Higher Pupil Conference April 2008 Wealth and Health Presented by Heather Fulton

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


Consequences of inequalities in wealth and health



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

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.


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.


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


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


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.


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


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%.


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.


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.


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

Documents

Higher Pupil Conference April 2008 Wealth and Health Presented by Heather Fulton