Inequalities In Health Flashcards
What is social class?
A segment of the population distinguished from others by similarities in labour market position and property relations
What is used to measure deprivation based on geographical residential area?
Index of multiple deprivation
How is the index of multiple deprivation calculated?
From census data on 7 domains including
- income
- employment
- health and disability
- education skills and training
- barriers to housing and services
- living environment
- crime
What is used to calculate deprivation based on individual occupation?
National statistics socio-economic classification (NS-SEC)
How is NS-SEC calculated?
From census data looking at
- current and past work status
- title
- responsibilities
- sector
What is the link between deprivation and ill health?
The more deprived someone is, the larger the proportion of their life that will be spent in ill health, and the more likely they will die at a younger age
What is the artefact explanation for inequalities in health
Due to the way statistics are collected
However, data problems often lead to UNDERestimation of inequalities
What is the social selection explanation for variations in inequalities?
Direction of causation is from health to social position
- sick individuals move down social hierarchies
- chronically ill and disabled more likely to be disadvantaged
Studies suggest this only has a minor contribution to health and mortality
Limitations of the behavioural-cultural explanation?
Behaviours are outcomes of social processes, not just individual choice
Choices may be difficult to exercise in adverse conditions
What is the behavioural-cultural explanation for inequalities?
Ill health is due to people’s choices and decisions, knowledge and goals
(People from disadvantaged backgrounds tend to engage in more health-damaging behaviours and vice versa)
Psychosocial explanation for inequalities?
Psychosocial pathways act in addition to direct effects of absolute material living standards
Social gradient of psychosocial factors
Some stressors are distributed on a social gradient eg negative life events, social support, autonomy at work, job security
How can stress impact on health?
Directly - physiological, immune system
Indirectly - health-related behaviours, mental health
Income distribution of inequalities in healthcare?
Relative income affects health
Counties with greater income inequalities have greater health inequalities
Not the richest but most egalitarian societies that have the best health
(some counties have redistribution policies which can improve social well-being)
What is the materialistic explanation for inequalities in health care?
Inequalities in health arise from differential access to material resources
(-low income, unemployment, work environments, low control over job, poor housing conditions)
Lack of control in exposure to hazards and adverse conditions
Accumulation of factors factors across life course
What do utilisation studies measure?
Receipt of healthcare
Access to healthcare is difficult to measure.
Define inequality
When things are different
Define inequity
Inequalities that are unfair and unavoidable
What are some contributing factors to inequities in ethnicity and health?
There may be potential discrimination in service provision, diagnosis and treatment
Services may not meet the needs of different groups
Some health related behaviours may vary by ethnic group
What is seen in the patterns of healthcare in the most deprived groups?
Higher rates of GP and emergency services
Underuse of preventative and specialist services
What is sex?
Biological factors eg hormonal and reproductive differences
What is gender?
Social factors eg roles and norms
How does health vary between men and women
Men
- higher mortality rates eg heart attacks
- more suicide and violent deaths
Women
- higher life expectancy
- higher reported poor mental health
- higher rates of disability and limiting long-standing illness
What are some explanations behind why these patterns of healthcare use are seen in more deprived groups?
Manage health as a series of crises
Normalise ill health
