18. INEQUALITIES IN HEALTH (PART 2)

Question 1

1. Based on this Case Scenario, identify some social reasons behind him developing a cardiovascular disease.

Answer 1

• behavioural issues
• lack of higher education
• lower social class (working class)
• chronic stress

Question 2

2. What are the 5 Models of Social Class and Health?

Answer 2

1. Social Selection
2. Materialist Model
3. Behavioural Model
4. Psychosocial Model
5. Life Course Model

Question 3

3. What does the Social Selection Model focus on?

Answer 3

• it focuses on biological reasons
• individuals are biologically vulnerable to diseases
• this is why people do not move up in the social strata

Question 4

4. Complete this sentence:
   _________ determines Social Class?

Answer 4

• health

Question 5

5. What is meant by the statement “Health determines Social Class”?

Answer 5

• if people fall ill:
  - they are unable to secure employment
  - a downward social mobility tends to occur
  - this is seen especially in lower classes

Question 6

6. What are the three limits of the Social Selection Model?

Answer 6

1. It is not sufficient to account for all of the differences in health by social class
2. Social mobility tends to occur before serious diseases become prevalent
3. Incapacity does not always lead to a downward mobility between social classes

INCAPACITY= physical or mental inability to do something/manage your affairs

Question 7

7. What does the Materialist Model argue?

Answer 7

• access to materials and resources influences people’s health
• the control of material resources influences people’s health

Question 8

8. What are the three main focuses of the Materialist Model?

Answer 8

1. Material Possessions
2. Access to resources
   (education, health care services, proper housing)

• people from lower socio-economic statuses are less
  likely to have access to healthy environments and
  healthcare

3. Poverty and Unemployment

Question 9

9. What can be said about Poverty and Unemployment with regards to the Materialist Model?

Answer 9

• it exposes people to greater health hazards
  (poor housing, air pollution, insufficient food,
  unhealthy food)
• poverty and unemployment are related to:
  - chronic stress
  - lost sense of control

Question 10

10. What are two effects in living standards for the post-war population?

Answer 10

• life expectancy is increased
• social inequalities in health still persist

Question 11

11. What does poor housing lead to?

Answer 11

• poor health care
• poor education

Question 12

12. What is the concept of Inverse Health Care?

Answer 12

• health care is least available where it is most needed
• available health care facilities may be less accessible
• they may be under utilised

Question 13

13. What are the reasons for variations in access to healthcare?

Answer 13

• availability
• quality
• cost
• information

Question 14

14. What does the Behavioural Model focus on?

Answer 14

• it focuses on individuals
• it focuses on how they behave
• it also focuses on Cultural explanations

Question 15

15. What are three examples of health damaging behaviours?

Answer 15

• smoking
• alcohol abuse
• unhealthy diet

Question 16

16. What are three examples of health-promoting behaviours ?

Answer 16

• physical exercise
• health literacy
• health beliefs

Question 17

17. What does Cultural Explanations refer to?

Answer 17

• middle and working class people have different cultures

Question 18

18. What are the implications of Cultural explanations?

Answer 18

• health inequalities may not be reduced by economic equality

Question 19

19. What does the Psychosocial model focus on?

Answer 19

1. how psychological stress is generated by society’s inequality structures
2. social inequalities may make people feel subordinate and disadvantaged
3. social support
4. two pathways from stress to poor health
5. methodological and conceptual issues
6. stress related mechanisms

Question 20

20. What can be said about How Psychological Stress is generated by Society’s Inequality Structures?

Answer 20

• the effects of social inequality may cause stress
• poverty can result in stress and social isolation

Question 21

21. What can be said about Social inequalities making people feel subordinate and disadvantaged?

Answer 21

• control
• autonomy
• there is an imbalance between home and work
• an imbalance between efforts and rewards

Question 22

22. What can be said about Social Support?

Answer 22

• evidence shows that people who have:
  - good relationships with family
  - good relationships with friends
  - participate in the community
• have longer life expectancies
• this is compared to those who are isolated

Question 23

23. What can be said about there being Two Pathways from stress to poor health?

Answer 23

1. there is a direct pathway on disease development
   (mental illness and somatic disease)
2. there is an indirect pathway when stress is experienced by health-damaging behaviours

Question 24

24. What can be said about Methodological and Conceptual issues?

Answer 24

• how psychological stress can generate mental and somatic diseases

Question 25

25. What can be said about Stress-related Mechanisms?

Answer 25

• lower socioeconomic groups experience a greater number
  of:
  - stressful life events
  - negative stereotyping
  - stigma
  - social isolation
• lack of social relationships can lead to:
  - maladaptive coping strategies
  - consuming alcohol to cope
• affluent individuals may have a beneficial network of social connections
• this gives them a social buffer against stressful life events

Question 26

26. What does the Life Course Model focus on?

Answer 26

• it focuses on one’s experiences with social conditions and social positioning across time

Question 27

27. What two points does the Life Course model revolve around?

Answer 27

1. A disadvantage at one time is associated with a disadvantage at a different time
2. Methodological and Conceptual issues

Question 28

28. What does it mean when we say that a disadvantage at one time is associated with a disadvantage at a different time?

Answer 28

• a disadvantage in childhood can lead to a disadvantage in adulthood
  (such as poverty)

EG: individuals who experienced poor home conditions in their childhood home are more likely to experience occupational disadvantages

Question 29

29. What can be said about Methodological and Conceptual issues?

Answer 29

• this is dependent on the timing and the duration of exposures across the life span of a person
• there are risk factors that accumulate over our lives
• they interact with synergy over the course of your life

SYNERGY= the interaction two or more substances, or other agents to produce a combined effect greater than the sum of their separate effects

Question 30

30. What is Class Mobility?

Answer 30

• the class that you originate from and the class that you finally end up in both influence your health

EG: being born in a working class is bad for your overall
health
: climbing up the social ladder cannot compensate for it

Question 31

31. Which social class results in the worst health outcomes?

Answer 31

• those who were born in working class families
• those who belong to working class families in their adult lives

Question 32

32. Based on the Case Study, which Social Class and Health model is most suited?

Answer 32

1. Materialist Model
   
   • his socioeconomic position
   • he is a low income worker at a bakery
2. Behavioural Model
   
   • his lifestyle is associated with the working class
   • he smokes
   • he uses heavy alcohol
3. Psychosocial Model
   
   • stress and social support
   • he feels stressed (even though he had friends)
   • he has a low sense of life control

• he has a high school education
• this can result in him having inadequate health literacy
• he struggles to recognise his symptoms

Question 33

33. What are working class people more likely to experience?

Answer 33

• they have access to limited resources
• smoking
• drinking
• unhealthy eating
• they have poorer health literacy
• they are more likely to be influenced by inequality culture
• they are more likely to adopt a fatalistic view of life
• this means that they believe that all events in life are
  predetermined
  and that they are inevitable

Question 34

34. Why are working class people more likely to suffer from chronic stress?

Answer 34

• smoking
• alcohol abuse
• food consumption
• are all coping mechanisms of stress and difficult life situations

Question 35

35. What is the result of Health Service provision inequities vs social inequalities?

Answer 35

• they both lead to different health outcomes
• inequality = unbalanced conditions
• inequities = state of being unfair and unjust

Question 36

36. Are inequities avoidable?

Answer 36

• yes
• no matter the location
• people at the lowest socioeconomic status experience the worst health

Question 37

37. How would addressing social dynamics rather than focusing on social categories help to stop inequalities from persisting?

Answer 37

• actions should focus on all determinants of health inequalities

Question 38

38. What are 5 determinants of Social Inequalities?

Answer 38

• resources
• migration
• gender
• social support
• stressful work

Question 39

39. What should policies that stop inequalities focus on?

Answer 39

• they should focus on all aspects of life:
  
  • income security
  • quality of health care
  • gender balance
  • social inclusion
  • healthy environments
• policies have to be multi layered
• no single action is effective

Question 40

40. Are people’s experiences confined by one determinant only?
    (such as their social class)

Answer 40

• no
• people are influenced by exposure to:
  - many other social experiences
  - identity practices
  - social location
  - historical forces
  - political forces

Question 41

41. Read through this summary.
    Does everything make sense?

Answer 41

• yes

Question 42

42. Answer this SBA.

Answer 42

D