S1) Socioeconomic Inequalities in Health

Question 1

How can socio-economic status be measured ?

Answer 1

• Individual occupation
• Area of residence
• Health status (life expectancy & infant mortality)

Question 2

Deprivation is strongly associated with ill health.

Explain the relationship between these two factors

Answer 2

The more deprived a person is, the larger the proportion of their life will be spent in ill health and the more like they are to die at a young age

Question 3

The Black Report offers explanations, theories and pathways for inequalities in health.

Outline the explanation proposed in Artefact

Answer 3

• Health inequalities are evident due to the way statistics are collected
• Concerns are about quality of data and method of measurement
• Discredited as more often data problems lead to underestimation of inequalities

Question 4

The Black Report offers explanations, theories and pathways for inequalities in health.

Outline the explanation proposed in Social Selection

Answer 4

• Direction of causation is from health to social position
• Sick individuals move down social hierarchy, healthy individuals move up
• Plausible explanation but minor contribution

Question 5

The Black Report offers explanations, theories and pathways for inequalities in health.

Outline the explanation proposed in Behaviour-cultural

Answer 5

• Ill health is due to people’s choices/decision, knowledge and goals
• People from disadvantaged backgrounds tend to engage in more health-damaging behaviours
• Limited as behaviours are outcomes of social processes, not simply individual choice

Question 6

The Black Report offers explanations, theories and pathways for inequalities in health.

Outline the explanation proposed in Materialist

Answer 6

• Inequalities in health arise from differential access to material resources – low income; unemployment; work environments; low control over job; poor housing conditions
• Most plausible

Question 7

The Black Report offers explanations, theories and pathways for inequalities in health.

Outline the explanation proposed in Psychosocial

Answer 7

• Psychosocial pathways act in addition to direct effects of absolute material living standards
• Some stressors are distributed on a social gradient of psychosocial factors – e.g. negative life events, social support, autonomy at work; job security

Question 8

The Black Report offers explanations, theories and pathways for inequalities in health.

Outline the explanation proposed in Income distribution

Answer 8

• Relative (not average) income affects health
• Countries with greater income inequalities have greater health inequalities
• The most egalitarian (not the richest) societies that have the best health

Question 9

Which services do more deprived groups use?

Answer 9

• GP services
• Emergency services

Question 10

Which services do more deprived groups under use?

Answer 10

• Preventive services e.g screening, LTC reviews, outpatients
• Specialist services e.g. CABG and cancer treatments