139 9 Health Introduction The maintenance of good health is fundamental for our welfare, and variations in the extent to which people enjoy good health are central to human inequality. This point is made most starkly with respect to variations in life expectancy (see Chapter 1). To die prematurely, if steps could have been made to prevent that death, is the most fundamental inequality. But when the issue is put starkly it highlights the fact that it is difficult to single out health as a ‘social policy’ issue from all the other policies that have an impact
All children have the right to a happy childhood and a standard of living sufficient for their mental health, wellbeing and development. (UNCRC, 1989) Introduction This chapter looks at poor health and its impacts on and interactions with poverty. There is the idea that poor health leads to poverty, and it does sounds as though it could or should be the case. However, there is now extremely strong (and growing) evidence that poverty actually leads to poor health. Even short-term falls in income increase the risk of ill health ( Smith at al, 2007 : 58
Where people live matters to their health. Health improvement strategies often target where people live, but do they work? Placing health tackles this question through an examination of England’s Neighbourhood Renewal Strategy and its health targets. It evaluates the evidence base for the strategy, compares experiences from the United States and elsewhere in Europe, and illustrates the relevance of complexity theory to area-based health improvement work.
The book brings together these topical issues with a social science analysis of current programmes based on the methods and concepts of complexity thinking. It concludes by setting out how local action based on these ideas offers a new approach to area-based health improvement work.
Placing health is aimed at researchers, academics and students in the social and health sciences with an interest in area-based health improvement work, as well as practitioners in health services, local government and voluntary agencies working on neighbourhood renewal and health projects.
51 Part Two Health and medicine Although the rise of sociology as a discipline coincided with the rise of scientific medicine, neither health nor the modern health care system were explicit topics of investigation among early sociologists. It was not until the 1930s that one of the most influential sociologists of the era, Talcott Parsons, began a series of studies that focused on illness and what he called “medical economics.” He identified medicine as a vital aspect of the social structure, acknowledging that a healthy population was necessary for
97 Part Three Health and families Families are important entities in shaping the health of their members. Historically, families were the major source of medical care (see Chapter Two) and, with the increase in chronic illnesses, much medical caregiving has been transferred back to families. But the impact of families on health extends far beyond caring for the sick: the family is the oldest social institution in existence and evolved to enhance the survival of its members, usually by organizing work, reproduction, and sexuality. Modern families
509 Policy & Politics vol 38 no 4 • 509-29 (2010) • 10.1332/030557310X501802 © The Policy Press, 2010 • ISSN 0305 5736 Key words: health • devolution • intergovernmental relations • professions Final submission February 2010 • Acceptance February 2010 Intergovernmental relations and health in Great Britain after devolution Scott L. Greer1 and Alan Trench Political devolution allowed policy divergence around the UK. But England, Scotland and Wales must coexist within the UK, which means that the overarching rules of devolution shape their policy options
What part do the values of growth and prosperity, freedom and justice, security and democracy play in social policy and human welfare? How can we judge the policies offered to us as the recipe for progress?
At a time of global ‘permacrisis’, Sebastian Taylor applies his extensive frontline experience working with health systems and healthcare in the Global North and South to assess the concrete impact of contemporary liberal values on our welfare, development and environmental survival.
Drawing on research from around the world, he uses health as an objective metric to assess how effective these policies are for individuals and society as a whole.
17 TWO Public health and a public health system As already noted in Chapter One, public health is a contested term, without a single or a simple definition. Its amoeba-like nature means its parameters change in line with perceptions of the key influences on the health and wellbeing of populations, while the components of a ‘public health system’ not only reflect how public health is defined but also inform the myriad of organisational routes through which public health problems are galvanised and addressed. In 1948, the World Health Organization (WHO
195 FOURTEEN Health and homelessness Katy Hetherington and Neil Hamlet Introduction Homelessness is both a consequence and a cause of poverty and social and health inequality. It is also, in many cases, a ‘late marker’ of severe and complex disadvantage that can be identified across the life course of individuals (McDonagh, 2011). Poverty is a pervasive factor for those experiencing, and at risk of, homelessness, and with homelessness comes an increased risk of excess mortality. In Scotland, homeless people in Glasgow are 4.5 times more likely to die than
155 CHAPTER SIX Prioritising public health investment We must re-orientate our health and social care services to focus together on prevention and health promotion. This means a shift in the centre of gravity of spending. (Secretary of State for Health, 2006: 9) In practice, health systems focus on immediate demands of health care services with, at best, only 3% of the total health expenditure in Organisation for Economic Co-operation and Development (OECD) countries committed to prevention (WHO, 2012a: para. 101). Evidence- based preventive services
