Marmot Review & Black Report Comparison sample essay
The Marmot Review and the Black Report are very similar in their aims; The Black Report was written by Sir Douglas Black and was published by the Department of Health & Social Security in 1980 and commissioned by Health Minister, David Ennals of the previous labour government in 1977, in an attempt to show exactly how ill health and death are both distributed among the population in what Black suggests is an unequal manner between social classes. The Marmot review, written by Professor Sir Michael Marmot, however, was not published until 2010 by University College London, and commissioned by the Secretary of State for Health, Alan Johnson in 2008. Similarly to the Black Report, the Marmot Review looks at how essentially, the lower a person’s social class, the worse said individual’s health is. The Black Report suggests that health inequalities have been growing more so since the establishment of the National Health Service in 1948.
Black also suggested that these inequalities were due to factors such as education, income, housing, diet, employment and the working conditions of individuals, which is similar to what Marmot implies within the Marmot Review however the review was written with six objectives: To provide all children, young people and adults with the resources and help to maximise their capabilities and for them to have control over their own lives, to create employment and suitable work for everyone, ensure that everyone has a healthy standard of living, to create equality within communities and social classes and to strengthen the impact of illness prevention. The Black Report was written to actually combat these inequalities by looking directly at the inequalities that still exist despite the National Health Service being in place, the differences in social classes and the use of medical services, infant mortality rates within social classes and also life expectancy.
Black found that there was explanations for these health inequalities. The artefact explanation suggests that there are no health inequalities within society, but rather just man-made statistics, whereas the social selection explanation explains that social classes are actually created based on people’s health – the worse an individual’s health, the lower their social class. The behavioural/cultural explanation suggests that people do not live healthy lifestyles, it implies that people of working class status smoke and drink too often and have poor diet and a lack of exercise, causing them to therefore become of ill-health, whereas Marmot simply looked at the problems but essentially didn’t create any explanations for them, just identified the inequalities; however if the Marmot Review had looked further into these health inequalities he would more than likely have been successful in finding explanations and having more of an impact.
Had the review looked at not just the lower social classes, but also the top end of the hierarchy the task would possibly not still remain to be improvement of health for the majority of the population in order to level out the social gradient. Despite this however, the Marmot Review saw that not only did life expectancy improve for the majority of the 150 local authority areas looked at, there is also a 3% improvement in children at age 5 developing at a good level and the number of young people not in education or employment decreased by 0.3%. The Black Report however simply suggested that the cause of the issues was in fact economic inequalities. Black brought his evidence to public attention and essentially promoted the problems of inequalities in health, as well as an interest in sociology of health and illness.
Black found that there was in fact an improvement in health across all social classes during the first 35 years of the National Health Service – despite the inequalities still standing, they have actually improved. In summary, the Black Report simply promoted inequalities and explained them further, however this meant that the report essentially stimulated further research into inequalities within health. It could also be said that because the report was written with all focus on particular aspects of inequalities such as mortality rates, it failed to go into full detail about any other problems with the inequalities presented.
The Marmot Review however is probably, in a sense, the opposite of the Black Report. Marmot failed to review a lot of aspects of inequalities such as taxation only being reviewed to look at low incomes, and the higher social classes essentially being forgotten about, however due to his review, there was in fact actual evidence that his ideas had been put into effect with the impact showing through the improvement of certain areas unlike the Black Report, despite their many similarities.
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