Lecture 14 SEP Flashcards
What is SEP?
The social and economic factors that influence what position a person holds within society
What is notable about the determinants used to measure SEP?
They should be objective, meaningful and measurable
Why should we measure SEP?
It helps quantify inequality within society, highlight changes to population structure, helps with understanding the relationship between health and other social variables, associated with health and life chances
What are measure we use to measure SEP?
Education, Income, Occupation, Housing, Assets and Wealth
How is SEP measured for populations?
Area measures (Deprivation and access), Population measures ( Income inequality, literacy rates, GDP)
What is something to keep in mind when measuring SEP?
SEP is relevant in high income and low income countries, and there is no universal threshold. The measures we use must be specific towards the country or area of interest
Where does SEP fall on the dahlgren and whitehead model?
It can be applied all throughout?
What is the relationship between individual and lifestyle factors and SEP on the Dahlgren and Whitehead model
Your education, income and occupation lead to different health outcomes. E.g, those with higher education are more likely to respond to health messages, those with higher income are more liekly to be able to afford to see the GP
What is at the core of SEP and health?
Education, Occupation, Income, Assets and wealth all play a role in deciding ones health
What do we need to look out for when measuring income and what type of measure is it?
Income can be subject to reporting bias and is a sensitive issue. Can be both absolute and categorical measure.
Measures of income:
Have a dose-response relationship with health - Cumulative effect over the life course - Greatest potential to change over a short duration - Most directly measure the material resources aspect of SEP
What is the trend between self rated health and levels of education?
Those with a higher education are more likely to rate themselves with better health regardless of race
What can we say about SEP and social/community influences?
Your parent’s education and occupation have a very big effect on your SEP. Students with high substance use also had parents and friends who had a high substance use
How can we measure SEP relating to level 3 of the dahlgren and whitehead model?
Area based measures (NZ index of deprivation, index of multiple deprivation - allows drilling into drivers of deprivation) or Geographic classification for health (urban 1 - rural 3)
How can we measure area level deprivation?
“Deprivation is the observable and demonstratable disadvantage relative to the local community/wider society which and individual/family or group belongs”
Focuses on material deprivation because it is difficult to measure wealth
Measures people relative position in society based on where they live, not their individual status.
Deprivation is applied to conditions of life lower than the average in a particular society
What are the variables included in NZDep 2018?
Communication, Income, Income, Employment, Qualification, Owned home, Support, Living conditions, Living space
What was the criteria for communication?
People with no access to internet at home
What was the criteria for income
People 18-64 receiving a means-tested benefit
People living in equivalised households with income below an income threshold
What was the criteria for Employment
People aged 18-64 unemployed
What was the criteria for Qualifications
People aged 18-64 with no qualifications
What was the criteria for Owned home
People not living in own home
What was the criteria for support
People aged <65 in a single parent family
What was the criteria for living space
People living in equivalised households below a bedroom occupancy level
What was the criteria for living conditions
People living in dwellings that are always damp or always mould greater than A4 size
What does equivalised mean?
Methods used to control household composition
What has changed for the places affected by area deprivation in New Zealand?
Despite lots of investment the places most affected by deprivation have not changed
What is the relationship between migrant generation and deprivation?
Deprivation decreases with time spent in new zealand, and europeans>asians>pasifika
What can we do for the outer layer of dahlgren and whitehead model and SEP?
Group people with similar SEPs together and do longitudinal/cross sectional anaylses,
What is the trend shown by the preston curve and what are it’s axes?
The preston curve shows life expectancy on the x axis and GDP on the y axis, there is a positive relationship between GDP and life expectancy. If GDP increased for low income countries we would see the greatest increase in life expectancy.
When understanding the causes of the causes, where should we start?
We should start at access to healthcare and ask why
How can education be measured?
Continuous variable: time in education
Categorical variable: educational achievement - more important in determining SEP
What are the characteristics of the education measure?
- Attempts to measure the knowledge related assets of an individual
- Are believed to be associated with our ability to respond to health promotion messages
- Capture transitions from parent’s SEP to personal SEP
- Are easy to obtain
- Often have a good response rate
- Relevant to all age groups
What are problems with using education as a measure of SEP?
There are different standards for measurement in different countries, cohort effect
What does occupation influence?
- Social networks - Work related stress leading to psychological effects - Occupational exposure to environmental risks
What are the characteristics of income?
- Closely associated with income
- Reflects social standing
- Possibly certain privileges resulting from SEP (lawyers, doctors etc)
- Individual experiences occupational or ‘social’ mobility over the life course
What is meant by the social gradient?
The social gradient in health refers to the fact that inequalities in population health status are related to inequalities in social status - In general, the lower an individual’s SEP, the worse their health
