public health with regard to the inequities that exist in the provision of health services has never been worse. Researchers have consistently and tirelessly made public health a subject of their study. The quest for a solution to these inequities is central in two spheres of public health: community based interventions and social epidemiology. The inequities in focus transcend social, economic, political and racial bounds. They are ever increasing at alarming rates. The severity of the inequities varies, but it is clearly disturbing in some countries. Some of the most notable inequities include: childhood obesity in disproportionate figures, food insecurity, and insufficient healthcare access in the various disadvantaged groups persists. Although both epidemiologists and community based intervention researchers have a long standing common interest, they have not achieved much as far as the usage of epidemiology is applied to provide solutions to health inequities.
It is typical epidemiological practice to hold constant variables in order to analyze the predictive potential of some known risk factors in specific population samples. It is such data that can be used to build intervention strategies (Wallerstein, Yen and Syme, 2011). Epidemiologists have helped the world understand that there are a lot of health matters that happen outside the office of the doctor. In particular, some conventional disease factors such as high blood pressure, serum cholesterol and smoking of cigarettes only tell half the story of the possible diseases they are meant to expose. Environmental and social factors tell the other half of the remaining story.
Prevention is a better measure in dealing with diseases. Diseases that are triggered by socio environmental factors should be countered directly from the very communities one acquires them. One outstanding absurdity is why we insist on using costlier approaches to handle health situations that can be mitigated with more cost effective alternative strategies. It is clear that the core root of the dilemma is a structural issue. Treatment that is anchored on payment systems naturally encourages more and more healthy care. If the systems can be reformed to reward the health providers for their efforts in keeping populations healthy naturally incentivizes prevention of disease before occurrence. One example is the intervention strategy for preventing the occurrence of asthma bouts. This is a solution that can be provided outside of health care facilities. Unfortunately, though, while we know that preventing asthma emergencies is by far cost effective than treatment, there is, ironically, no system of payment for such measures. Emerging invention by social epidemiologists provides a sustainable solution by redirecting savings made at hospital level to programs that minimize asthma emergencies.
Communication between sectors is another underlying problem that stands in the way of disease prevention. Epidemiologists have demonstrated that more exposure to stressful situations leads to the building of high cortisol levels; a reason for early deaths. The problem with the knowledge of that state of affairs is that these epidemiologists have no solution to the problem. Solving such a global challenge demands a global networking system that will coordinate and reduce the probability of people encountering such seriously stressful situations. Educators, doctors, lawyers, law enforcement and such community-based groups will have to take the lead in such a mission (Syme and Emeritus, 2014).
Measuring self-esteem is best done when it is viewed as a continuum. It varies from low, medium and high. It is usually quantified in figures of empirical studies. Interestingly, unlike what many think, both low and high self-esteem could be harmful to the individual. Optimum self-esteem lies somewhere in the middle of the continuum. People at this level of self-esteem are considered socially dominant in the relationships they have with others. There is reliable evidence of major differences between people with low and high self-esteem levels. One key characteristic that has been observed is that people with high self-esteem tend to focus on growth and development while those with low self-esteem focus on avoiding committing mistakes. Low self-esteem is commonly blamed for such negative outcomes as depression. Those with low self-esteem tend to overplay failure. They exaggerate negative outcomes (McLeod, 2012).
Psychological forces of subjugation and oppression could be the cause of such negative outcomes. Such forces include humiliation, trauma, degradation, religion, tradition, convention, cultural domination, ideology and objectification. These forces are harmful to persons that are subjects of oppression and deprive them of the ability to recover from their regressive circumstances by impeding their ability to compete effectively with others in the market place and preventing further self-destruction. The end effect is lower self-esteem.
When one loses self-esteem, they are drained of assertiveness and confidence. Low self-esteem is, therefore harmful and is a product of unjust treatment. Yet, the material elements of oppression are not directly responsible for the feelings of low self-esteem and shame. For one to manifest these feelings, they firstly need to acquire the common knowledge of the circumstances of their state of oppression; which inspire feelings of worthlessness and, lack of respect and dignity (Cudd, 2006).
Poor self-esteem that emanates from oppression manifests in some unique individual behavior. Such people tend to develop poor social skills. Many people that suffer low self-esteem acquired it from their early developmental stages. They are likely to have missed the social support they needed at the time. They now fear seeking help and view it as a demonstration of inadequacy. They are often unable and fearful of trying to do anything in a different way. These people end up being the receivers of everything that comes their way. They are unable to shape their destiny with decisions.
Emotionally depressed people often shut down emotionally. Such people will have emotional defenses from past experiences because they have been exposed to hurtful circumstances far too many times. The do not seem to know how or what to feel in hurtful situations. They lower their expectations of others and what life offers generally.
When an individual comes to the decision that they made a fool of themselves before others by committing a mistake, they tend to beat themselves emotionally. They develop a phobia-like reaction to similar occasions where they are likely to make a mistake. Such people respond to their self-defeating perception by refraining from public activity or simply stay quiet and refrain from sharing any talk or ideas because they cannot afford rejection (Sorensen, 1998).
Victims of oppression can be helped by examining them and digging out their background. Groups that consist of recovered victims could be helpful in assisting low self-esteem people recover from their disposition. The oppressors must be sought and made to face justice. This will help victims recover faster and feel safe.
The systematic mistreatment of people because they belong to certain groups is what defines institutionalized oppression. When society has laws, customs or practices that produce or reflect systematic inequities inspired by virtue of one’s membership to pre-stated or perceived social group, it is effectively engaged in institutionalized oppression. This is often the case irrespective of whether those enforcing such laws and practices intend to oppress or not. Some common oppressive institutions include: religion, government, school system, media, and the law and health service provision.
Victims of institutionalized oppression need to regain power from the oppressive systems. The victims will then, transform from their victimized role to allies of the dominant groups and lead the way in helping others under oppression to come out of such abyss. The group also needs to rebuild its social identity. They will need to walk through the underlying causes of discrimination and understand that these were never really personal. They have to demystify the fallacies and chart forth a new way of looking at life as opposed to the older ways that led to long standing oppression (Bearman, 2015).
Income injustice is the uneven spread of household or personal income across the participants in an economy set up. Income inequality is computed as a ration of the percentage of income visa avis the percentage of population. Such inequalities are mostly manifested in the way people are spread in an income distribution continuum. Nevertheless, income distribution of people is also linked to other factors including whether they have a disability or even their socio-ethnic background. The gender element also informs a lot of variations in income distribution in many societies. The Equality trust has such dynamics at the center of focus. The central concern at the moment is the discrepancy between the level of income of the rich and the poor. Such focus is apparent in the statistical data and choice of terms under this section.
Although inequality can be measured in several ways, the final result does not change much. Some changes in inequality levels over a period of time in some countries may look significantly different if a variety of measures are used to determine the same. The most common method applied for measuring income distribution across the board as opposed to comparing incomes of different groups is the Gini coefficient. Ratio Measures is another common method. The method shows how people at a specific distribution level compare with people at another level. The Palma ratio is the ratio of income share of the top ten percentages to the one at the bottom 40%. In equal societies, the ratio is usually 1 or below. This implies that the top 10% does not earn significantly more than the bottom 40%. Income injustice is classed into three main categories. The first lot is the income inequality that refers to the extent that income is spread unevenly among members of a group. It is common occurrence for some groups to receive higher allocation from the national budget than others. Such is a typical case of unevenly distributed economy. Income does not only refer to the money received as payments; rather, it is all the monies received through wages, salaries and bonuses too. It also includes investments earnings. Measuring income can be done at individual or household basis. The income that a household gets from social security before tax is referred to as gross income. The income that includes all tax deductions and due benefits is referred to as the net income.
Wage inequality is the second type of economic injustice. Pay is not the same as income. Pay refers to what one gets from employment. Pay inequality defines the differences in people’s income within or across companies. People working in the same department may earn different amounts because of experience, education and skill levels.
Wealth inequality is another set of economic injustice. Wealth is the total worth of the assets an individual or household owns. It spans from bonds, stocks, real estate, pension rights and more. Inequality in wealth refers to the unequal spread of such assets in a group (The Equality Trust, n.d).
Some of the possible approaches in solving economic injustice and inequality in society include:
Promoting access to education
Encouraging educational equity
Allocating monies to active labor market polices
Making wage determination more flexible
Promoting labor market products for women
Moderating tax with a focus on growth and not unintended deterrence that arises from tax regimes (Organization for Economic Co-operation and Development, 2012).
Bearman, S. (2015). Oppression101. Retrieved July 16, 2016, from http://www.interchangecounseling.com/blog/oppression-101/
Cudd, A. E. (2006). Analyzing oppression. New York: Oxford University Press.
McLeod, S. (2012). Low Self-Esteem. Retrieved July 16, 2016, from http://www.simplypsychology.org/self-esteem.html
Organisation for Economic Co-operation and Development. (2012). Going for growth. Paris: OECD.
Sorensen, M. J. (1998). Breaking the chain of low self-esteem. Sherwood, OR: Wolf Pub.
Syme, L. S., & Emeritus, P. (2014). Community Development’s Role in Disease Prevention. Retrieved July 16, 2016, from http://www.frbsf.org/community-development/blog/social-epidemiology-disease-prevention/
The Equality Trust. (n.d). How is Economic Inequality Defined? Retrieved July 16, 2016, from https://www.equalitytrust.org.uk/how-economic-inequality-defined
Wallerstein, N. B., Yen, I. H., & Syme, S. L. (2011). Integration of Social Epidemiology and Community-Engaged Interventions to Improve Health Equity. American Journal of Public Health, 101(5), 822-830. http://doi.org/10.2105/AJPH.2008.140988
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