The Black Report There are considerable health inequalities amongst Britain’s social classes. Health is formed by socio-economic, political and environmental factors; these elements shape inequalities and influence the health of various social groups in Britain. Health inequalities is the term used to describe the consistent recurring differences of the health complaints involving the social classes of Britain. These differences were first highlighted by Sir Douglas Black in a research study called The Black Report. The reason for The Black Report was to find information about the problems with health variations among the social classes.
In 1977 under a Labour Government, the Secretary of State for social services developed The Working Group on Inequalities in Health; Sir Douglas Black was the chairman. The group were given the task of gathering information about health contrasts in society and to analyse lifestyles from all the social classes. In addition, any likely reasons had to be established and a course of action was to be drawn up (www. sochealth. co. uk/Black/blackforeword. htm). Evidence was collected using quantitative data from sources such as the Official Register of Deaths and Births, doctor’s surgeries and hospital records.
The official statistics were then used to determine the morbidity and Standardised Mortality Ratio (SMR) of the social classes. The Black Report established four possible explanations for health inequalities; Artefact, Cultural, Materialist and Social capital. The Artefact explanation measures the inequalities of health between the social classes and adopts the belief that there is a fake association between health and the social groups. This account suggests that the rise in health differences is superficial and deceptive.
Shaw et al insinuated health complications were the consequences of lower class socio-economic difficulties (Holborn, Burrage and Langley, 2009) Also, Illsley (1987) implied that health complications directly affected those in lower social classes; indicating poor health occurs through unemployment (Holborn, Burrage and Langley, 2009) Cultural explanations suggest that health inequalities are due to class differences; proposing that lower class lifestyle is inadequate and unhealthy compared to the beneficial lifestyle of the higher classes. The lower class are associated with certain ill-health causing behaviours, such s high rates of smoking, excessive alcohol consumption, unhealthy diet and little exercise; these issues produce high rates of cancer and heart disease. It has been noted that irresponsible decisions could be the outcome of how individuals cope with class related circumstances. To illustrate, Graham and Blackburn (1998) understand that women of the working class deal with their stressful lives by smoking (Holborn, Burrage and Langley, 2009) The advertising of unhealthy food often appeals to individuals that cannot afford to buy healthy food due to poverty.
These concerns were argued by Paterson (1981) who pointed out that structural issues within society are overlooked by the cultural explanation (Holborn, Burrage and Langley, 2009) The materialist explanation suggests the inequalities of health are due to the structures of society. This account underlines economic and environmental conditions associated with health. There is evidence to support this statement, provided by research studies and a series of arguments. For example, Martin et al (1987) discovered that respiratory diseases could be connected to poor living conditions such as cold damp housing.
Increased support is presented in research by The American Multiple Risk Factor Intervention Trial (1996). They found that the lower class had significantly more fatalities than the higher class. The difference between the classes death toll was accounted for by concerning factors such as smoking and high blood pressure (Holborn, Burrage and Langley, 2009). Additional evidence by Doyle and Parnell (1979) expresses that adverts designed for profit, promote unhealthy food produce creating health threats.
In relation to this, Lobstein (1995) established that deprived areas had poor diets because healthy food tended to more expensive in poorer communities than in the well-off ones (Holborn, Burrage and Langley, 2009) It is understood that manual workers endure more work related injuries than non-manual workers. Recent studies to support this claim come from Clapp et al (2005) who indicate that a probable 12? of cancer deaths are workplace related, also, Meldrumm (2005) found that working conditions cause up to 20? of lung cancer deaths (Holborn, Burrage and Langley, 2009).
Social Capital explains health inequalities in various ways, including unexpected disadvantages. This can be supported by Shaw et al (1999) who found that if difficulties occur at important times of life it can result in health inadequacies; for example, lack of nutrients as a child (Holborn, Burrage and Langley, 2009). Josh et al (2000) suggested that Social Capital was an important explanation regarding health issues. Supporting the theory that life chances are influenced by social environment and the people around us (Holborn, Burrage and Langley, 2009).
The Black Report unearthed an increasing gap in the inequalities of health between lower and higher social classes. There was a general improvement in health but it wasn’t equal within the classes; poor health was increasing. The Black Report also discovered that health inequalities were associated with social and economic influences such as unemployment and inadequate housing (http://www. sochealth. co. uk/Black/black. htm) 260 copies of The Black Report were published in 1980; it contained suggestions on possible ways of sorting out the healthcare problems.
At this time, there was a new Conservative Government which was led by Margaret Thatcher. Consequently the report was given the cold shoulder from the Tories as it contained potentially harmful spending suggestions. They declared that expenditure on the health services wouldn’t change the circumstances. After a prolonged delay in publishing the report, it was eventually released on an August Bank Holiday Monday (http://www. sochealth. co. uk/Black/black. htm) Altogether The Black Report devised 37 recommendations which focused on reducing Britain’s poverty.
The recommendations were band together under headings; the first requested more money to be spent on the education of health. The additional suggestions were a District Action Programme, The care of Elderly and Disabled people in their own homes, Prevention and the role of Government, Additional Funding for Special Areas and Measures to be Taken outside the Health Services (http://www. sochealth. co. uk/Black/black10. htm). Further research has been carried out examining the conclusions of The Black Report.
In 1987 a report was sanctioned by the Health Education Council, describing the health inequalities and its evidence and evaluating the Black reports progress. This report was called The Health Divide and it was directed by Margaret Whitehead. Her report discovered that, since the Black Reports initial findings were first published, health inequalities continue to exist within the social classes (http://her. oxfordjournals. org/cgi/pdf_extract/3/3/346). An independent study by Sir Donald Acheson investigated health inequalities in the UK.
The Acheson Report (1998) was appointed by the new Labour government in 1997 and found that health inequalities were caused by poverty: this reinforced the findings of The Black Report (http://www. sochealth. co. uk/Black/interpreting. htm). The response of the new Conservative Government headed by Margaret Thatcher criticised the report and wanted the findings supressed. Thatcher’s plans were conflict-ridden and worrying as her Tori government wanted to reduce public expenditure and privatise the NHS (http://www. ochealth. co. uk/Black/interpreting. htm). Health inequalities exist because of problematic government policies. If health improvements are to take place, there must be a decrease in the rift between the rich and poor societies. This can be achieved with a dependable government. Bibliography Websites http://www. sochealth. co. uk http://her. oxfordjournals. org Books Holborn, M. Burrage, P. Langley, P. (2009) Sociology Themes and Perspectives. As and A Student Handbook, Seventh Edition. London, Collins.
