HadSoc Session 3 Flashcards
How is individual SES measured?
Census data –> complex calculation –> NS-SEC group 1-8
How is the SES of an individual measured by geographical residential area?
Census data–> 7 domains –> index of multiple deprivation
What are the 8 NS-SEC groups?
1: higher managerial and professional
2: lower managerial and professional
3: intermediate
4: small employers and own account holders
5: lower supervisory and technical
6: semi-routine
7: routine
8: long term unemployed/never worked
What is seen in health trends as you move from higher to lower SES?
Increase in self-reported poor health, infant mortality and a decrease in both life expectancy and healthy life expectancy
What are the effects of deprivation on health?
More deprived –> larger proportion of life in health and more likely to die younger
What provides evidence for explanations regarding inequalities in health?
Census data, Black report, Acheson report, Whitehall studies, Marmot report
What are the Whitehall studies?
Long-running cohort studies of civil servants investigating health, risk factors and job
What is the artefact explanation?
That health inequalities are due to the way statistics are collected e.g. Self reported occupation promoted in comparison to occupation recorded at death
What are the limitations of the artefact explanation?
Mostly discredited as if anything data collection leads to an underestimate of inequalities
What is the social selection explanation for health inequalities?
Direct cause between health and social position as sick individuals move down groups but healthy can move up
What are the limitations of the social selection exactions of inequalities in health?
Studies suggest it only makes a minor contribution and a higher proportion of people with slowly progressive diseases are not seen in the lower classes as would be expected
What is the behavioural-cultural explanation for health inequalities?
Ill health is due to people’s choices/decisions, knowledge and goals
What pattern supports the behavioural-cultural explanation for health inequalities?
People from disadvantaged backgrounds tend to engage in more health-damaging behaviours and people from advantaged backgrounds are more likely to engage in health-promoting behaviours
What does the behavioural-cultural explanation provide an opportunity for?
Health education
What are the limitations of the bean behavioural-cultural explanation of health inequality?
Doesn’t have a SES components which affects behaviours by social pressures, creating adverse conditions or providing environment in which behaviour is rational
What is the danger with using the behavioural-cultural explanation for health inequality?
Can lead to victim blaming
Which is the most plausible explanation for health inequality?
Materialist
What is the materialist explanation for health inequality?
Inequalities in health arise from differential access to material resources - low income etc lead to lack of choice in exposure to hazards and adverse conditions –> accumulation of factors across life course
What is the limitation with the materialist explanation for health inequality?
More research is needed to find the precise routes through which material deprivation –> ill health
Which explanations for health inequality arose from the Black Report?
Artefact, social selection, behavioural-cultural and materialist
What is the psychosocial explanation for inequality in health?
Psychocial pathways act in addition to direct effects of material living standards as there is a social gradient of psychosocial factors
How does the distribution of some stressors on a social gradient lead to poor health?
Stress impacts directly (physiological and immune effects) and indirectly (health-related behaviours, mental health)
What is the income distribution explanation for health inequality?
Relative income affects health therefore countries with greater income inequities have greater health inequalities so the most egalitarian, not richest societies have the best overall health
Why does greater income inequality lead to higher levels of stress and thus poorer health?
Increases social evaluative threat due to threats to status and feeling devalued
What is the difference between inequality and inequity?
Inequality= things are different, inequity= unfair and avoidable inequalities
Is it possible to have inequality without inequity?
Yes e.g. matching resources to population
How are inequities in access to healthcare measured?
Utilisation studies
What is the limitation of measuring inequities in healthcare access?
Doesn’t measure lack of access through lack of knowledge/individual barriers
What do studies in inequities in access to healthcare show?
Deprived groups seem to have higher use of GP and emergency services and lower use of preventative measures and specialist services
What is the explanation behind the higher rates of GP and emergency service use in more deprived groups?
Manage health as a series of crises, normalise ill health, reluctant to assume ‘ill’ role, need event-based consulting for legitimisation, difficulty marshalling resources for access, lack of cultural alignment between services and lower SES and tendency to use more ‘porous’ services
What is the health of each individual related to?
SES, constraints in which they live, ethnicity, gender and age
What are the general trends seen in gender inequalities in health?
Males have higher mortality rate with more suicide and more violent deaths. Females have a higher life expectancy but higher reported poor mental health and higher rates of disability and limiting long-standing illness
How do gender and sex cause diversity and inequality in health?
Gender: social factors such as roles, social norms, discrimination and interaction with HCPs
Sex:biological factors such as hormonal and reproductive differences
What factors interplay in diversity and inequality in health?
SE context and factors, ethnicity, culture, access, genetic/biological factors, life course, cumulative factors (inc migration), risk, exposure, protective factors, response and recognition and healthcare quality and quantity
How can health be measured?
Mortality, life expectancy, hospital records, ONS surveys and self-report surveys
