Comparative Study Of Gorontalonese Noun Phrase Sample College Essay

The English language, considered the leading, global language in international discourse and the common denominator mediating all the other non-English natives, is a West Germanic language that arose from England but eventually spread into some parts of Europe. It originated from a multitude of dialects, palpably influenced by by Latin and French, among others.

The Gorontalonese language, on the other hand, is the local language named after the local province it originates from. It is considered the official language of Bahasa Indonesia, at least in written form. The pronunciation, however, is another story. The way speech is uttered varies from region to region.

It is now considered that the English language is the lingua franca in all parts of the world, the main language bridging the cultural gaps of all the participating countries in the global market, albeit not the most natively spoken language.  The body of rules in using the English language, in both written and spoken form, despite seemingly being the benchmark of all other languages, however, is not standard. Grammar is a very complex subject. It is as-a-matter-of-factly context-specific, varying from one language to another. This paper will expound on this subject, particularly the grammatical structures and rules regarding the noun-phrase between English and Gorontalo language or Gorontalonese.

            The purpose of this paper is to compare and analyze the noun phrases in both languages. Similarities and differences shall be uncovered through a careful analysis of the different aspects of language particularly its parts and the structure in general.

            Several theorists have claimed that cross-linguistically, the same grammar rules apply. Chomsky, among other Linguistics theorists, has maintained that much of grammar, or the body of knowledge possessed by language speakers, is inherent. The parochial features of native languages are developed and learned through the years. This fraction, claimed by Chomsk as the innate body of linguistic knowledge, is termed Universal Grammar. Theories on Universal Grammar basically postulate that all languages, whether as popular as English or as low-key as Gorontalonese, are built upon a common Grammar, save for some accidental variations. Linguistic universals do not necessarily apply to basic structuring or syntax issues on Grammar, but a specific theory on the Generalized Phrase Structure Grammar, describing the general patterns among syntaxes and semantics of languages. It has a questionable, if not none, empirical basis. Universal Grammar is altogether an entirely new topic but this framework can help compare the extreme languages of arguably the most basic language of English and the almost never-heard-of language, at least on the global level, of Gorontalonese: their similarities and dissimilarities and the questionable existence of the “innate” grammatical rules between these two languages.

            Phrases, particularly, follow structure rules. The syntax of the phrase is circled to this set of rules. Every sentence is comprised of parts called phrasal categories and lexical categories. The lexical categories are also known as parts of speech. The noun phrase, among other types of phrases such as the verb phrase and prepositional phrase, comprise the phrasal categories.

            In simple terms, the phrase structure usually follows the form A -> B  C, meaning one of its lexical categories is separated from B and C. In every phrase, there is one constituent. In noun phrases, the constituent lexical unit is the head, which may either be a noun or a pronoun. This phrase structure applies not just on phrases but also on sentences. To sum it all up, in sentences, it is S -> NP-VP or a noun phrase should be followed by a verb phrase. In noun phrases, it is NP -> Det- N or the determiner should always come before a noun. The noun (or the head/N) can be be further modified by adjective phrase before it and a prepositional phrase after it. It follows the structure: N1 -> (AP)-N-(PP). A classic example was devised by Chomsky to illustrate the basic phrasial rules of the English grammar. The sentence “Colorless green ideas sleep furiously,” for example follows the order NP(Colorless green ideas)-VP(sleep furiously). The noun phrase (NP) “colorless green ideas” can be further dissected into three parts. “Colorless” and “green” are both modifiers or adjectives and naturally they are placed before “ideas” or the head of the noun phrase. This is the core rule in English noun phrase.

A simple Contrastive Analysis shall be used to decisively find out the notable nuances between the two languages. This framework has already been regarded as main pillars in the domain of foreign language acquisition especially for Indonesians. Through this analysis, the basic language features of Gorontalo (in this case, Indonesian) language shall be compared vis-a-vis the English language. Kardaleska (2006) describes it as an inductive investigative approach based on the distinctive elements of language. Structure is primary to this approach, while emphasis is towards the differences in structure between and among languages.

            The major areas of language are phonology, morphology, lexicology, syntax, and text analysis. When trying to learn a new language, these major areas are individually taken into consideration. When our tongue has already been accustomed to speak a distinct language or dialect, with accent and conviction, it is extremely difficult to learn a new language, unless of course the second language is essentially of the same linguistic features of the mother tongue.

In constructing a sentence, a single word is often insufficient, when trying to convey a complete, detailed thought, hence the necessity of using other figures of speech such as adjectives and adverbs. By itself, a single word, in the form of a noun, may be a tad too one-dimensional, even bordering on ambiguous, when trying to convey a thought. Nouns, in English, are traditionally described as naming “persons, places, things, and ideas.”

 Thus in order to supply the reference needed for a sentence to be complete, it is important to add words that will specifically describe a certain object, or for this matter, a noun. This is how phrases are formed. A phrase is essentially a group of two or more grammatically linked words without a subject and a predicate. Thus, it may function as a noun, verb, adverb or an adjective.

A noun phrase, in simple grammar terms, consists of a noun with any associated modifiers, including adjectives, singular or in the form of phrases, and other nouns. Just like nouns, a noun phrase can act as the subject, the object of a verb, as object complement, or object of the preposition. It functions just like nouns, just in clusters of words. Interestingly, noun phrases that act as object of a verb or verbals can also form the nucleus of a noun phrase. For instance, “swimming in a lake in this weather”, a noun phrase in the form of a verbal, can act as a subject, or any other applications of noun phrases.

In simpler terms, a noun phrase is but a set of words with an incomplete thought whose center of attraction is a noun. It is most commonly preceded and modified by a determiner, then a pre-modification word in the form of adjective or an adjective phrase, and is, on most occasions capped off by a post-modification that may take either the forms of phrase or clause. Essentially, these words modify the head of a noun phrase.

This is what we have been accustomed to, particularly as it is used in English grammar. Studies show that noun phrases more or less take the same form cross-linguistically, save for a few exceptions. Both the English noun phrase and the Gorontalose noun phrases will individually be delved into deeper for a clearer analysis of the themes common and different between the two languages.

The structure, first and foremost, being the most concrete aspect of language will first be taken into account. Any slight changes with the language structure can easily, instantly be noticed. However there are instances when the changes in structure are only on the abstract level. They may look entirely the same, when literally translated, but may denote a different meaning.

            On this note, Gorontalo, or Gorontalonese for this matter, will be taken in its general Indonesian form. The Indonesian language, in general, is widely known for its rather peculiar, having English as the benchmark, construction of phrases. When literally translated in English, a noun-phrase would actually pass for a verb-phrase as in “makan malam” which is literally translated as “night eat”. Although “night eat” is not common, may pass for colloquial but never formal, when someone says or write “night eat”, one would instantly think of it as a verb phrase. The order of the words plays a pivotal role in the English language. In a compound verb-phrase, the verb always has to be the second word (i.e. shoe-shop, nail-bite, etc.). In the Indonesian language, “makan malam” can actually be interchanged as either a verb or a noun. In its popular usage, it actually means “dinner.”

            This obvious alteration of structure is in fact one of the major issues regarding translation problems of Indonesian and English. Indonesian, when translated verbatim, may completely denote a completely different thought that what it really means.

            Take “Bahasa Indonesian” for instance. Literally, “Bahasa Indonesian” translates to language Indonesian. The placement of modifier (in this case, Indonesian) in this example is in a sense questionable in the English grammar. In English, it is more grammatically apt to call it “Indonesian language.” English noun phrases follow the pattern of modifier-object being modified. It follows the pattern: 1.) modifier, being the object being used to explain and; 2.) the object being explained, or the noun. In Indonesia, the noun phrase follows the opposite pattern.

            Even Indonesian sentences follow a different pattern. It follows the pattern: subject, verb, object or adjective, or adverb. A sentence basically consists of a noun phrase and then a verb phrase. Yet in many cases, this order is flexible. It can be put in various ways. This runs similarly with the English grammar, except that this pattern is strictly followed in the English Grammar.

For example, the sentence: “Ibu ke pasar naik becak” runs similarly with the English sentence structure noun phrase-verb phrase. The sentence literally translates to “Uncle went to Surabaya last night,” which basically follows the same structure.             The sentence “Bibi di kebun”, however does not literally translate to “Aunt is in the garden.” The Indonesian sentence follows the pattern noun phrase-adverbial phrase, wheras its English translation still follows the noun-verb-phrase pattern.

Gorontalo noun phrases are essentially similar, structure-wise, with the more widely spoken Indonesian noun phrases. Provided in the examples in the appendix are the different structure forms of simple Gorontalo nounphrases such as: 1.) Nomina + Nomina (Noun + Noun); 2.) Nomina + Adjektiva (Noun + Adjective); and 3.) Nomina + Numeralia (Noun + Numeral) In English grammar, the modifying figure of speech (could take the form of a noun, adjective or a numeral) always comes first. It is the other way around in Gorontalo language.

To further elaborate on this rather peculiar pattern, several examples will be provided. The simple Gorontalonese phrase “bele dupi” for instance which translates to the more widely-pken Indonesian as “rumah papan” is literally translated a “house board.” As it is used in the Gorontalonese statement “Te Aamiri lomongu bele dupi” and in the Indonesian statement “Si Amir membangun rumah papan,” it means (in English) “Amir builds a clapboard house.” In English noun phrases, the noun being modified always comes last. In this case wherein the modifier is also a noun, the noun modifier always comes first.  Other examples include “bele seni” (literally “house zinc” but really zinc house when properly translated), “taluhu deheto” (literally “water sea” but pertains to sea water), “kadera hutia” (literally “chair rattan” but pertains to rattan chair) and, “kadera ayu” (literally “chair wood” but pertains to wooden chair).

The phrases  “Wala’o malu’o” (”chick/young chicken), “Wala’o Sapi” (calf/young cow), and “Wala’batade” (kid/young goat), on the other hand, follow the typical modifier-modified pattern in the English grammar. It can also be noticed that some simple non-phrases in Gorontalonese such a “Wala’o malu’o”, “Wala’o Sapi”, and “Wala’batade” , which respectively mean chick, calf, and kid in English language can be translated into singular nouns in the English language. This goes to show that the English language, through the years, has been thoroughly expanded. Or put simple, the English vocabulary is vast. Down to the most specific of things such as “young chicken” (chick), “young cow” (calf), and “young goat” (kid), the English vocabulary has it.  On the contrary, Gorontalonese and Indonesian do not. Perhaps this has something to do with the English language being more widely spoken, and thus more likely to have a more encompassing vocabulary.

Other examples of Gorontalonese noun phrase that more or less run similarly with the aforementioned observed pattern are “dungito olobu” or literally tooth buffalo but pertains to buffalo tooth, “o’ato wadala”(literally “foot horse” but pertains to horse foot), “olu’u’tau” (literally “hand person” but pertains to person’s hand), “tulidi pangimba” (literally “snake ricefield” but pertains to paddy-field snake , “yinulo bongo” (literally “oil coconut” but pertains to coconut oil, “peambolo bele” (literally “terrace home” but pertains to home terrace), and “lipu Hulontalo”(literally “country Gorontalo” but pertains to Gorontalo country) among others. When translated literally, these phrases follow the modified-modifier pattern.

For the Nomina + Adjektiva (Noun + Adjective) form, the same pattern (modified, in this case the noun, – modifier, in this case the adjective). Examples of Gorontalonese noun phrases essentially describing a house for instance are: “bele bohu” (literally “home new” but pertains to new house), “bele damango” (literally “home large” but pertains to large house), and “bele muloolo” (literally “home old” but pertains to old house). This pattern practically applies to every noun+adjective noun phrases. Other examples would include Gorontalonese phrases “apula biongo” (appropriately translates to crazy dog), “kameja moputi’o” (appropriately translates to white shirt), “talala moitomo” (appropriately translates to black pants), and “putito mohutodu” (appropriately translates to rotten egg). Compared with the English language, the structure of the Gorontalonese noun phrase is the other way around, so to speak. It is essentially similar, structure-wise, with Indonesian. “Dalala Meepito”also follows the same structure pattern in Indonesian as “jalan sempit” (in English, it literally translates to “road narrow”). It is a basic rule in the English language that the adjective must always come before the noun it modifies. In the English language, it should be “narrow road” and not “road narrow.” The latter is considered unacceptable in English grammar. It doesn’t convey a thought, at all, as in the cases of the literal translations of Gorontalonese noun phrases such as: “langge meenggo” (jackfruit youn/immature), “ileengi motanggalo” (garden wide), “bo’o beresi” (clothing clean), “palipa mokotoro” (sarong dirty), and “nanati molutu” (pineapple ripe).

 In the cases of “malu’o teelo” (hen), “malu’o bangge” (rooster), “wadala bilango” (mare), “wadala la’I” (horse), the Gorontalonese noun phrases can be translated into single nouns in the English language. This goes to show, time and again, that the English vocabulary is far more encompassing than Gorontalonese, for obvious reasons that there’s a greater necessity for the English language to cover and take in the most specific of things, actions, and descriptions.

            As for noun phrases that take the form nomina + numeralia (noun + numeral), basically the same structure follows.  Whether the numeral is a cardinal (denoting quantity) or an ordinal (denoting order), or perhaps multiplicative (denoting the number of repititions), so long as the numeral is used as an adjective modifying the noun, the same order (modifier-modified) follows.

This opposes the English gramar. For instance the noun phrase “pingge ngoduusingi”, in English, is literally translated as “plates one dozen.” In this noun phrase, “plates” is the noun or the object being modified and “one dozen” is the numeral adjective denoting the quantity or how many plates there are.

However this rule doesn’t always follow. “Timi’idu bele”,  for instance, translates literally to “each house” or “every house.” In English grammar, “each house” or “every house” is but the apt way of putting it.

For longer Gorontalonese noun phrases, it is an utterly different case. It has a more complex structure. Also, the structure is hardly consistent.“Bu’olohemomo’o to botu patihu” (literally “waves breaking on the rocks”), for example, is grammatically correct, relative to the English grammar. The set of accompanying modifiers (the verbal “breaking on the rocks”) is rightfully placed after the noun. Also, the simple nounphrase “ti kaka woli taata” (literally meaning “older male and ballooning women” also follows the everything-modifies-to-the-right basic direction of modification in the English grammar.

Not just adjectives but also determiners usually are place after the head or the noun being modified. “Pombangaa botiye” ( or in Indonesian “tebing ini”) is “cliff this” in English. It is not different from the noun phrase “tangguli mongoliyo” which means “names their” in English. The same modified-modifier rule applies, even when the modifiers take the form of a determiner.

As far as the elements go, there practically is an innate similarity between Gorontalonese and English. However, on most occasions, there are dissimilarities when it comes to syntax and structure. The noun phrase“Bungo lo ayu damango to penthadu boyitom,” for instance is “tree large on the edge beach” when translated word per word. It follows the peculiar modified-modifier order as the noun + adjective form. “Tree large on the edge beach” is ungrammatical in English. It should follow the syntax “large trees on the beach” or “large trees on the edge of the beach” for it to be correct.

Among the other countless of phrases that have an atypical syntax, “bungo lo ayu moombungo”, literally meaning “wood tree leafy” is quite notable. It can be observed that the adjectives in this phrase “wood” and “leafy” are respectively placed at the beginning and at the end of the phrase. Normally in Gorontalonese language, the modifier (adjective) comes after the modified (noun). In this particular example, the noun (“tree”) is placed between the two adjectives. But then again, perhaps “wood” in this particular example is taken as a noun synonymous or adding emphasis to the already mentioned noun which is tree. In English, the only way for it to be grammatical is to put the noun at the end of every simple noun phrase like such, depending on the elvel of importance of the adjective. If wood is taken as an adjective, it should be “leafy wooden tree.”

The longer Gorontalonese noun phrases are, the more peculiar is its ordering. Suffice it to say, the Gorontalonese language is more loose when it comes to the syntax and structure of noun phrases, as compared with the English syntax which is, in a nutshell, more rigid. What the Gorontalonese language seems to lack, or at least not palpably implied, is that based on the ordering of what constitutes a Gorontalonese noun phrase modifications are not established as a kind of dependency. Based from the examples given, the modifiers are all over the place.

Now that the world is in a globalized setting, whereas the value of cosmopolitanism or that one common culture is valued above all things, it cannot be avoided that English is now being considered the benchmark of Grammar, since English has practically become the medium of global diplomacy. Also in comparison to a much smaller, almost never-heard-of dialect, naturally English will emerge as the more formal and better language, even unintentionally.

Language is culture and culture is language. Language is easily the most explicit expression of culture. Common language and culture facilitate trade between people.  Despite the rather strange ordering and arrangement of the constituents of noun phrases in Gorontalonese language, what’s important is among native speakers of this language, there is a common understanding among its people.


•         Pusatbahasaalazhar, Oleh. A Contrastive Analyisis Between English and Indonesian Language. Retrieved July 22, 2010 from

•         Kosur, Heather Marie. The Functions of Nouns and Noun Phrase in English. Retrieved July 22, 2010 from

•         Schiffman, Harold. Teaching Grammar Interactively: A Talk on Language Teaching Methodology. Retrieved July 21, 2010 from


Community Health Development

It is often the most vulnerable members of society that are at risk of health inequalities, these include the gypsy and traveller communities, black and minority ethnic communities, refugees and asylum seekers. As well as bisexual, gay, lesbian, and trans-gendered people, people with a sensory impairment, physical or learning disability and people with poor mental health (Jones, 2007).

To answer this question this essay will explore the aspects of vulnerability and history of health inequalities experienced by people with learning disabilities. The factors commonly expressed as the root causes of such inequalities will be addressed by referring to relevant research as well as the aims, objectives and outcomes of key government policies.

Due to the complexity of the term ‘learning disability’, the health inequalities linked to the lives of people with a learning disability will be approached from two perspectives. Firstly, health needs associated with the primary impairment of a learning disability will be explored, in particular issues concerning access and inclusion to primary health care services and resources. Research will be reviewed, and key findings presented, in an aim to establish how the health of people with learning disabilities compares to that of people without a learning disability.

Secondly, the health implications and relevance of socio-economic factors associated to living with a learning disability will be explored, and aspects of deprivation and poverty will be addressed.  In particular, the concept of social exclusion and how it impacts on the health and social wellbeing of people with a learning disability will be addressed. In addition, the social and economic issues prevalent to maintaining and achieving good health will be explored, in particular; the impact of unemployment, low educational achievement, limited social relationships and a little or no choice with regards the provision of suitable housing.

To determine what action is required to reduce the occurrence of such inequalities, policies influential to the health and social well being of people with learning disabilities will be reviewed from deinstitutionalisation to present day. The complexity and varying degrees of health impairments encompassed under the term ‘learning disability’ are not reflected in any single definition.

The definition stated in the Government’s White Paper entitled ‘Valuing People: A new strategy for learning disabilities for the 21st Century, refers to learning disability as the presence of; a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence), with; A reduced ability to cope independently (impaired social functioning) which started before adulthood, with a lasting effect on development (Department of Health, Valuing People, 2001: 14)

In contrast the British Institute of Learning Disabilities, 2009 (BILD), regard the terminology ‘learning disability’ simply as a label, which is convenient for the purpose of discussing and planning services. However, BILD state that people with a learning disability are people first, and that a learning disability ‘label’ is one of many belonging to an individual, and therefore does not represent the person as a whole (BILD, 2009).

The term ‘learning disability’ has carried many variations over the years, and what was once seen as an acceptable description and appropriate use of language, has changed over time, as a result of increased awareness and understanding. Many historic terms are nowadays seen as an offensive and discriminatory use of language, and as a negative representation of present day circumstances. The term or label ‘learning disability’ has been utilised as an acceptable description since 1996, following a speech to MENCAP by the then secretary for Health, Steven Dorrell (BILD, 2009).

The Foundation for People with Learning Disabilities refer that as a result of the use of differing definitions by organisations, mixed methods of diagnosis and the number of people with learning disabilities that are undiagnosed, statistics vary. The number of people in England with a learning disability was estimated at 985,000 in 2004 (cited by Institute for Health Research, Lancaster University), which equates to approximately 2% of the population. Furthermore, according to the National Statistics and NHS Health and Social Care Information Centre (2004) only 20% of adults with learning disabilities are registered with learning disability services (

The term ‘learning disability’ refers to a lifelong condition which if not apparent from birth will start before adulthood (Reid-Galloway, 2003). The learning disability ‘umbrella’ (Foundation for People with Learning Disabilities) incorporates many health conditions, generally characteristic to genetics, developmental factors or brain damage occurring during child birth (Reid-Galloway, 2003).  The extent of a learning disability varies from person to person, even among those with the same disorder or condition. The degrees of which are often referred to as mild, moderate, severe and profound learning disabilities and are often based on the assessment of intelligence quota’s or IQ’s of less than 70.

It is widely recognised that people with learning disabilities are more likely to experience inequality in many facets of their lives, compared to the rest of the population. The comments of the Prime Minister in the 2001 White Paper, (Valuing People: A new strategy for learning disabilities for the 21st Century) acknowledges that people with learning disabilities are still experiencing inequality, and refers  that ‘almost all encounter prejudice, bullying, insensitive treatment and discrimination at some time in their lives’ (Department of Health, 2001:1).

Historically, there have been numerous suggestions to explain the reasons why people with learning disabilities are treated in such a way that is unequal to the rest of society. Douglas (1966) suggested that the public’s perception of disability reflects a ‘deep rooted psychological fear of the unknown, the anomalous and the abnormal’ (Barnes, 1991: 11). This particular suggestion is based on the understanding that the definition of ‘normality’ is established by an individual ‘through learning and the natural transmission of ideology and culture’ (ibid, 1991: 11). In this principle, ideology and culture refer to a widely acceptable set of norms, which are the basis of individual beliefs and perceptions (ibid, 1991).

Until the 1950’s people with learning disabilities tended to either live with family members or more commonly resided in an institutionalised capacity with other people with disabilities, living in the community was rare. The creation of the Welfare State during the 1940’s saw policies concerned with disability, move away from the harsh historical approaches to a more ‘paternalistic approach’ (Barnes, 1991: 20). This era had a major impact on the well being of disabled people, and saw the government intervene in an attempt to replace some institutions and provide alternative community based living (Barnes, 1991).

The Government White Paper entitled Better Services for the Mentally Handicapped (1971) set out a twenty year agenda, committing the Government to ‘helping people with learning disabilities live as normal life as possible, without unnecessary segregation from the community ’ (Department of Health, 2001: 17). This was to be achieved by reducing the number of institutionalised residences and increasing the independent living opportunities and the provision for care in the community.  Although many of the original objectives set out in the 1971 White Paper, have been accomplished, the process is still ongoing and a holistic approach has been deployed with a view to reducing the inequality gap between the lives of people with learning disabilities and those without.

Bigby and Fyffe (2006) refer to the process of deinstitutionalisation as the main reason for the shortfall in the advancement of disability services between the 1970’s and the 1990’s. Emerson (2004) suggests that the progression of learning disability services were dominated by the closing of institutions and the application of deinstitutionalisation policies (ibid, 2006).

The closure of institutions was driven by a number of factors, Castellani (1996) and  Mansell & Ericsson (1996) refer that these include ‘exposure of the abuse in institutions; legislative reform; normalisation theory; and the recognition of the spiralling costs associated with humanising institutions’ (ibid, 2006: 567).

It was envisaged that rather than living in institutions, people would receive care and support packages to enable them to live more independently and be part of the community. This process was to be achieved via the transition from institutionalisation to community based living. However ‘the absence of attention to community-based services’ resulted in some people facing homeless, no support, isolation and tackling the disabling barriers of a general needs society (Bigby et al, 2006: 568).

Without taking into account health implications as a result of lifestyle difficulties and aspects of exclusion and discrimination, people with learning disabilities have ‘greater health needs than the general population’ (Trayhorn, 2008:75) and as a consequence are; more likely to experience mental illness and are more prone to chronic health problems such as epilepsy, cerebral palsy and other physical disabilities. People with learning disabilities are also at higher risk of premature death. (Trayhorn, 2008:75)

The UK Disability Rights Commission recently undertook a research project concerning the health inequalities experienced by people with disabilities. The research reviewed data from eight million primary care records to identify whether people with learning disabilities or long term mental health issues are more likely to experience physical health implications, such as heart disease, cancer and strokes (Sayce, 2009). The research also aimed to identify the likelihood of people with a disability receiving recommended treatments for such health problems, and aimed to determine the life expectancy following  the occurrence of the afore mentioned conditions (Sayce, 2009).

Liz Sayce, Chief Executive of the Royal Association for Disability Rights (RADAR) led the research in her previous job at the UK Disability Rights Commission, and discussed the findings of the research in an interview with Tom Shakespeare, from WHO’S Department on Disability and Rehabilitation.

During the interview Sayce (2009) refers that in addition to the analysis of eight million care records; ‘We did qualitative interviews with all the players in the system, people using the services, people providing the services, relatives, advocacy organizations to get a really rich picture of what were the barriers that people were facing to accessing health promotion, health assessment, treatment and what were the areas of good practise and suggestions for change. (Sayce, 2009: 060)

The research found that people with long-term poor mental health or learning disabilities were more likely than other members of society to suffer the major life threatening diseases of our time. Sayce (2009: 060) refers to ‘heart disease, stroke, diabetes, and some cancers’ as the ‘killer diseases’ (ibid), that people with poor mental health or learning disabilities are more likely to experience.

The interview also discusses that the research uncovered some completely new findings, Sayce (2009: 060) states that the research established that ‘people with schizophrenia were twice as likely to get bowel cancer’ than other members of society.  Sayce (2009:060) continues, ‘this factor had not been found anywhere before to our knowledge’.  In addition the research also found that ‘people were more likely to get these diseases at a young age and once they got them, they were more likely to die of them within five years’ (Sayce (2009: 060).

This research provides valuable information to support the fact that there are serious medical health consequences apparent as a result of a learning disability.  Further issues concerning access and inclusion to health care services were also incorporated within Sayces’ (2009) research. It was expressed that although the United Kingdom has the reputation of maintaining a good primary health service, as a whole they are not ‘providing the right services for people who are really excluded and at real risk of developing serious health conditions and dying young’ (Sayce, 2009: 060)., make reference to previous findings as reported by the Disability Rights Commission (DRC), which support the view that generally people with learning disabilities have greater health risks than others. The Interim Report entitled Equal Treatment: Closing the Gap, DRC (2005) revealed that; approximately one in five of the general population is obese, compared to one in three with a learning disability.

The DRC Equal Treatment: Closing the Gap (2006), reported the following facts; in comparison to the general population, four times as many people with learning disabilities die of causes that are preventable; compared to the general public, people with learning disabilities are fifty eight times more likely to die before the age of fifty years; a person with learning disabilities is 2.5 times more likely than the general populations to have health problems (DRC, 2006, as cited by

In addition to the findings reported by the DRC, Trayhorn (2008) refers that in comparison to the general public, vision and hearing impairment is more likely to be found in people with learning difficulties.  In terms of accessing health care services, Trayhorn (2008) considers the dilemma that people with learning difficulties typically do not seek out the general health care provisions that are provided to all, as part of the National Health Service. These include routine services such as regular cervical smear tests, and screening to protect against or which can detect in the early stages the development breast and bowel cancers (ibid, 2008).

One of the main objectives set in the cross government strategy entitled Valuing People Now: From progress to transformation (2009) which follows on from the 2001 White Paper, is to ensure that the NHS provides full and equal access to good quality healthcare for people with learning disabilities. Valuing People Now (2009) incorporates the Government’s response to the ten main recommendations raised in the report Healthcare for All, which undertook an independent inquiry into access to healthcare for people with learning disabilities. It also provides further consideration to the Human Rights report; A Life Like Any Other (

Reports by MENCAP entitled Treat Me Right (2004) and the follow up campaign Death by Indifference (2007) have been key to raising the awareness and highlighting the severity of unequal health care that people with learning disabilities have received. The2004 report by MENCAP clearly identified that serious action is required to ensure that people with learning disabilities are treated equally and decently within our care system. The 2007 report reiterates that even though awareness has been raised, health inequalities are still common place for people with learning disabilities.

Since the Treat Me Right report was published in 2004, various policies which recommend measures to reduce health inequalities in this group have been set, these include; White Paper, DH (2004), Choosing Health: making healthy choices easier, and White Paper, DH (2006) Our Health, Our Care, Our Say: A new direction for community services. The afore mentioned White Papers highlight the understanding that ‘health checks result in previously unrecognised health needs being identified earlier for people with a learning disability and on-going audits are required to sustain any health improvements’ (Trayhorn, 2008:76). In addition, The White Paper Our Health, Our Care, Our Say (2006) is aimed at giving people with learning disabilities greater choices and more control in terms of their own health and well being (DOH, 2006)..

More recently it has been acknowledged that to tackle inequalities in health, services must address the underlying sources of many health problems, which are incorporated in socioeconomic model of health (Acheson, 1998). This model identifies the main determinants of health as ‘layers of influence over on another’ (ibid, 1998: 1). Individuals are at the centre of the model along with the fixed concepts such as age, gender and ethnicity, which are factors that influence health potential (Acheson, 1998).

The next layer which surrounds the individuals are; ‘layers of influence that, in theory, could be modified. The innermost layer represents the personal behaviour and way of life adopted by individuals, containing factors such as smoking habits and physical activity, with the potential to promote or damage health’ (Acheson, 1998: 1). However, the model recognises that individuals ‘do not exist in a vacuum: they interact with friends, relatives and their immediate community, and come under the social and community influences represented in the next layer’ (Acheson, 1998: 2).

It is acknowledged that care and support within the community can sustain the health of its residents, which may otherwise have resulted in inequalities in health. Moreover, the socio economic model takes into account the wider influences of a person’s ability to maintain health, which include housing and employment conditions and access to essential goods and services (Acheson, 1998: 2).

In summary it reflects that there are the economic, cultural and environmental conditions,  prevalent in society as a whole, which can in some cases result in poverty, low educational attainment, unemployment, discrimination and social exclusion (The NHS Plan, 2000, cited in Trayhorn, 2008:76).

It is widely recognised that people with learning disabilities generally have a lower social economic status, which is implied as one of the main determinants of health. This can be observed by comparing employment statistics, housing opportunities, educational achievement and limited social networks. Although these matters are being addressed via Disability Legislation and Government White Papers, it is still likely that some factors will continue to present barriers for people with learning disabilities.

The implementation of the Social Model of Disability has greatly aided the removal of physical barriers which are seen as disabling people within society, however the emotional and social factors are still of great concern. Although

there are policies in place which are aimed at preventing rather than curing, in some cases as reported by MENCAP (2004) this is sadly, too little too late.


  1. Acheson D (1998) Independent Inquiry into Inequalities in Health Report.  London: The Stationery Office. (accessed 16thJuly 2009)
  2. Barnes, C. (1991) Disabled People in Britain and Discrimination: A Case for Anti-Discrimination Legislation London: C. Hurst ; Co. (Publishers) Ltd.
  3. Bigby, C and Fyffe, C (2006) Tensions between Institutional Closure and Deinstitutionalisation: What can be learned from Victoria’s Institutional Redevelopment? Disability ; Society, 21:6, 567 – 581  (accessed 28th June 2009)
  4. British Institute of Learning Disabilities (2009)  (accessed 27th June 2009)
  5. Department of Health (2004) Choosing Health; Making Healthy Choices Easier: Executive Summary.                                                                    London: The Stationery Office
  6. Department of Health (2001) Valuing people: a new strategy for learning disability for the 21st century. London: The Stationery Office.

Communication Channels: Mode Of Transmission Of The Message


            A part from the content, the other important constituent of communication is the channel. Communication channel refers to the mode of transmission of the message. This paper explores the communication channels available for use in an organization and ways of improving their effectiveness. The paper also identifies implications for developing health communication strategies provide health information with both internal and external organizations. An effective communication is one that applies the appropriate channel to reach the intended recipient (Perkins et al, 2008).

Communication Channels

Numerous communication channels exist for use today: notices, memos, email, verbal, recorded video tapes, telephone are just some of the channels. Others include annual reports, networking, TV, radio, newsletters, classifieds, displays/signs, posters,  direct mail, special events, brochures, neighborhood newsletters, The channels vary in their strengths and weaknesses and by extension, the effectiveness (Paleg et al, 2004). Different organization requirements imply that different channels are and methodologies are applied.

To relay health information an organization should use a method that is easily accessible by all the targeted recipients. Using the wrong channel might delay the receipt of the information resulting in health related consequences. In modern world, the use of mobile telephone is mostly applied in relaying crucial health information in organizations. It is more applicable since it is fast, secure and reaches all the targeted recipients. The use of digital means to share health information results in some disparities in reaching vulnerable populations. Strategies should be put in place to ensure undeserved populations access and utilize vital health information (Brock et al, 2000). This will ensure the entire targeted groups make informed decisions on health –related issues.

Whichever method of information dissemination applied, improvements can always be made to ensure effective relaying of health information both within and outside an organization. The communication media preferred by the target group should be used to send the message. The media used must ensure a large proportion of the targeted receives the information. In addition, inculcating good communication skills in the members of the organization improves the effectiveness of communication. These skills include listening, speaking, questioning, and sharing feedback. Every individual must also take the responsibility of ensuring that the information relayed is properly understood and feedback given (Bough, 2005). This will assure the sender that communication is complete.


For efficient communication in an organization, all the elements of communication such as the sender, the channel, the content, the recipient, and the feedback have to be actively incorporated. The communication must not only be clear, it should also be accessible, fast, and should be framed in a manner that prompts the recipient to respond appropriately.


Allen, J., & Brock, S. A. (2000) Health care communication using personality type: Patients are different. Routledge.

Bough, B. (2005). 101 ways to improve your communication skills instantly. Goal Minds, Inc.

Martha, D., & Paleg. K. (2004). The messages workbook: Powerful strategies for effective communication at work and home .New Harbinger Publications.

Perkins, P. S., & Les, B. (2008). The art and science of communication: Tools for effective communication in the workplace. Wiley.

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