Research into Truancy: Causes and Effects

Research into Truancy: Causes and Effects Introductory orientation Truancy is about learners who have not been attending school regularly as required by the school, parents and even the authorities. Truant behavior is a problem for the individual, the family, the school and society in general. Free and compulsory education is recognized as a basic entitlement under international standards, including the United Nations Universal Declaration of Human Rights (1948), the Convention of the Rights of the Child (1989) and the European Convention on Human Rights (1950). With the right to free education and the obligation corresponding to this right observed and enforced through a national emphasis on school attendance, The National Statistic Office (Malta) states that in the 2004/2005 scholastic year the figure for school absenteeism accounted for 7.7% of the total number of school days in the reference period or an overall absence rate of 9.2 absent days per pupil that for boys being 10.0 days per pupil and for girls 8.4 days per pupil. As a teacher this makes me fretful about students missing school as this can be associated with subsequent emotional and psychosocial problems in early adulthood and is a predictor of multiple problems (Fogelman and Hibbert, 1990). Truancy may have both short and long term effects on society. There is evidence that truancy is linked to delinquent behaviour and juvenile crime (Collins, 1998; Reid, 1999). According to Jones (1996), ‘Absenteeism is a sign of trouble that often leads to lower academic skills and grades, delinquency, and dropouts. Studies have shown that high school dropouts are twice as likely to be unemployed and on welfare, and overall, tend to be facing a more difficult life than their graduating counterparts. Jones (1996; p.128), All members who form part of any educational institution cannot allow these students to give up on themselves. We as a modern, fast developing society, we cannot afford to let them surrender. It is clearly far less expensive to educate them than pay for a lifetime of welfare and all of the deprivations that welfare represents. These are ominous issues, which imply that the number of students who skip school is rising and that school absenteeism is a new generations behaviour that is today a dramatic social phenomenon. This proposal drafts the intent to investigate and explore realities of how truancy manifests with Maltese youth and also explore the psychosocial world of truants in Maltese schools. Problem Analysis The Pre-Scientific Problem awareness As a supply teacher for these past five years, I have witnessed incidences of truancy in the period 2006 to 2009. One of the common truancy reducation measures used was to lock the school gates during lessons and breaks and open them after school hours (my personal exsperience). Despite the limited impact on truancy reducation, the approach of locking gates is still common and evident in some secondary schools. I found locked gates while visiting some of the schools. Gangsters, to control late coming and to stop learners from dodging classes, locked gates to prevent trespassing, sepecially. Exploring the problem Incidence and nature of truancy Malta Since 1946 education has been compulsory for all children between six to fourteen years and extended to the age of 16 by the Education Act (Malta) of 1971. Maltese law imposes a duty on parents to ensure that their children of compulsory school age receive appropriate education, whether through attendance at a state or independent school. If they fail to do so, without any reasonable excuse and if found guilty, they are liable to a fine not exceeding in previous currency one Maltese Lira (equivalent to â‚ ¬2.33) for each day during which the offence continues, unless the parent fails to give a good and sufficient explanation within three days from the date he or she receives a notice from the Director of Education (Malta Education Act 1988). From January 2001 up to December 2002 there were 8,903 arraignments before the local tribunals in connection with school absenteeism (Grech, 2002). This figure represents only the number of students who were absent from school without a valid reason on more than three occasions in the time frame of a month. It is a known fact that there are a number of students that systematically plan three days off from school each month, just for the sake that they use their monthly absence allowance and knowing that in this way their parents would not receive a citation. Surveys show that the overall absence rate between 25th September 2000 to 31st March 2001 stood at 10.5 days per pupil (NSO Malta, 2001). This figure reveals an increase of 5.2% over 1999/2000 scholastic year (NSO Malta, 2001). Thus it shows that during this period, 657,604 pupil days were lost to absenteeism and authorised absence due to sickness. Indeed, the Clark Report (2005) shows concern for the increase in unauthorised absenteeism with parental consent, particularly in state secondary schools which cater, in the main, for a student population coming from a working- class background. Family problems, psychological problems, illnesses, school phobia and bullying have, significantly, been indicated by the Clark focus group to be the topmost reasons contributing to school avoidance. Some Overseas Countries Most of the research conducted abroad seems to provide information regarding the nature and extent of truancy in secondary schools. Results of a study conducted at a school in London from 1985 to 1987 revealed that 70% of the sampled pupils admitted truanting during the three-year period (Stoll, 1990:22). In the study that involved nine secondary schools, 66% of the 765 fifth year pupils admitted truanting (ibid). Figures on truancy in 150 English secondary schools revealed that 31% of pupils in years 10 and 11 admitted that they played truant or skipped lessons (OKeefe Stoll, 1995:12). Gray and Jesson (1990:25) report about the major national survey results of truancy in English secondary schools. According to this study, 23% of all fifth year pupils were involved in truant behavior and they were less likely to stay on in full-time education. Furthermore, schools facing serious problems of truancy tend to be in the inner city rather than in other areas (ibid). on the other hand, Collins (1998:26) reports that absentee rates vary between schools in the London Education Authority. Munn and Johnstone (1992:4) found that out of a sample of 50 Scottish secondary schools, 18% of the pupils (11% in June and 7% in November) were classified as truants and were mostly form the senior years. These figures exclude truants within the school day, as â€Å"14 schools reported that they did not keep period attendance records† (ibid). Truancy has long been a subject for research in various parts of the USA. According to Nelson (1972:98), 64% of the 591 students surveyed identified themselves as class truants. Learners habitually play truant each day in Los Angeles, Pittsburg and Milwaukee (Black, 1996:33). Bos, Ruiters and Visscher (1992:393) found that the average rate of truancy in 36 schools in the four Dutch cities studied was 4.4% and that truancy increased with the level of the class in almost all schools. Some researchers further indicate that truancy does not necessarily mean missing the whole day of school but found that I could be in the form of missing a part of a day or particular lesson (Kilpartick, 1998:31; Reid, 1999:91). In a study conducted by Malan in South Africa (1972:144), 2,738 out of 69,908 pupils were identified by their teachers as truants. Masithela (Masithela, 1992:33) observed that learners tend to miss lessons during the first and second periods, as well as during the last give periods. The tendency of missing certain lessons towards the end of the school day shows that some form of â€Å"hidden truancy† is prevalent and that pupils can be marked present in the register but fail to attend all lessons (ibid:45). On the other hand, they may come late and be marked absent or be somewhere on the school premises not attending certain lessons or periods, but still be marked as being present on the class resisters. Factors associated with truancy Malta Truancy is about learners who have not been attending school regularly as required by the school, parents and even the authorities. Tyerman (1968) defines the term truant as the child who is absent from school purely on his or her own initiative. Gabb (1994) includes in his definition of truant, that a child who is absent with leave given by his or her parents, or who are actually kept at home by the parents. Hersov (cited in Gabb, 1994) goes still further, dividing from truants, ‘school phobics and ‘school refusers. King (2001) furthermore defines school refusal/school phobics as a difficulty to attend school due to emotional distress, especially anxiety and depression. Fenech (1991) (in an unpublished research) defines ‘absenteeism as ‘being away from lessons for any period of time and for reasons not considered as legitimate, with or without the parents knowledge (p.3). She goes on to include ‘physical presence without any attention being given to a lesson in progress [as well as] masked or selective truancy (ibid., p.3). Fenech (ad. lib.) refers to the latter as ‘skiving off specific lessons or disappearance after registration (p.3) remarking that a number of sources consider absenteeism and truancy synonymous. Sultana (1997), like Fenech (1991), defines absenteeism as ‘staying away from school for reasons not justified by the law (p. 355). However, she goes on to include other ‘less overt ways (ibid., p 355) such as what Willis (1977) calls participating in ‘informal mobility (ibid., p. 355). This includes not entering the class for lesson, intentionally staying in another class, leaving the class without permission, or staying in class without bothering to follow the lesson. Studies conducted abroad When seen from a psychological viewpoint, truancy may be symptomatic of learns who are insecure and have low academic achievement levels and low self-esteem. Lewis (1995:37) states that attendance difficulties my broadly result from a combination of â€Å"pull† and â€Å"push† factors. Pull factors are personal and social aspects that â€Å"pull† a learner out of school. The pull factors may be related to the psychological indices mentioned by Reid (2002:11), such as maladjustment, a lower general level of self-esteem and academic self concept, anxiety and lower career aspirations. Factors that â€Å"push† learners away from school include academic and classroom aspects such as inapproachability of the teaching staff, incomprehensible teaching style and inappropriate classroom management. Other factors relating to the school and the classroom include bullying, the curriculum, boring lessons (Reid, 1999:91), teachers humiliating remarks (Porteus, Clacherty, Mdiya, Pelo, Matsai, Qwabe and Donald 2000:11), poor record-keeping and school organization (Bimler Kirkland, 2001:90; Coldman, 1995:29). According to Pappas (1996:1), truancy is often symptomatic of family dysfunction, since the parents of truants tend to be permissive, undisciplined and unavailable. Some authors believe that truancy is associated with a poor socio-economic background, including poverty, poor housing and unemployment (Bell, Rosen and Dynlacht, 1994:204; Tyerman, 1958:222). Some researchers state that there is a link between truancy and delinquent behavior (Collins, 1998:38; Brown, 1998:298-299; Reid, 1999:25). Truancy differentiated from school phobia There is a need to distinguish between truancy and school phobia. The concept â€Å"school phobia† describes a learner who is unwilling to attend school and stays at home with the knowledge of parents (Wicks and Nelson, 2000:123). A learners problem often stats with a vague complaint or reluctance to attend school and progresses to total refusal to go to school. Blagg (1992:121) asserts that school phobia may be induced by fear-arousing aspects of school, such as fear of failure caused by anxiety about meeting the standards. Fear may also be related to worries about the health and welfare of parents (Blagg, 1992:123). In the other hand, a learner who plays truant misses the whole school day or lessons without the knowledge of parents or caregivers. Furthermore, a truant tends to be involved in various forms of anti social behavior (Blagg, 1992:121). Milner and Blyth (1999:18) acknowledge the difficulties involved in studying the prevalence and pattern of truancy and in comparing current and past school attendance or absence. The difficulties are partly compounded by the variations in the definition of truancy itself (Boyd, 1999:22; Gabb, 1997:2) and the multifaceted nature of truancy (Edward and Malcolm, 2001:1; Reid, 1999:17). The problems associated with studies on truancy should, however, not prevent further research from being conducted. Solutions should be found, or the cause at least eliminated, because truancy is regarded as a serious problem with socio-economic implications. A preliminary review of the literature reveals that truancy is a major problem form schools and society and a most powerful predictor of juvenile delinquent behavior (Van Petegem, 1994:272; Wiehe, 2000). Reid (2002:2) maintains that the amount of money spent on truancy reduction initiatives proves the extent of truancy. Statement of the problem Data on the extent and nature of truancy in schools are often based on information obtained from class registers. This information may be inadequate or almost incomplete and limits the understanding of the phenomenon, thus making it difficult to develop appropriate intervention strategies. More insight on how truancy manifests is needed to provide a base on which to suggest, plan and develop effective intervention strategies. Therefore, further research is needed to enable education officials, schools, parents and other professionals to manage learners with attendance difficulties more efficiently. This study serves to bridge the information gap regarding the nature of truancy and to provide a picture of the life world of truants in Secondary Schools. Aims of the Research The General Aim The aim would be to describe truancy in general as stated in the literature and to conduct an empirical study in order to determine how truancy behaviour manifests in secondary schools and what the life world of truants looks likes. The findings can then be used to inform and guide future practice. The Specific aim The aim of the study would be to gather information that will be used to guide the school (college) community namely the SMT, form teachers, subject teachers, guidance teachers and school councillors, youth workers in school and other stakeholders to help in the interventional approaches and procedures that can be used for reducing truancy. In order to realise the above aims, the following questions are set to direct the research: What is the extent and degree of truancy in terms of the frequency and number of learns involved? What are the patterns, type or nature of truancy? Where do truants go when not at school or in class? What measures are used to monitor and manage truancy? Research Method The study will comprise two methods, namely, a literature study and an empirical investigation. A study of the literature will derive information on studies about poor school attendance and procedures employed to mange or reduce truancy from books, research articles, journals and other resources. A quantitative research design will be used in the empirical investigation. This investigation aims to gather data by means of a questionnaire that will be given to learns in Form 1 and Form 2 in eight randomly selected schools, , incorporating two Junior Lyceums, two Area Secondary and two Church schools. A qualitative research design will be used with guidance teachers, counselors, youth workers, form teachers, Assistant Head of Schools and Heads of School currently working in schools. A focus group and interviews with Heads will help me to investigate what the School community is doing to combat truancy. Such data will be advantageous in that they are ‘the most adequate [tool] to capture how a person thinks of a particular domain (Goldsmiths Collage, n.d.). More over since a face to face rapport with the interviewee, it is induced to continue questioning the subject in order to confirm the hypothesis about his or her beliefs, seeking appraise any underlying meaning in the process. Demarcation of research Due to time constraints, the preset research is confined to then 8 randomly selected secondary schools in Malta. A list of all secondary schools was compiled to allow for the random selection of 8 schools, which will form part of this study. This sample was mainl cohosen on the basis of cost implicaitons and accessibility. Explanation of concepts In this section a number of concepts that are relevant to this research are defined. Truancy Reids (1999:1) asserts that the term ‘truancy is often misused and can be applied both generically and with a local meaning. In the different parts of Great Britain, truancy is known as ‘dodging, ‘skipping off, ‘mitching, ‘skiving, ‘bunking off and ‘going missing, respectively. Whitney (1994:49) defines truancy as ‘absence that has not been authorized by the school and where leave has not been given or approved. Another definition provided by Collins (1998:2), who states that truancy is about pupils who have been registed with a school but identified as not attending school when the law says they should. This definition includes absences from a particular lesson or lessons, known as ‘post-registation truancy (Gabbs, 1994:5; Stoll, 1990:23). Clark Report (2005) identify as truancy when a student is voluntarily absent or not attending school without their parents permission and often, awareness (Anglicare, Werribee Family Services 2000). Truancy is defined as unjustifiable or unexplained absence from school with attempts by the student to conceal the absenteeism. Usually the child avoids home when not at school and the parents are often unaware of the childs absence (Rollings, King, Tonge, Luk, Heyne, Ramsdell, Burdett Martin, 1999). The concept blanket truancy refers to absence from the whole school day, which is usually reflected on the class register, while post-registration truancy occurs when the learner is marked present but fails to turn up at a lesson or lessons (Stoll, 1990:23). In this research, the term ‘truancy is broadly defined as unauthorized absence from school. The definition is adopted with the assumption that absence with the knowledge and permission of the school and parents or guardians does not constitute truancy. Since the study seeks to explore the type of truancy as manifested at secondary schools, both concepts of truancy (blanket and post-registration) are relevant and will be investigated. A Truant A truant is a ‘child aged 6 17 years old who absents himself or herself form school without a legitimate reason and without permission of his or her parents or the school official (Schaefer and Millman, 1981: 335). For the purpose of this research, a truant refers to a learner who, after being registered at a school, absents himself or herself from school or lessons without a legitimate reson or permission from parents or the school official. The traditional or typical truant: Traditional truants tend to be isolated that come from an unsupportive home background, possibly with a tendency to be shy. It is likely that they will have a low self-concept, be introverted and be the citim of their social circumstances. The psychological truant: could be the school phobic (school refusal) case but more othen than this psychological truant miss school for psychological related factors such as illness, opsychomatric complaints, laziness, a fear of attending scholl for any reason (such as dislike of a teacher, a lesson, an impending confrontation or fear of bullying.) The Institutional truant: Institutional truants are more likely to indulge in ‘on the spur of the moment absences from lessons and to be selective about days or lessons to miss. Secondary School A school that admits or registers and educates learners in Form 1 Form 5 is known as a secondary school. Life World In this research, the term ‘life world refers to the psychological context this is made up of elements such as interpersonal aspects, the family, school and the broader community. According to this definition, the life world involves the personal and external world of the learner. The personal word refers to intrinsic factors. The external word is made up of the broader educational systems, the home environment and the community where the child spends his time when not at school. Relevant intervention strategies would be easier to suggest if the contextual issues related to the phenomenon under investigations are understood. Research Program The research comprises give chapters, as follows: CHAPTER 1 In this chapter, the background information in the seriousness and implication of truancy are discussed. The chapter also includes an analysis of the problem, the problem statement, aims of the study, description of the research method and definition of the concepts. CHAPTER 2 Chapter 2 entails a review of the literature on types of truancy and the causes of truancy or contributing factors in different countries, including in Malta. Different approaches that the various countries and schools use to manage truancy will also be discussed. CHAPTER 3 This chapter deals with research designs and methods. A discussion of the research problem, the aim of the empirical investigation, the research tool used in the study and the selection of the sample will be included. Details of the compilation and administration of questionnaires as well as an analysis of data will be presented. CHAPTER 4 In this chapter, the results of questionnaires will be presented. The results will be analyzed to find answers to the research questions. CHAPTER 5 The chapter entails a summary of the research finding, conclusions and recommendations. A summary of the results from the literature study and the limitation of the study will be included. Conclusion This chapter focuses on the background and analysis of the problem, as well as the aims of the study. An attempt will be made to explain the research method used, relevant concepts and planned programmes of the research. The next chapter will contain the review of the literature on the types of truancy, factors contributing to truancy behavior, the rate and extent of truancy and the strategies used to manage truancy. CHAPTER 2 TYPES OF TRUANCY, CAUSAL FACTORS AND APPROACHES USED IN THE MANAGEMENT AND REDUCTION OF TRUANCY Introduction According to Tyerman (1958:217), truancy has been a problem to all concerned with education since 1870s. Approximately 750 children were charged for truancy in England and Wales in 1954 (ibid: 220). This figure could have been an underestimation as it was based on learners who were referred to courts, and therefore represented mainly incorrigible truants (ibid). Furthermore, the figure gives a general picture of truanting children in one country only and without an indication whether it was absence from certain lessons or whole school day absence. Truancy is currently a problem in communities. In Clarks report concern was expressed about truancy among school children. Data presented in this report indicates that non-attendance exists, and has become an issue of increasing concern for schools, educational and student welfare organizations. Non-attendances viewed as being among one of the key problems facing some schools. There is increasing concern for the seemingly large number of ch ildren and young people, who are, for a range of reasons, missing out on the benefits of education and possibly on a better future (Dr. L. Galea, The Times 9th February, 2005). Non-attendance can be the beginning of countless problems for students who regularly miss out on school (Heyne, King, Tonge, Rollings, Pritchard Young,1999). The extent and nature of truancy are best understood in terms of whether it implies absence for the whole day or during a particular lesson. This chapter deals with how blanket and post-registration truancy manifest, the causal factors and various measures of reducing truancy in secondary schools. Blanket Truancy Perspectives in various countries England and Wales Normab (2001:49) states that 50,000 children play truant on a normal school day in England. The number of truants increases steadily with age and most truants are found at secondary school (ibid). This confirms past research findings about the existence of truancy in secondary school in some parts of England. Gray and Jesson (1990:25) gathered information on the incidence of truancy from the youth cohort survey of England and Wales. The result of their survey shows that 6% of final-year secondary school learners reported to have played truant for several days or weeks at a time. Malcolm, Wilson, Davidson and Kirk (2003:50) state as follows: ‘In 1999, the Audit Commission noted that at least 40,000 of the 400,000 learners absent from school are truanting. Scotland In a study done at 50 Scottish secondary schools, it was found that 30% to 33% of learners had been playing truant at least once in the survey week (Munn and Johnston, 1992:38). These schools were requested to provide both the overall attendance rate and the numbers of learners (ibid). Australia Haddon (1996:110), citing a comprehensive study conducted in Victorian secondary schools in Australia, states that 40% to 60% of learners of compulsory school age reported that they engaged in truancy. Cohen and Ryan (1998:12) state that about 10,000 learners in Tasmania play truant at least one day a week. The Netherlands The research done at 36 schools in four Dutch cities indicates that the average level of truancy at all schools was 4.4% (Bos, Ruiters and Visscher, 1992:393). The average percentage of allowed absence was 4.7%, therefore suggesting that learners in most schools are just as often absent with a valid reason as without one. United States of America It appears that truancy is a problem in American schools, although at varying levels. According to Black (1996:33), approximately 2,500 and 4,000 learners play truant on a daily basis in Pittsburg and Mulwaukee, repectively, while 300,000 of the 1.6 million students in Los Angeles are habitual truants. This shows that some learners stay absent without permission every day and that a day never goes by with a recording of 100% attendance. Truancy is so much of a concern that the Department of Education has prepared a manual that gives schools some guidelines on how to reduce it (United States Department of Education, 1996). Malta From January 2001 up to December 2002 there were 8,903 arraignments before local tribunals in connection with school absenteeism (Grech, 2002). This figure represents only the number of students who were absent from school without a valid reason on more than three occasions in the space of a month. It is a known fact that there are a number of pupils that systematically take three days off from school each month just for the sake that they use up their monthly absence allowance and knowing that in this way their parents would not receive a citation. Survey results issued by the National Statistics Office Malta on December 16, 2002 showed that overall absence rate from schools between September 25, 2000 and March 31, 20001, stood at 10.5 days per pupil. That included both absenteeism and authorized absence (such as those due to sickness). During this period, 657,604 pupil days were list to absenteeism, accounting for 8.9 per cent of the total pupil days. This reveals an increase of 5. 2 per cent over the 1999/2000 scholastic year. Absences in government schools stood at 19.12 days per pupil whereas that of government dependent (church schools) and independent private schools was 5.76 days per pupil. The rate of truancy in terms of gender Some of the overseas researchers state that there is no difference in the levels of truancy reported for males and females (Gray and Jesson, 1990:26; Haddon, 1996: 110; Smith, M., 1996:226; Stoll, 1994:36; Whitney, 1994: 59). Recent research on truancy in the seven local education authorities reports that the numbers of learners in secondary school admitting truancy was almost equal for boys and girls (Malcolm et al., 2003:31). Coldman (1995:68) also states that the variation that exists in truancy levels of males and females is slight. It is, therefore, apparent that some research are in agreement with regard to the truancy levels of male and females learners. Earlier research that was conducted in South Africa suggests that more males than females tend to play truant Coldman (1995:68) warns against making assumptions and generalisations about the existence of gender differnce in truancy levels. He argues that observed findings might result from the fact that some schools have more males than females, particularly when one is dealing with a large sample. What the above studies suggest about truancy levels of males and females is that the difference might be slight, if it does exist. Furthermore, observed diffrenences may be incfluenced by other variables, such as the enrolled number of male and female learners in a sample. Truancy rate according to the geographical location of the school Serious truancy is said to be more prevalent in inner-city secondary schools in England (Gray and Jesson, 1990:36; Stoll, 1990:23). Munn and Johnstone (1992:4) also found that the Scottish school with the highest percentage of unauthorized absence was all in the inner city. Coldman (1995:69) asserts that claims that truancy is a problem mainly experienced in inner city schools are disputable, since another survey showed that the truancy level is high even in the suburban, rural and industrial areas of England. It may therefore be purely speculation, without much supporting evidence, to suggest that inner-city school experience higher levels of truancy. Hard evidence needs to be gathered, where possible, in order to verify the claim that inner-city experience higher rates of truancy. According to some researchers, truancy levels also appear to differ from school to school, since they may be more prevalent in schools than in others (Blackm 1996:33; Bos et al., 1992:385; Gray and Jesson, 1990:26; OKeefe and Stoll, 1995:12). It is therefore apparent that the levels of truancy seem to vary from country to country, and in some cases, also in terms of geographical locations within a city or town. The literature indicates that blanket truancy is common in many secondary school and that, in some cases, learners play truant on a daily basis. The levels of blanket truancy can also vary according to regional locations within the same country. In the next section, the evidence regarding the level of post-registration truancy drawn from the literature will be discussed. Post-registration Truancy Very little information is given in the literature about national trends of post-registration truancy in countries where research on truancy was conducted. Most of the studies conducted in the United Kingdom, Australia, the United St Determinants of Health: Area of Residence Determinants of Health: Area of Residence Lisa Theaker The overall health of an individual and of communities can be defined and affected [LF1]by many factors. Circumstances and environment play a massive part in determining whether a Person or Persons can be categorised or labelled as being â€Å"Healthy†. Some of the more common of these determinants are issues such as area of residence- the affluence and prosperity of the general area, the income of the individual or family unit, the levels and standards of education available within the area, social relationships and at the most fundamental level, genetics also play a part. From a social perspective, factors such as access to good quality health services are considered to be a secondary factor and have less of an impact on the individuals’ health than the others. A person’s health is often determined by issues such as their social and economic environment, their physical environment and their general behaviours and lifestyle choices. An individual only really has control over one of these factors – the lifestyle as it is of their own choosing whether they have a healthy diet, if they smoke or drink alcohol. This too is determined to some extent by the level of social, physical and economic factors (WHO, date unknown) (Naidoo et al, 2000). Income and social status or class differences are displayed in statistics from different areas and often show direct correlation to the health of the individuals within them. A better income and â€Å"higher class† proves to be critical in better health. This is due to better quality of diet, access to education and better working environments. Studies have shown that where the greater difference in income between richer and poorer individuals exist, then this is reflected and evident in the statistics of health (Naidoo et al, 2000). Education levels at a lower standard are also linked with poor health. People with a low level of education often have low self-confidence and are found doing lesser paid yet more manual labour in health affecting environments such as factories. This also affects stress levels as well as income. The knock-on effect this produces brings inequalities such as poor housing and unsanitary living conditions in what are commonly labelled as â€Å"deprived areas†. All the factors affecting these communities have a profound effect on the health of not just the individual, but of their families also (BBC, 2008). The physical environment often impacts upon the health of families and individuals [LF2]alike, both in a domestic and workplace. Areas of residence with good quality road networks, decent acceptable housing, safe water and clean air [LF3]are statistically proven to show greater levels of better health of residents than areas with heavy industry, both now and historically. Air pollution is a major contributor to ill health, especially if the individual has an underlying or pre-existing health condition such as asthma. People who live and work in cleaner environments are often generally healthier, or display less health issues than people working within these area of heavy industry. Workers in heavier industries such as coal mining and steelworks have no control over they’re working environment, and although health protection equipment such as dust masks and ear protection are now issued as standard, this has not always been the case and generations of workers have suffered some times horrendous health issues from diseases and conditions associated with working in the dusty, noisy conditions for many years unprotected. Cases of emphysema, a lung condition where essentially the lungs are filled with dust which eventually hardens, have[LF4] affected many generations of coal miners (WHO, date unknown). Social support networks in communities are also proven to show links to improved health. Areas with community support outlets that offer help and advice with aspects covering stop smoking services, job-seeking and educational courses can encourage and offer the means to people within the community to improve themselves both mentally and physically and this has a profound effect on their health by improving their prospects and their self-esteem (WHO, date unknown). The genetic makeup of an individual can also be a major contributing factor to their health and can determine possible lifespan, overall healthiness and the possibility of developing certain illnesses. Personal behaviours of lifestyle can be influenced at an early age, where a parents input on the diet and lifestyle habits are often impressed upon children from a very early age. These attitudes are often carried into adulthood from children having witnessed the un-healthy practices of parents, and assume them to be acceptable and normal. Factors such as smoking and the consumption of alcohol are some of these. General coping skills can be witnessed by the nest [LF5]generation and can often lead to problems with their own coping mechanisms later in life (BBC News, 2008). Access to health services are a fundamental factor too. Good accessible health provision is essential for the maintenance of health within communities – whether the individual chooses to access these available services is down to their general attitudes to their own health (WHO, date unknown). Lifestyle choices such as smoking, drinking, promiscuity and a balance of healthy diet and exercise are in the hands of the individual. These choices are also determined by the levels of income and area of residence. Deprived areas, even within the same general locality and country statistically show that this is the case. For example – Calton, an area of Glasgow in Scotland, shows a distinctive rise in the mortality rates in males when compared to a more affluent area of Lenzie. A baby boy born in Calton will have an average life expectancy of 28 years less than a boy born and resident in Lenzie. This is explained by Calton simply being less affluent. The population of Calton are generally of a lower social class, and the mortality rate reflects this amongst males of comparable ages. This is not just in Scotland however, similar findings have been reported in areas of London. The life expectancy varies by 11 years from residents of affluent Hampstead to St Pancras, which is c onsidered to be less affluent (BBC News, 2008). [LF6] People from lower classes experience greater levels of sickness and ill health, whether this is from lifestyle choices or work environments (if they actually work). Work and employment levels are a very important factor to consider. The work environment determines income levels and can directly affect the health of the individual. Some work environments are considered to be â€Å"high-risk† because of accidents, hazardous materials or even stressful situations (WHO, date unknown). A very detailed and thorough discussion of determinants of health however this could be strengthened by creating greater links to the models of health. There are more factors to the determination of â€Å"Health† than reviewing and [LF7]considering the technical issues of income, employment, lifestyle and the areas where people live, although these are statistically proven to have a major impact. Many would consider that ill health of an individual comes about as a direct result of lifestyle choices and that by adequate and improves healthy lifestyle promotion campaigns, theses can make a difference and encourage the individual to make changes and be responsible for taking steps to improve their health and that of their family. This is not always the case however, when the truth maybe that the individual has little or no control over the choices to be made. This serves to strengthen the argument that ill health is not in the hands of the individual rather that its roots lie in the social and economic domain. If the means are not available to make the changes, then it is impossible to do so. It is true however that some people do make the effort to maintain their health and that of their families eve on sometimes limited income however the social environment of poor quality housing and the air around where the live prevents them from doing so. The air quality is beyond the control of anyone. These factors are major contributing issues. Regardless of the input of any health promotion campaigns and any amount of income, this cannot be changed – other than to provide the means to move their family to a less polluted environment. Ill health does not occur merely by bad luck. The imposing factors from birth and through the entirety of an individuals’ life, through to their demise are paramount to affecting how these years are spent, whether in good or bad health. Social factors such as class and ethnicity come into play when tied in with the universal factors of age and gender. The gender, ethnicity and age of the individual cannot be changed, however it is possible that the social class can be altered given the right circumstances. Environmental factors such as housing provision, and the quality and area of it are also major factors – the area of residence and the amenities that are offered there, such as leisure facilities and access to health services have an impact upon the health of the residents. Lifestyle factors such as smoking, nutrition, exercise and the psychosocial environment are also major factors. The amount of stress and worry experienced by the individual are paramount to the levels of the other factors. Smoking levels increase in stressful environments as does overeating (Naidoo et al, 2000).[LF8] References BBC News (28th August 2008) ‘Social factors key to ill health’ [online] Available at: http://www.news.bbc.co.uk/go/pr/fr/-/1/hi/health/7584056.stm [Accessed 5th April 2014] Health Poverty Action (date unknown) ‘ factors that Determine Good or Poor Health’ [online] Available at: http://www.healthpovertyaction.org/policy-and-resources/the-determinants-of-health/ [Accessed – 5th April 2014] Naidoo, J Wills, J. (2000) ‘Health Promotion – Foundations for Practice’ (2nd edition) London, UK: Harcourt Publishers Ltd World Health Organisation (date unknown) ‘Health Impact Assessment – The determinants of health’ [online] Available at: http://www.who.int/hia/evidence/doh/en/ [Accessed – 5th April 2014] Bibliography Health Poverty Action (date unknown) ‘The Cycle of Poverty Poor Health’ [online] Available at: https://www.healthpovertyaction.org/policy-and-resources/the-cycle-of-poverty-and-poor-health/ [Accessed – 5th April 2014] The College of Occupational Therapists (COT) (2013) ‘Social Determinants of Health’ [online] Available at: https://www.cot.co.uk/social-determinants-health [Accessed 5th April 2014] Very good range of sources used. [LF1]Is this the ‘Introduction’ section? [LF2]Is this the ‘Discussion of Findings’ section? [LF3]You are right but need to clarify what is meant by these i.e., give the parameters [LF4]‘has’ [LF5]‘next’ [LF6]Excellent points and use of example/source [LF7]Is this the ‘Conclusion’ section? [LF8]An excellent conclusion – very well thought out! Well done! However this should have been in report format!