung, 2012).

The researchers advanced after empirical findings that taking action regarding social determinants of health requires‘collaboration of various government, civil and health actors’(Muntaner & Chung, 2012). More importantly, nursing theory supports the ideals of advance practice nurses taking action to improve social conditions that create poor health outcome

This is expected to open avenues whereby the nursing profession can extend itself towards being an agent of change for minorities in the society (Muntaner & Chung, 2012).

According to these researchers, it would necessitate advocating for acknowledging first that women and children are vulnerable to social inequities. Analysis of present policy to evaluate their effectiveness must be embraced. The political ideology surrounding social welfare policies ought to be examined for influences of neo-liberalistic attitudes(Muntaner & Chung, 2012).

Nurses at their level of practice must join forces with other health care professionals in activating change in Canada’s health care policy, the same way pediatricians, obstetricians, politicians and social workers exploit their professional competence in executing health care policy reform. The goal is to narrow health inequalities which has plagued Canada for centuries despite public awareness that this social problem exists.

The truth is that individual biological factors do not influence social determinants of health; rather it is a person’s access to quality health care services along with government’s failure to appropriately intervene that makes the remarkable difference in health determination factors. In designing more equitable health care policies and increasing budget funding towards improving health care services is the logical solution to this moral crisis in Canada.

Discussion and Implications

This research concerning social determinants of health embedded in Canadian Healthcare and social services policies clearly indicates that this nation faces both an ethical dilemma and a moral crisis. Truly developing nations demonstrate immense health iniquities among minoritieswhich are so obvious that it is difficult to ignore. Policies relating accessibility to obstetric care for poor women should be among the top priorities for policy reform.

Unfortunately, children are affected. Form research findings Canadian government actually ignores the existence of social inequalities and its influence on health care inequities. As such, no policies exit to address this discrepancy. More importantly, there are no specific data to quote the severity of this social disorder (Raphael, 2000)

These foregoing findings suggest that social services administration ought to make recommendations for improving health care accessibility for minorities by initiating a more liberal social welfare system in this country. Public sector health care should move beyond a funding agency typology towards being more concerned about levels of health care and health inequities influenced through poverty within the mixed model executing of healthcare services.

In monitoring private sector funding public sector agencies ought to evaluate financial assets intervention regarding the intangible health care delivery such as who receives services when, how and at what costs.

There are serious implications/outcomesof social determinants. According to Raphael (2000) it goes beyond ill health towards social effects manifesting as symptoms of societal disintegration. They persist in societies where inequalities exist. These are demonstrated as   increase in alcoholism, crime, road accidents and deaths; infectious diseases, illiteracy; drug abuse and offences, family dysfunctions, and decreased voter turnout (Raphael, 2000)

These factors affect life expectancy rates internationally. Evidently this suggests that in the absence of supporting statistical data the life expectancy ratio of Canadians can untimely decrease.Unhealthy children produce unhealthy adults and the cycle continues.Human resource is the greatest in any nation. If no attention is given to minorities’ accessibility to quality health care by narrowing gaps eventually human resource development in Canada could be jeopardized. Social structures will collapse and the nation can crumble financially.

Conclusion

The question of this moment is with all of this data at our disposal, where do we go from here? The truth based on the foregoing analysis implies that Canada has a very far roadto travel if social determinants of health are to be addressed through policy reformative intervention strategies. First collaboration of disciplines must be encouraged to research and document social determinants of health issues exiting presently among women and children.

Social service intervention should be solicited. Subsequently,approaches ought to be made for petitioning government to change policies. In the interim social service agencies ought to be notified through writing of the situation facing Canadian women and children. Efforts of non-governmental agencies supportive of women and children health care ought to becollaborated in the struggle.

They also should be sensitized regarding social inequities in health care facing this minority group. Arrangements must be made for a massive information dissemination campaign soliciting public support. Interest groups involvement is essential to successful outcomes.  They can be encouraged to can organize social action through peaceful demonstrations picketing agencies directly related to the policy making process for Canadian women and children’s health.

References

Coburn, D (2004). Beyond the income inequality hypothesis: class,neo-liberalism, and health Inequalities. Social Science & Medicine 58 (2004), 41–56

Coburn, D., & E. Coburn (2007).Health and health inequalities in a neo-liberal global world. London. Cambridge University Press.

Ewald, W. (2007). Evolution of Infectious Diseases. New York: Oxford University Press.

Larson, C. (2007). Poverty during pregnancy: Its effects on child health outcomes.Paediatr Child Health, 12(8): 673–677.

McMillian, J.,&Davies, L. (2012). Social Class and Health Inequalities. Toronto.

Muntaner, C. Ng, E., & Chung, H (2012). Better Health.  Ontario. Canadian Health Services Research Foundation and Canadian nurses association.

Raphael, D (2002). Poverty, Income Inequality,and Health in Canada. Toronto. The CSJ Foundation for Research and Education.

Raphael, D (2000). Health inequalities in Canada: current discourses and implications for public health action. Critical Public Health, 10 (2). 194-204