Thursday, 2 April 2009

Why some people don't go to their doctor

One of the areas of my work I was interested in is to find out how young people and parents perceive services (public and voluntary) in their communities. While the programme of work that I drew up and presented got rejected on the count of being too expensive and too long (it was about engaging the poorest children and families in Glasgow, building relationships of trust and facilitating a process whereby they would make changes to their lives and communities - the kind of work that does actually take a lot of resources), it was still benefitial to talk to organisations and people.

Here are some of the issues that young people and voluntary sector organisations have come up with:

Accessing health services:
Young people are reluctant to access health services and often only do this in emergencies. This includes antenatal services. The reason they give for this is that their parents only see a GP/go to hospital when very ill, which leads to bad experiences. If you see that you only get out of hospital in a box, you rather avoid hospitals. As to antenatal services, young people are often reluctant to go because they fear being told off for smoking, alcohol consumption and not wanting to breastfeed. There is a real lack of using health services to prevent illness and as health support. So the dentist sees some kids only when all their milk teeth need taken out. Ouch.

Literacy of secondary pupils
In areas of deprivation, there is a high incident of teenagers who are not sufficiently literate. They are very likely to disengage with school (this ranges from truancy to lack of participation and destructive behaviour), have low self esteem, compensate with negative behaviour, not engage in any programmes of further learning or vocational programmes.

A biggie in Glasgow. There are invisible but real boundaries young people will not cross. They are afraid of being attacked if they do, so they won't use services on offer in an area outside of their own. Territorialism is mostly passed on from generation to generation and has a long history. Parents often support territorial behaviour, even if they are critical of gang fighting. In Glasgow, the gangs are often aligned along religious/ethnic lines (Catholic/Protestant, Irish/Scottish).

Parental literacy
Where parental, and specifically, maternal literacy is low, children are exposed much less to books. As a consequence, they are less prepared for school, often a full year behind when they start school. This gap widens rather than narrows (leading to teenage functional illiteracy in the worst case scenario). Parents are less confident to support their children, less likely to engage with school, less likely to read information about services. It seems commonplace that children entering schools have never seen a book, or shared a book with their parents.

There is a culture of smoking which makes it very hard for an individual to give up smoking. Smoking is normal behaviour, and smoking cessation programmes are taken up more by more affluent people, and are more successful among more affluent people because they are not in a culture of smoking and aren't exposed to other people smoking as much.

In addition there is a general misconception of what healthy/good food is, the actual effects of alcohol and tobacco consumption. With all the advertising and focus on healthy eating and the dangers of smoking, the media attention binge drinking gets, it raises the question if we fail to communicate to a significant proportion of the population.

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