S2 : Health Inequalities Flashcards
What are some ways to measure socio-economic status?
Individual occupation - National Statistics Socio-Economics Classification (NS-SEC)
Where people live - Index of Multiple Deprivation, calculated from census data
What are some ways to measure and compare health?
Infant mortality
Life expectancy
What is the social patterning of health in the UK?
Health inequalities are evident between different socio-economic groups
Deprivation is strongly linked with ill health - the more deprived a person is the larger the proportion of their life spent in ill health, also more likely to die younger.
What are some explanations of health inequalities? (4)
Black Report, 1980
Outlined 4 explanations for health inequalities
Acheson Report, 1998
Inequalities had widened since the Black Report
Whitehall Studies, 1967, 1985, present
A cohort study of civil servants (health, risk factors, job grade etc)
Marmot Report, 2010
Review evidence-based strategies for tackling inequality
What are the four explations the Black Report puts forward?
- Artefact
- Social selection
- Behavioural-cultural
- Materialist
A small bee movie
What does the artefact explanation mean?
Health inequalities are evident due to the way the statistics are collected
Largely discredited as an explanation
Lead to an underestimation of inequalities
What does social selection explanation mean?
The direction of causation is from health to social position, not form social position to health
Sick people move down the social hierarchy, health people move up
Makes on minor contributions to S-E differences in health and mortality
What does the behavioural-cultural explanation mean?
Ill health is largely due to people’s choices, decisions, knowledge and goals
People from disadvantaged backgrounds tend to engage in more health-damaging behaviours
A useful explanation for health education, HOWEVER
Behaviours are the outcome of social processes, not just individual choice.
Choices may be difficult to exercise in adverse conditions / with lack of resources
What does the materialist explanation mean?
Inequalities in health arise due to differential access to material resources, low income, unemployment etc
Most plausible
More research needed for precise routes
What are two other socio-economic inequality explanations, not from the black report?
Psychosocial explanation, income distribirtion
Whatis evidence on access to healthcare based on? What are some issues with this?
Based on utilisation (a receipt of services), evidence about utilisation is contradictory and difficult to interpret
What are some forms of evidence for deprivation access?
Normalisation of ill-health
The tendency to use more porous services like emergency and GP services
Difficulty marshalling the resources needed for negotiation and engagement with health services
What are the differences in health service usage in the UK associated with?
Social disadvantage
Ethnicity - BAME groups
Gender - Women
