Inequalities in Health Flashcards
Where do social inequalities stem from?
Structured social divisions that exist within societies across history and cultures
What do social divisions lead to?
Differential “life chances” in education, career and health
How are social divisions identified today?
Difference in:
Socio-economic class
Gender
Ethnicity
How is social class measured?
What is it based on?
Since 2001, the official classification measure has been the National Statistics Social Economic Class
Based on employment conditions and relations, but not assessed in relation to skill levels
1-8 with 1 being high managerial/professional and 8 being long term unemployed
Outline the socio-economic model of health
Social inequalities in health outcome reflect differential risk exposure to the social and environmental factors impacting on health outcomes (‘social determinants’) across the lifespan
The risk in this instance being an individual’s socioeconomic class
What is relative health risk primarily associated with?
An individual’s socioeconomic class position
What are ‘social determinants of health’?
The broad social and economic circumstances that together determine the quality of the health of the population
Examples of social determinants of health
Living and working conditions Water + sanitation Education Healthcare services Agriculture + food production Housing Social and community networks Individual lifestyle factors Age, sex and constitutional factors
Top 3 social determinants of health
Educational attainment
Employment
Living standards/income
How does educational attainment impact health?
Low attainment may impact on many outcomes in later life including, quality of work, future earnings, involvement in crime, morbidity, and death
How does employment impact health?
Effect of unemployment does not just affect individuals
Children growing up in workless households are almost twice as likely to fail at all stages of education compared with children growing up in working families
How do living standards/income impact health?
Many health outcomes improve incrementally as income rises
A parent’s income may influence a child’s early development and educational opportunities, which in turn can affect a child’s employment opportunities and their income
What did the Black Report (1980) do?
Examined the association between social class and health, and indicated the death rate of disease incidence (morbidity) and the rate of incidence of death were not randomly distributed throughout the population
Argued that it was primary material circumstances that were the primary cause of social inequalities in health (rather than lifestyle choices)
Outline the main differences in health outcomes that currently exist between social classes in the UK
Life expectancy is increasing for every social class, however, it is increasing faster in higher social groups
Mortality and morbidity has decreased for every social class. However, mortality rates are much higher in lower classes than higher e.g. rates are 4x higher in lower 10% compared to upper 10%
The social class gradient of mortality and morbidity in Britain holds for most disease classifications
The gap in inequality has been reduced in terms of the absolute number of deaths involved.
The gap in health equality has become larger. In 2001, a worker in a routine or manual occupation was twice as likely to die before the age of 65 than his manager,
but in 2008 that ratio had risen to 2.3 times
How does income inequality affect social/health outcomes?
Social and material conditions pertaining within a particular society at a particular time serves to structure health outcomes
How do health risks change over time?
Risks to health are associated with social disadvantage, which cluster together and accumulate over time/longitudinally
Inequalities in health should therefore be seen as manifested across a social gradient, rather than being an outcome of poverty alone
What does ‘stress theory’ argue?
What does this mean in terms of inequality?
Social anxiety about status produces biological stress mediated by a range of psychological factors
If so, inequality is harmful because it places people in a hierarchy which increases competition for status, causing stress and leading to poor health and other negative outcomes
What has happened to the social class gap in health inequality in recent years?
Has become larger in relative terms
i.e. number may have decreased, but ratio gap between groups has increased
What did the Black Report find?
Health standards directly linked to social class
Ill health is increased down the social scale
Problems were linked with social + economic factors such as: income, unemployment, poor housing + education
List the Acheson Report (1998) actions to reduce inequalities in health
Reducing income inequality Reducing unemployment + improve employment opportunities Reducing risk of poverty Improving housing conditions Improving schooling Improving living environment Crime reduction
Outline the two concepts of social inequality
Social inequalities do not reflect biological differences and therefore are not inevitable or unavoidable
Social inequalities stem from structured social divisions that exist within societies across history and cultures→ e.g. social classes
Social scientist use socio-economic class to see how it affects: Education, work and health outcomes
How was the Registrar-General’s Occupational Classification (RGOC) used to measure social class until 2000?
Looked at the relative status of a person’s occupation on a scale of 1-6 with 1 being higher status/skill
1- Professional (doctors, lawyers, higher managers)
2 - Intermediate non-manual (nurses, middle managers)
3- Junior non-manual (secretary, technician)
4- Skilled manual (carpenters, electricians)
5- Semi-skilled manual (postman, farm worker)
6- Unskilled manual (hospital porter, cleaner, labourer)
What did the Black Report (1980) find in terms of health outcomes in relation to socio-economic class?
Artefact/Error→ results are due to individual health behaviour and human error
Cultural factors→ Different health behaviours and beliefs in different classes e.g. lower class more likely to smoke, drink and have poor nutrition
Health selection→ Those with poor health are downwardly mobile
Material circumstances→ social difference in income, diet, housing and working environment
The report found that it was mainly material circumstances that caused the unequal distribution
Describe the differences in health outcomes that currently exist between social classes in the U.K
Increased life expectancy in all classes
Decreased morbidity and mortality in all social glasses
Increased gap in health inequality
