aOvertime, sociology has played an essential role in the aid of healthcare policies and procedures, along with playing a fundamental role in one’s understanding of health inequalities. This paper explores how sociology has played such a role in healthcare, whilst including discussions regarding the influence of social structures and inequalities in the health of an individual, their family and community, with the topic of health variations between social classes being the focus of the discussion.
Sociology can be defined in a number of ways, due to its almost limitless scope (Denny, Earle, and Hewison, 2016). Clarke, (2010) explains that sociology is a form of social science discipline, in which a distinctive approach is taken to investigate society. Morrall (2001) expresses that the use of sociology in healthcare is essential, as the subject aids in highlighting the nature of health and illness, along with the social causes of the disease and death. This exposes any ethical predicaments in the production of healthcare, ultimately creating practitioners who are capable of competent and focused decision making and in turn providing the healthcare system with more individualised policies and practice.
The inclusion of sociology and nursing practice has been criticised by many since it was first introduced. Sharp (1994) was one of the first to critic the idea of the inclusion of sociology within nursing practice, arguing that nursing is an “action-orientated profession”, therefore nurses should only be concerned with the knowledge of how to perform tasks, rather than acquiring the theoretical knowledge of sociology. However, Porter (1995) was in favour of this inclusion, arguing that health not only determined on the assessment of an individual’s physical state, but can in fact be determined by factors such as social and cultural, which nurses should both be educated in and understand. Porter goes on to explain that in turn, this would allow nurses to care for patients in a holistic and individualised manor.
Inequalities in the UK have been researched by many sociologists over time. Karl Marx (1818-83) explored social class inequalities, basing his analysis around Capitalist society, expressing that “the rich get richer at the expense of the poor”. This portrayed that wage labourers develop a significant amount more financial profit and wealth for their employers than they were to keep for themselves – stating that for himself, this strongly highlighted the essence of society. (Denny and Earle, 2005).
In 1921-2000, social class was categorized in accordance to the ‘The Registrar General’s Classification of Social Class’ which provided an explanation stating that individuals were to be allocated to one of five social classes, based on both the occupation and income of the head of the household (Waugh and Brooker, 2013). This suggests that the structures highlighted by Marx still existed in modern day society, as women, students, and the unemployed were excluded from this. However, in 2001 this classification was revised, with both women and the unemployed or retired being considered, along with seven social classes being put in to help accommodate this. (Waugh and Brooker, 2013).
According to research conducted by sociologists throughout history, socioeconomic inequalities and an individual’s health status have been proven to have a strong correlation. In 1988, an analysis of socioeconomic classification inequalities in health was carried out. The study suggested that individuals with a significantly higher financial income had relatively low death rates, compared to those individuals whose occupation consisted on manual labour (Kirby et al, 2000).
Highlighting the conspicuous link between an individuals’ socioeconomic classification and their health, studies have found that between the years of 1982 and 1986, men in class one (the highest categorised class) had a life expectancy of 2.3 years greater than those in class three, and 4.9 years greater than those in class seven (the lowest categorised class) (Matthews, 2015). Present day sociology research confirms this link, as the gap between those in classes one and seven increased to 5.8 years in 2002-2006, whereas that between classes one and three declined to 1.9 years (Office for National Statistics, 2011).
In 1980, The Black Report (Black et al) exposed the extent of health inequalities in the UK and answered the question that many people had been asking; how does an individuals’ socioeconomic classification effect their health status? Findings from the report suggest that materialistic deprivation is the main cause of social inequalities in health. White (2013) agreed with The Black Report, stating that materialistic influences on health include; working conditions, diet, exposure to pollution, and housing.
The Marmot Review, published in 2010, has effectively reduced health inequalities in the UK since being released. The review has aided in the rise in commitment from health professions and service providers to reduce health inequalities and address the social determinates of health (University College London, 2017). Currently, 16.9% of adults smoke in the UK, with cigarette smoking prevalence being found to be significantly higher in more deprived areas of the UK (Cancer Research UK, 2017) , thus suggesting that socioeconomic classification and health inequalities are linked to this statistic. In 2011, in response to professor Sir Michael Marmot’s fair society, healthy lives Marmot report, the Department of Health published health policy documents, with one of which aiding in the control of tobacco consumption. Public Health England, a new integrated public health service, was also created to ensure responsiveness, excellence, and expertise. (Department of Health, 2011). To reduce tobacco consumption in England, the UK government planned to implement the display of tobacco products in all shops from April 2015, along with reducing the promotional impact of tobacco product packaging before the end of 2011 (HM Government, 2011).
The proposed Healthy Lives, Healthy People policy has, currently, proven effective as a study carried out by the Office of National Statistics stated that in March 2017, 16.9% of UK adults currently smoked tobacco, decreasing from 17.2% of adults in 2015. (Cancer Research UK, 2017).
To conclude, sociology plays an essential role in the aid of healthcare policies and procedures, with nurses and health care professionals requiring knowledge of sociology services to ensure the care of patients is individualised and holistic, with individual cultural and social aspects being taken into consideration. Sociology informs healthcare policy and procedures by allowing policy makers, to identify both problems and needs and address these by implementing policies and plans to address these needs. It remains clear that social classification continues to both influence and have an effect on the health of individuals, families and communities, thus making it essential that these health policies and regularly evaluated in order to ensure the current issues raised are being dealt with effectively.