Patterns of health inequalities

Question 1

What is an epidemiological transition?

Answer 1

The term epidemiological transition refers to a change in disease patterns as certain countried undergo transitions to thier economic status.. the disease patterns include at first being affected by infectuous diseases, but as medicine and the economy improves, you get a decline in these infectous diseases and an increase in neurodegenerative diseases.

Question 2

Major Trends of Health and Disease in the UK part 1

What are some paramaters we look at to assess where a nation is in the epidemiological transition?

1. What is Infant mortality rate? what is associated with it?
2. How has England’s infant mort rate looked? child mort rate?
3. How has England’s infant mort rate looked?
4. healthy life expectancy?

Answer 2

Infant mortality rate, child mortality rate, life expectancy at birth, healthy life expectancy

1. Infant mortality rate (death w/in the 1st yr of life) : good indicator of the nation’s health status and it is associated with the nation’s living conditions.
2. Declined over the past 30 years until 2014 where we have seen a 2% increase.

Child mortality rate has steadily declined as well but relative to other EU countries it is poor 20/28

3. Life expectancy at birth has steadily increased in the UK until 2010, since which, it has remained stagnant.
4. healthy life expectancy - woman used to live longer than men which is no longer the case

women live about 77% of thier lives in good health; men 79%

both live on avg 63.5 years in good health and 20% in ill health.

Question 3

Major Trends of Health and Disease in the UK part 2

A.What are the major current causes of death in the UK?

B.Major cancers leading to death?

Answer 3

A.

1. Dementia ( trend rising) - Leading cause of death in women

2. Ischemic heart disease - Leading cause of death in men

3. Cerebrovascular disease
4. Chronic lower respiratory disease
5. Lung cancer

B.

1.Lung

2. Bowel
3. Prostate
4. Breast

Question 4

How health is socially patterned/distributed in the UK

( in other words.. Who are the groups that are most affected by the major health trends?)

1. What is social epidemiology?
2. what are the groups that observe this social patterning?
3. What is SEP and how is most often measured?

3.1. What is health inequality? ***

4. What happens each step down the 7 classes ladder based on occupation? what are the outcome measures?

Answer 4

1. Concerned with social patterning of population health.

It examines:

a) differential risks for social groups and
b) looks at what attributes (social conditions, age,gender) within these individuals give rise to these health problems
- be careful of generalisations.. these are just tendacies for this group to have these patterns not all individuals.
2. GAGSES - Gender, Age, Geography,sex, ethnicity, socioeconomic position

looking at geography and SEP in this lec*

3. Persons economic position in society

• Measured in a number of ways: occupation, income, education, access to or ownership of assets (housing, car), index of multiple deprivation
• Registrar General’s socio-economic classification ( most common) uses occupation b/c

proxy for status, income, access to material resources, education

3.1. systematic differences in a health across different social groups

4. Health gets worse

across many indicators:

male and female life expectancy

Cancer ( larynx cancer, lung)

Affluent lifestyles:

prostate ( higher SEP)

Brain tumors ( higher SEP)

Melanoma ( vacations?)

Geography: People that live in the north west tend to have poorer health outcomes?

sig differences in london boroughs and in different regions in coventry

Question 5

What is health inequality?

Answer 5

Systematic difference in health across different social groups

Question 6

Health inequality : Systematic differences in health across certain social groups.

1. What models can be used to explain the systematic differences in these groups?
2. What is the Model of health behaviour and culture?
3. Model of health behaviour and culture wont expalin all the variance, what is another reason ( what is the materialist model of health inequalities?)
4. Whats an argument agains the materialist model and what does it indicate? ( What is the Psychosocial explanation for health inequality?

Answer 6

1.

a) Models of health behaviour and culture
b) social inequality

• material and neomaterialist model
• psychosocial model

2.

• Health inequalities are seen as a result of variations in health behaviours and lifestyles influenced by behavioural choices, knowledge and culture
• Poor health behaviours also tend to follow social gradients .. such as smoking, lack of exercise, poor nuitrition etc..
  
  • Smoking .. This is best explained by social inequality ( socioeconomic position) rather than a lack of knowledge, motivation, etc.. ( people with social inequality are under increased cognitive load and are less able to plan and make decisions for the future) and not a lack of knowledge, atitude ( recklessness) or unhealthy cultural habits.

3.

Social inequality - Material explanation

Health inequalities result from a decreased access to material goods relative to those of their less
Impoverished peers

Health inequality results from a direct effect of the lack of these resources
( income, food, fuel, housing, transport, healthy environments, exercise facilities)
Food - social security benefits inaqequate for healthy diet
- higher calorie, low nutritional food costs less –> increased risk of CHD, type 2
Diabetes, childhood obesity etc..

higher income thus associated with better diet - more fruits, veg, fibre etc..

Location : where we live ( post code lottery) will affect our access to resources means poorer health outcomes

Problems: doesn’t explain all variance AND also in countries that have more wealth , but greater
Gaps between the rich and the poor, you see poorer health outcomes. .. so if you see more social
Inequality, you see more health inequality.

4.

Psychosocial explanations of health inequality state that health inequality is linked to how people’s
Environments make them feel.

Thier SEP can make them stressed an this can have a negative impact in the following ways:

1) Directly: allosteric load .. stress hormones (money problems, relative poverty, low social control, position in social hierarchy to others))
2) Adoption of unhealthy behaviours to manage stress

It is likely that health inequality is due to a combination of all 3 models over time called
Life course effects. Psychosocial explanations appear to explain more of the health inequality
Than behavioural explanations.