2013 Health - Corna life course perspective Flashcards
when was the study published?
2013
what is the aim?
A life course perspective is adopted to understand the socioeconomic position (SEP)-health dynamic
what does Corna criticise about the current literature?
fails to consider structural factors properly, and ignores gender’s influence on SEP
how can socio-economic inequalities in health be seen as persisting all through an individual’s life? (3)
lower income, education and previous work in lower grade professions are all associated with poorer self rated health, mental well-being and greater functional limitations among older adults
why, when considering diseases, is the life course important?
Most conditions have long development (latency) periods
what can health itself be viewed as?
as a type of life course capital – one that is depleted or protected over time due to individual and structural factors (O’Rand and Henretta)
how does cumulative exposure influence health?
the length of time in disadvantaged circumstances is particularly important for understanding subsequent health disparities
what is greater cumulative exposure to disadvantaged SEP associated with?
poorer health and greater mortality among middle/old age adults
why are life course epidemiological models valuable?
for highlighting the significant role of early disadvantage, which encourages policies to be implemented at this early stage
what are two limitations of epidemiological models?
– inattention as to why these inequalities develop in the first point, conceptualise SEP as rather fixed
tend to focus on how disadvantage influences health at a given time, without realising that health like SEP can change over time
what are the two social science approaches to the SEP-health dynamic?
CAD and AAL
what do the two approaches consider in regards to the SEP-health dynamic?
how inequalities develop over time, and about whether divergence, convergence or maintenance of inequalities best captures how the SEP-health relationship changes as individuals become older
what does CAD stand for?
cumulative advantage/disadvantage theory
what is CAD?
a process whereby initial relative advantage (or disadvantage) associated with structural location and resources results in systematic divergence in life course processes across individuals or groups over time, early advantage will confer subsequent advantages (which are subsequently denied from those experiencing early disadvantage) and higher rates of return to initial circumstances relative to those with less advantageous beginnings
what does AAL stand for?
age as leveller hypothesis
what is AAL?
inequalities which are evident earlier in the life course connect or reduce as individuals enter later life
what factors can be seen as driving the convergence in health in older age? (3) (Herd)
biological factors play a stronger role than social ones, the potential for welfare state supports associated with retirement to level economic inequalities and their subsequent influence on health, and the possibility that inequalities fade out as older adults disengage from important stratifying systems, such as the labour market
how can this convergence in old age be criticised?
any observed reduction in the impact of SEP in later life is based on selection – only the wealthiest and healthiest survive to old age, creating a homogenous group
what did Willson et al find in relation to old age and wealth?
respondents with higher wealth and income reported slower declines in health than their less advantaged counterparts
what did Dupre find in relation to health and education?
diseased incidence and mortality increase with age at a faster rate than for less educated people
how can it be seen that it isn’t age alone which causes socioeconomic mortality differences to converge in old age?
growing evidence that illness not advancing age is behind the observed reduction of the effect
what policy decisions do those who support AAL think will be most effective?
suggest redistributive measures and social services for old people are especially important
however, what is important to remember about CAD and AAL?
CAD and AAL are not mutually excusive, emphasising early vs later policy intervention overlooks the fact that provisions are needed across the life course
how does the life course model need to be updated? (3)
- Need for a better understanding of what leads to a disadvantaged SEP
- Need for a focus on how SEP is a gendered construct
- Need to consider how the labour market and family experiences shape SEP
what is life course theory fundamentally concerned with?
the dynamic interaction between individual biography, structural context and historical time, study of different trajectories, different roles we occupy combine to create social pathways
what must be considered when understanding individuals within their social contexts? (4)
agency, historical context, family, policy
what is the principle of agency?
individuals construct their life course experiences within the constraints and opportunities of the social circumstances
why do individual biographies need to be further contextualised? example?
life course is embedded and shaped by historical time and place, old adults now were alive within world war 2, characterised by significant welfare expansion as well as rigid gender divides in the formal labour market and the home
what are Esping-Anderson’s three worlds of welfare capitalism based on? (3)
based on the extent to which they de-commodify or reduce market dependence for a living wage, on the extent to which they stratify individuals through access to benefits, and in reference to the relative roles of the state, the market and the family in the provision of welfare
what are Esping-Anderson’s three worlds of welfare capitalism?
liberal, social democratic, corporatist
what is an example of liberal capitalism?
the UK
what is liberal capitalism? (3)
low degree of de-commodification, high extent of stratification and an emphasis on market solutions
what is an example of social democratic capitalism?
Sweden
what is social democratic capitalism? (2)
Wider range of benefits to all citizens, rely less on markets or families for the provision of welfare
what is an example of corporatist capitalism?
Germany
what is corporatist capitalism? (3)
provide benefits tied to previous earnings, upholding earlier stratification, depend on the family for welfare
why should a gendered approach to health be considered based on the life course?
Progress has been made, but most women will still take off at least a bit of time to spend with their child which affects them later in life
how can SEP be linked to health? (4)
- Differences in material standards of living and access to resources
- The psychosocial implications of one’s position in the social hierarchy
- Lifestyle and behavioural factors
- Differential exposure to social stressors
why is it important to remember to attribute individual SEP to structural factors?
runs the risk of attributing it to individual choice, privileging the proximal rather than the structural determinants of health
how do policy contexts influence SEP?
in regulating/providing benefits which influence SEP through their influence on work and family experiences including childcare
