2. Social Inequalities in Health

Question 1

What is the strongest predictor of morbidity & premature mortality worldwide?

Answer 1

Low socioeconomic positions

Question 2

What is Social Inequality?

Answer 2

Describes the fact that people regularly get more ore less of:

• Scarce (knapp) & valued material
• or immaterial resources

…..based on their position in a social hierarchy

Question 3

Example of different forms of resources…

Answer 3

Social capital

• Networks, relationships

Economic capital

• Income, wealth

Cultural capital

• Education, titles, books, cultural objects

Symbolic capital

• mostly through social, economic, and cultural capital (Honor, prestige…)

Question 4

How can we measure Social Inequalities?

Answer 4

SEP

Socioeconomic Position

An Indicator for Social Inequalities

Question 5

What do we measure with SEP - Socioeconomic Position?

Answer 5

• Education
  
  • WHO Classification into primary, secondary, tertiary education
  • Measurement: Ask about the highest education level
• Income & wealth
  
  • ​The direct impact of life situation / highly relevant for health
  • Measurement: Income (person or household)
    
    • But not easy to measure nobody wont to talk about it
• Occupation
  
  • ​ (What kind of job you have)
  • Crystallizes social position: defines income, access to social security
  • Health relevance: (hazards job)
  • Measurement: Job position, Prestige, Leading position

-> CATEGORIE: Low, Middle, High

Question 6

SEP

Advantage / Disadvantage

Answer 6

Advantage

• Multidimensional

Disadvantage

• Difficult to argue for weights, chances over time
• Status inconsistency
  
  • Mast in Bio -> kein Job arbeitet als Kellnerin

Question 7

Dynamics to change within SEP Group

– Vertical social mobility

• Aspect of time

Answer 7

Mobility: up or down (Besser oder schlechter werden)

Aspect of time:

• Person : intra generative
  
  • z.b schlechter Job- Uni - guter Job
• Generation : inter generative
  
  • Mutter Ärztin - Kind Bauarbeiter

Question 8

Often when the families living in a low-income household - the kids later didn’t earn a lot of money either.

Answer 8

Question 9

Health Inequalities: Non ordered Groups

(There are not in the 3 groups like before)

Answer 9

Question 10

Was heisst:

Empirische Evidenz

Answer 10

Ein empirischer Beleg liegt vor, wenn die getroffene Hypothese durch gesammelte Daten bzw. Erfahrungen belegt wird. Um die Hypothese zu belegen werden oft statistische Methoden in Form statistischer Tests herangezogen, um zu überprüfen ob das Ergebnis eines statistischen Tests statistisch signifikant ist.

Question 11

Evidence on Social Inequalities in health?

The difference in low/high income, diseases?

Answer 11

Question 12

The link between SEP & Health: Two Hypothesis

Answer 12

• Selection / Drift Hypothesis = Diseases causes social downward mobility
• Social Causation Hypothesis = Material, Behavioral, Psychosocial factors

Question 13

Social Causation Hypothesis

Answer 13

Question 14

Material Factors

Answer 14

Question 15

Psychosocial factors

Answer 15

Question 16

Critical period model

Answer 16

Without later effects

With later effects

Question 17

Classical Accumulation of risk models

Answer 17

Question 18

Chain of Risk model

Answer 18