Health Inequalities Flashcards
Key features of epidemiological transition
A decline in mortality concentrated on infectious disease; displaced by non-infectious degenerative disease Burden of illness shifts from younger to older age groups Shift from acute fatal illness to chronic conditions Flattening of curve relating life expectancy to GDP per capita Diseases of affluence more common in poorer groups.
Theoretical explanations of the social gradient in health
Behavioural/cultural Material/lifestyle Psychosocial
Behavioural explanation of social gradient in health
Inequalities are the result of social variations in health-related behaviours e.g. Smoking, diet
Assumed to be the result of individual choice I.e. due to ignorance and poorly informed individual choices, more culturally accepted in lower social groups
N.b. differences in health behaviour only account for 50% of the current patterns of health inequality
Materialist explanation of health inequality
Result of social circumstances related to income (housing, nutrition, working environment)
Damp/mould associated with higher rates of asthma, RTI.
Poorer diet increases risk of CHD, diabetes and cancer. Reflects lack of resources at individual and community level
Exposure to one form of material deprivation increases risk of exposure to others (poor childhood circumstances set children on pathways which bring more exposure to disadvantages later in life
Psychosocial explanations of health inequality
Can affect indirectly: by unhealthy behaviours e.g. Smoking
Directly: increased vulnerability to mental and physical illness via mind-body pathways Chronic stresses now seen as important for health. People in lower social groups tend to face negative circumstances more frequently.
Negative emotions result in poorer health and health-behaviours. Perceiving one’s self to be poor in an affluent society can affect health
Difference between absolute and relative poverty
Absolute poverty: minimum standards of food, shelter and clothing necessary to sustain life
Relative poverty: below ‘acceptable’ standards of living which prevents people participating in community life
Explain the neo-materialist approach to health inequality
The effect of material circumstances on health reflects a lack of resources at individual and community level; related to public under investment in education, health and social infrastructure.
Explain how health inequalities can affect the life course of an individual
Parental disadvantage in health is transmitted in utero and in the early years of life; leads to a range of health problems in later life
Poor childhood circumstances set children on pathways which bring further exposure to disadvantage in later life
Exposure to one form of material deprivation increases the risk of exposure to others. This can mean that disadvantage ‘clusters’ across the life-course
What are the psychological effects of relative poverty?
Perceiving one’s self to be poor can be damaging for an individual’s health
Produces negative emotions such as anger and resentment which results in poorer health and poor health behaviours
Result in aggression and anti-social behaviour, which undermine community levels of ‘social capital’ conducive to good health
What is social capital?
Social capital is defined in terms of both social networks: ability to participate in community groups and activities, and norms: levels of trust and reciprocity among community members.
Two main types of social capital – ‘bonding’ and ‘bridging’
Bonding; strong ties between members of a social network who see themselves as the same
Bridging; links across different social groups in society that do not necessarily share similar social identities
Define health inequalities
Refers to the systematic differences in health of individuals in different socio-economic groups.
The unequal distribution of health is manifested in the differences between the health of the poorest and the rest of the population and differences in health between socio-economic groups.
Why is it important to understand inequalities in health?
Individuals in a population do not experience the same level of health
Health is socially patterned
Important to understand that the distribution of health across a population is affected by social, economic and political factors
Aim of public health is to improve the health of the population
Why are smoking rates higher among low income groups?
Nicotine addiction is fundamental in sustaining smoking behaviour. The more addicted you are, the more difficult it is to quit. Levels of nicotine dependence increases systematically with deprivation.
Family and social factors influence smoking behaviour. Smokers are more likely to live and socialise with other smokers, cheap form of recreation. Cigarettes are a readily available coping mechanism and mood regulator - acts as a means of managing stress.
Define health behaviour
Behaviours that people engage in that affect thier health
Why is it important for doctors to understand health behaviours?
Social inequality is a strong determinant of poor health behaviour
Health behaviours are dependent on a number of factors: socio-economic, gender, ethnicity
Poor health behaviours are strong determinants of poor health and premature death
Improving knoweldge and attitude doesn’t always change health behaviour
