3) Inequalities in Health

Question 1

Suggest three different categories which we can classify people in regard to their access to healthcare.

(what an awfully worded question)

Answer 1

• Socioeconomic status
• Ethnicity
• Gender

Question 2

What is disability free life expectancy?

Answer 2

The amount of time you can live without suffering from a disability.

Question 3

What is the Black report from 1980? What does it suggest?

Answer 3

Report by the DoH in 1980 and gave 4 explanations for why inequalities occur:

• Artefacts - way stats are collected
• Social selection - as you get ill you move down socially
• Behavioural-cultural - ill health is due to people’s choices
• Materialist - different access to resources between classes

Question 4

Discuss the Black report with reference to its explanation of how artefact collection relates to inequality.

Answer 4

• Suggests health inequalities are evident due to the way statistics are collected
• Discredited as an explanation, as if anything data problems lead to under, not over estimation of inequalities.

Question 5

Discuss the Black report with reference to its explanation of how social selection relates to inequality.

Answer 5

• Direction of causation is from health to social position (not other way round)
• People who are ill move down the social hierarchy (as they can’t work etc.)
• Plausible, but, only with a minor contribution

Question 6

Discuss the Black report with reference to its explanation of how behaviour and culture relate to inequality.

Answer 6

-Suggests ill health is due to people’s choices/decisions, knowledge and goals
-People from disadvantaged backgrounds tend to engage in health damaging behaviours
-Useful, however limited as:
+behaviours are outcomes of social processes, not simply individual choice
+choice may be difficult to exercise in adverse conditions
+choice may be ration for those whose lives are constrained by their lack of resources

Question 7

Discuss the Black report with reference to its explanation of how materialism relates to inequality.

Answer 7

• It suggest the inequalities in health arise from differential access to material resources (low income, unemployment, work environments)
• Lack of choice in exposure to these things and the factors accumulate over a lifetime
• This is the most plausible explanation of how inequality arises, more study needed

Question 8

What is the difference between inequality and inequity?

Answer 8

Inequality is when things are different (therefore not equal) whereas inequity is when an inequality is unfair and avoidable.

Question 9

How might we classify people by socioeconomic status?

Answer 9

• Profession (registrar general scheme, national statistics socio-economic classification)
• Area based
• Education
• Income
• Mixed methods such as Townsend deprivation score