Health & Social Care: Structural Issues & Well-being

Hello everyone! Welcome to your study notes for "Structural issues related to health, social care and personal and social well-being". Don't worry, the title sounds more complicated than it is!

Think about this: is being healthy just about eating vegetables and exercising? Not really. Our health is also shaped by the world around us – things like how much money our family has, the community we live in, and the government's policies. In this chapter, we're going to be detectives and investigate these "big picture" or structural issues. Understanding them is super important because it helps us see why some groups of people face more health challenges and how we can work towards a fairer, healthier society for everyone. Let's get started!

1. Vulnerable Groups: Who Needs Extra Support?

In any society, some people face more challenges than others. We call them vulnerable groups. Think of them like a young plant in a storm – they need a bit more protection and support to grow strong.

Who are they?

The syllabus points out a few key groups in Hong Kong:

  • Children: They depend completely on adults for their health, safety, and well-being. They can't make decisions or earn money for themselves.
  • Disabled People: They may face physical barriers (like no ramps for wheelchairs) or social barriers (like discrimination when looking for a job), which can affect both their physical and mental health.
  • The Aged (Elderly): As people get older, they may have more health problems, lower incomes after retirement, and may experience loneliness.
  • Ethnic Minority Groups: People from different cultural backgrounds might face language barriers that make it hard to access healthcare or social services. They can also experience discrimination.
  • Poor Families: Families with low income struggle to afford nutritious food, decent housing, and quality healthcare. The stress of financial hardship also takes a toll on their mental well-being.
Analogy Time: The Uneven Race

Imagine life is a running race. Some people start at the starting line with good running shoes and lots of training. But vulnerable groups might start way behind the line, with no shoes, or with hurdles placed in their lane. It's not that they can't run; it's that the structure of the race is unfair for them.

Key Takeaway

Vulnerable groups are not weak; they just face extra barriers created by society's structure. Identifying them is the first step to providing the right support.

2. Economic Crises: When the Economy Gets Sick

The economy is like the weather – it has good seasons ("ups" or booms) and bad seasons ("downs" or crises/recessions). These economic changes affect everyone's health and well-being, not just the money in our pockets.

How do economic "ups and downs" affect us?
  • On Communities: During a crisis (like the 2008 financial crisis), businesses may close, and the government may have less money for public services like parks, libraries, and community centres. This can reduce social connection and support.
  • On Families: Job losses are common during a recession. This creates immense financial pressure and stress, which can lead to family conflicts, mental health problems like depression, and poor physical health.
  • On Vulnerable Groups: These groups are often hit the hardest. For example, low-skilled workers are often the first to lose their jobs. Government cuts to social welfare budgets directly harm poor families and the elderly who rely on that support.
Did you know?

During the Asian Financial Crisis in 1997, Hong Kong's unemployment rate shot up. Many families faced sudden poverty, and social workers reported an increase in cases of family stress and conflict. This shows the direct link between the economy and social well-being.

Key Takeaway

An economic crisis is also a health crisis. It creates stress and reduces resources, hurting families and especially the most vulnerable members of society.

3. Displacement and Migration: People on the Move

Sometimes people have to leave their homes. This can be a choice or something they are forced to do.

  • Displacement: This is when people are forced to move.
  • Migration: This is when people choose to move, usually for a better life.
Why do people move?

The syllabus highlights several reasons:

  • Natural Disasters: e.g., A family losing their home in a typhoon.
  • Human Activities: e.g., People being moved to build a large dam or a new highway.
  • War and Conflict: e.g., Refugees fleeing a war zone to find safety.
  • Job or Education: e.g., Someone moving from the Philippines to Hong Kong to work as a domestic helper, or a student moving abroad for university.
  • Family Reunion: e.g., Children from Mainland China moving to Hong Kong to live with their parents.
What are the risks?

Moving to a new place can be very difficult. Newcomers can face:

  • Possible care deprivation: They might be separated from their family and support networks, leading to loneliness and a lack of help when they get sick.
  • Readjustment to a new environment: Imagine moving to a country where you don't speak the language and don't understand the culture. It can be incredibly stressful and isolating. This can lead to mental health issues.
Key Takeaway

Moving home, whether by choice or force, creates significant stress and vulnerability. Newcomers often need special support services to help them adjust and stay healthy.

4. Poverty: More Than Just an Empty Wallet

Poverty isn't just about not having money. It's about not having the resources and opportunities to live a healthy, decent life. It's a trap that's hard to escape.

What causes poverty?
  • Underlying reasons: This can include a lack of education, discrimination, long-term illness, or being born into a poor family.
  • A poverty culture: This is a complex idea. It suggests that sometimes, the feelings of hopelessness and despair caused by long-term poverty can create a cycle where people don't see a way out, making it harder for the next generation to escape.
Social Security: The Safety Net

Think of social security as a safety net under a tightrope walker. If you fall (lose your job, get sick), it's there to catch you. In Hong Kong, the main system is the Comprehensive Social Security Assistance (CSSA) scheme.

However, this safety net depends on two things:

  1. Politics: The government decides how much money to put into social security.
  2. Economic fluctuations: When the economy is bad, more people need the safety net, but the government has less tax money to fund it. This creates a huge challenge.
Common Mistake to Avoid

Don't just say "poverty is not having money." For a good grade, you need to explain that it's a multi-faceted problem involving a lack of opportunities, social exclusion, and a cycle that's hard to break.

Key Takeaway

Poverty is a complex cycle that affects health, education, and future opportunities. Social security systems act as a vital safety net, but their strength depends on political and economic stability.

5. Inequalities and Resource Deprivation: An Unfair Slice of the Pie

Inequality means that resources like money, healthcare, and education are not distributed fairly in society. Imagine society's resources are a giant pizza. Some people get huge slices, while others are left with just the crumbs. This is resource deprivation.

How does inequality show up?

Inequality isn't random. It's often linked to a person's background.

  • Social Class: People from wealthier families have better access to good schools, private doctors, and safe housing.
  • Gender: In some places, women may be paid less than men for the same job or have fewer educational opportunities.
  • Age: The elderly may be discriminated against in the workplace, while the needs of young people can be overlooked in city planning.
  • Ethnicity: As mentioned earlier, ethnic minorities can face barriers to accessing services due to language or discrimination.
  • Religion: Sometimes, people of certain faiths may face prejudice that limits their opportunities.
Quick Review Box
Factors linked to inequality:

S - Social Class
G - Gender
A - Age
E - Ethnicity
R - Religions

Key Takeaway

Inequality is a structural problem where resources are unfairly distributed based on factors like class, gender, and ethnicity. This directly creates health and social disparities.

6. International Social Justice: Thinking Globally

These problems aren't just local; they are global. International social justice is the idea of creating a fairer world for everyone, no matter which country they live in.

Who are the global players?

Several large organisations work towards this goal:

  • United Nations (UN): Works to maintain peace, protect human rights, and promote social progress around the world.
  • World Health Organization (WHO): A part of the UN that focuses on global public health. They help fight diseases (like COVID-19 or Ebola) and work to improve healthcare systems worldwide.
  • International Court of Justice (ICJ): The UN's main judicial body, which settles legal disputes between countries.
Developed vs. Developing Nations

The relationship between richer (developed) and poorer (developing) countries is a key part of social justice. Fair trade, foreign aid, and sharing medical technology are ways to reduce global inequality. An unfair relationship can make it harder for developing nations to improve their citizens' health and well-being.

Key Takeaway

Health and social care problems cross borders. International organisations play a crucial role in promoting global social justice and helping to bridge the gap between developed and developing nations.

Final Summary: Connecting the Dots

As you can see, a person's health is deeply connected to the structure of society. Poverty, economic crises, inequality, and displacement are not personal failings – they are large-scale problems that create barriers to well-being. By understanding these structural issues, we can better identify who needs help, design effective support services (like NGOs and community centres), and advocate for fairer policies. You've now got the foundational knowledge to see the bigger picture of health and social care. Well done!