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ESA 4 - HaDSoc > Inequalities and Inequities in Health > Flashcards

Inequalities and Inequities in Health Flashcards

1
Q

What is inequality?

A

When things are different (not equal)

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2
Q

What is inequity?

A

Inequalities that are unfair and avoidable, or not accounted for by clinical need

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3
Q

Can you have inequality without inequity?

A

Yes

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4
Q

How can health be measured?

A
  • Mortality and life expentancy
  • Self report
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5
Q

How can health be measured by self-report?

A

Surveys asking how their health is in general

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6
Q

How can socioeconomic position be measured?

A

Based on individual occupation

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7
Q

What measures socioeconomic position based on individual occupation?

A

The National Statistics Socio-Economic Classification

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8
Q

What is the National Statistics Socio-Economic Classification (NSSEC) calculated from?

A

Census data

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9
Q

What is class 1 of NSSEC?

A

Higher manegerial and professional

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10
Q

Give examples of jobs that would fall into class 1 of NSSEC

A
  • Lawyers
  • Architects
  • Medical doctors
  • CEs
  • Economists
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11
Q

What is class 2 of NSSEC?

A

Lower managerial and professional

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12
Q

Give examples of jobs in class 2 of NSSEC

A
  • Social workers
  • Nurses
  • Journalists
  • Retail managers
  • Teachers
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13
Q

What is class 3 of NSSEC?

A

Intermediate

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14
Q

Give examples of jobs in class 3 of NSSEC

A
  • Armed forced up to sargeant
  • Paramedics
  • Nursey nurses
  • Police up to sergeant
  • Bank staff
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15
Q

What is class 4 NSSEC?

A

Small employers and own-account workers

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16
Q

Give examples of jobs in class 4 of NSSEC

A
  • Farmers
  • Shopkeepers
  • Taxi drivers
  • Driving instructors
  • Window cleaners
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17
Q

What is class 5 NSSEC?

A

Lower supervisory and technical

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18
Q

Give examples of jobs in stage 5 NSSEC

A
  • Mechanics
  • Chefs
  • Train drivers
  • Plumbers
  • Electricians
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19
Q

What is class 6 NSSEC?

A

Semi-routine

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20
Q

Give examples of jobs in stage 6 NSSEC

A
  • Traffic wardens
  • Receptionists
  • Shelf stackers
  • Care workers
  • Telephone salespersons
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21
Q

What is class 7 NSSEC?

A

Routine

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22
Q

Give examples of jobs in class 7 NSSEC

A
  • Bar staff
  • Cleaners
  • Labourers
  • Bus drivers
  • Lorry drivers
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23
Q

How can deprivation be measured?

A

Based on geographical residental area

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24
Q

What is the Index of Multiple Deprivation calculated from?

A

Census data

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25
Q

What allows for comparisons in the Index of Multiple Deprivation?

A

Small areas are ranked

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26
Q

Where are health inequalities evident in the UK?

A

Between and within regions

27
Q

What is deprivation strongly associated with?

A

Ill health

28
Q

Why is deprivation strongly associated with ill health?

A

The more deprived a person is;

  • The larger proportion of their life is spent in ill health
  • They are more likely to die at a young age
29
Q

What did census data allow from 1911?

A

Occupation-based comparisons on death rate

30
Q

What was the Black Report (1980)?

A

A landmark text that outlined 4 explanations for inequality in health

31
Q

What explanations for inequalities in health did the black report outline?

A
  • Artefact
  • Social selection
  • Behavioural-cultural
  • Materialist
32
Q

What did the Acheson report find in 1998?

A

Inequalities had widened since the Black Report

33
Q

What did Whitehall studies in 1967, and 1985-present do?

A

Cohort study of civil servants

34
Q

What was the Marmot report in 2010?

A

A review of evidence-based strategies for tackling inequalities

35
Q

What are the explanations for health inequalities?

A
  • Artefact
  • Social selection
  • Behavioural-cultural
  • Materialist
  • Psychosocial
  • Income distribution
36
Q

What does the artefact explanation for heatlh inequalities say?

A

Health inequalities are evident due to the way that statistics are collected regarding the measurement of class

37
Q

What is the numerator based on in statistics regarding the measurement of class?

A

Occupational distribution of those who die during the period considered

38
Q

What is the denominator based on in statistics regarding the measurement of class?

A

The occupational distribution at the most recent census

39
Q

What has happened to the artefact explanation of health inequality?

A

It has been mostly discredited

40
Q

Why has the artefact explanation for health inequality been largely discredited?

A

If anything, data problems lead to an underestimation of inequalities

41
Q

What does the social selection explanation of health inequalities say?

A

The direction of causation is from health to social position

42
Q

How can the direction of causation be from health to social position?

A

Sick individuals move down the social hierarchy, healthy individuals more likely to move up, therefore chronically ill and disabled people more likely to be disadvantaged

43
Q

Is the social selection explanation for health inequality likely to be correct?

A

Plausible explanation, but studies suggest that at most it makes only a minor contribution to S-E differentials in health and mortality

44
Q

What is the behavioural-cultural explanation of health inequality?

A

Ill health is due to peoples choices/decisions, knowledge, and goals, and people from disadvantages backgrounds tend to engage in more health-damaging behaviours, while people from advantaged backgrounds tend to engage in more health-promoting behaviours

45
Q

Where is the behavioural-cultural explanation of inequality useful?

A

In health education

46
Q

What are the limitations of the behavioural-cultural explanation of health inequality?

A
  • Behaviours are the outcome of social processes, not simply individual choice
  • ‘Choices’ may be hard to exercise in adverse conditions
  • ‘Choices’ may be rational for those whose lives are constrained by their lack of resources
47
Q

What is the materialist explanation for health inequality?

A

Inequalities in health arise from differential access to material resources

48
Q

Why may someone have differential access to material resources?

A
  • Low income
  • Unemployment
  • Low control over job
  • Work environment
  • Poor housing conditions
49
Q

What is the result of differential access to material resources?

A

Lack of choice in exposures to hazards and adverse conditions

50
Q

What happens to factors in the materialistic explanation over the life course?

A

They accumulate

51
Q

What is the advantage of the materialist explanation to health inequality?

A

Most plausible

52
Q

What are the limitations of the materialist explanation of health inequality?

A

Further research needed as to precise routes through which material deprivation causes ill-health

53
Q

What does the psychosocial explanation of heatlh inequality act in addition to?

A

The direct effects of absolute material living standards

54
Q

What is the psychosocial explanation of health inequalities derived from?

A

The Whitehall studies

55
Q

What does the psychosocial explanation for health inequalities say?

A

There is a social gradient of psychosocial factors, and some stressors are distributed on a social gradient

56
Q

What stressors are distributed on a social gradient?

A
  • Negative life events
  • Social support
  • Autonomy at work
  • Job security
57
Q

Via what pathways can stress impact on health?

A
  • Direct
  • Indirect
58
Q

What are the direct pathways through which stress can have an impact on health?

A
  • Physiological
  • Immune system
59
Q

What are the indirect pathways through which stress can have an impact on health?

A
  • Health related behaviours
  • Mental health
60
Q

How does income affect health?

A

Relative (not average) income affects health

61
Q

Which countries have the greatest health inequalities, regarding income?

A

Those with greater income inequalities- not the poorest

62
Q

What is the effect of income distribution on health partly associated with?

A

The psychosocial explanation

63
Q

Why is the effect of income distribution on health related to the psychosocial explanation?

A

Increase income inequity = increase in socio-evaluate threat = increased stress = decreased health

64
Q

What do redistribution policies aim to do?

A
  • Reduce income inequality
  • Improve social well being

In turn, improve many other health and social factors

ESA 4 - HaDSoc (13 decks)

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