Theories of Healthcare Inequities, and Applications to the UK

Question

Explain theories of health inequalities such as Artefact explanation, Materialistic explanation, natural explanation and link back to health inequalities in modern Britain.

Answer

Interest in creating equity has grown within the UK health care system, particularly since the recent exit from the European Union. Many population groups experience social exclusion and have their health and social needs compromised due to such inequities (McCartney, Collins & Mackenzie, 2013). Theories of health care inequities are useful to understanding their causes, predicting future individual and social behaviours and promoting equity and balance. Artefact explanations of health care inequalities suggest that these imbalances are a result of errors in measurement (Mackenbach, 2012). The potential for social class biases, a lack of accounting for all demographic groups, monitoring and statistical error all account for the perception that inequity exists (Mackenbach, 2012). However, artefact explanations assert that such health inequities are not real. Conversely, the materialist explanation of health inequities suggests that these imbalances are real, though the central factors that drive such inequities are dependent on material resources like income, class structures, career and education (Preda & Voigt, 2015). The natural selection explanation of inequity suggests that evolutionary favourable characteristics that predispose some individuals to higher social and economic ranks naturally create imbalances in health care (Preda & Voigt, 2015). This process occurs on the social level as well, with more socially favourable qualities allowing some individuals to receive greater societal opportunities like health care access.

The theory or causal model used by a particular health care system impacts its distribution of funding and services (McCartney et al., 2013). The UK faces many socioeconomic inequalities that impact its health care policy. The seminal Black et al. report (1980) confirmed the validity of each of these explanations in the UK, including social health inequality, errors in census information leading to artefact explanations and poverty or wealth being associated with low or high health, respectively.

References

Black, D., Morris, J., Smith, C. and Townsend, P., 1980. Inequalities in health: report of a research working group. London: Department of Health and Social Security.

Mackenbach, J.P., 2012. The persistence of health inequalities in modern welfare states: the explanation of a paradox. Social Science & Medicine,75(4), pp. 761-769.

McCartney, G., Collins, C. and Mackenzie, M., 2013. What (or who) causes health inequalities: theories, evidence and implications? Health Policy,113(3), pp. 221-227.

Preda, A. and Voigt, K., 2015. The social determinants of health: Why should we care? The American Journal of Bioethics, 15(3), pp. 25-36.