Inequalities in healthcare Flashcards
Name some health inequalities
Socioeconomic status
Ethnicity
Gender
What is a social class?
A segment of the population, distinguished from others by similarities in labour market position & property relations
How is socioeconomic status measured/classified?
Individual - Registrar general scheme, National statistic socio-economic classification (NS-SEC)
Area-based - Townsend deprivation score
Education - Years/level reached
Income - E.g. household
What is the Townsend deprivation score?
Census data 4 variables - Unemployment - Car ownership - Overcrowded housing - Housing tenure Limitations include heterogeneity & transient populations
How are health and socioeconomic status linked?
Less deprived a population, the higher their life expectancy & disability-free life expectancy
Age standardised mortality rates are also higher in lower socioeconomic groups
How are ethnicity & health linked?
CVS disease - highest % prevelance in men of South Asian origin
Cancer - Lower prevelance in Black Minority Ethnic (BME) groups
Infant mortality - Higher rates in women of Pakistani & Black Caribbean origin
Mental health - People from BME more likely to be diagnosed with mental illness
Highest reported % of poor mental health in women of Pakistani & Black Caribbean origin
What is ethnicity?
The identification with a social group - membership of a collectivity - on the basis of shared values, beliefs, customs, traditions, language & lifestyles
How are gender and health related?
Social & biological variances between genders both affect health
Gender roles & relationships are socially constructed
“Men die quicker, but women get sicker”
What is the Black Report?
Report published by department of health (1980), which gave 4 theories to explain why health inequalities occur:
- Artefact explanation
- Social selection explanation
- Behavioural-cultural explanation
- Materialist explanation
What is the artefact explanation theory of health inequality mentioned in the Black Report?
Health inequalities evident due to way statistics are collected (measurement of class)
Concern about quality of data & method of measurement
Mostly discredited as explanation, as if anything data problems lead to under not over-estimation of inequalities
What is the social selection explanation theory of health inequality mentioned in the Black Report?
Direction of causation is from health to social position
Sick individuals move down social hierarchy, healthy individuals move up - health determines class
Chronically ill & disabled more likely to be disadvantaged
Plausible explanation, contribution only minor
What is the behavioural-cultural explanation theory of health inequality mentioned in the Black Report?
Ill health due to people’s choices/decisions, knowledge & goals
Disadvantaged background - tend to engage in health-damaging behaviours
Advantaged background - health-promoting behaviours
Useful explanation e.g. Health Education
What are the limitations of the behavioural-cultural explanation theory of health inequality mentioned in the Black Report?
Behaviours are outcomes of social processes, not simply individual choice
Choice may be difficult to exercise in adverse conditions
Choice may be rational for those whose lives are constrained by their lack of resources
What is the materialist explanation theory of health inequality mentioned in the Black Report?
Inequalities in health arise from differential access to material resources
- Low income, unemployment, work environments, low control over job, poor housing conditions
Lack of choice in exposure to hazards & adverse conditions
Accumulation of factors across life-course
Most plausible
Limitations: Further research needed as to precise routes through which material deprivation causes ill-health
What did the Black Report conclude?
Materialist explanation is the most powerful explanation
Some merit in others
Report identified the problem of inequalities & led to further theorisation & research
