Session 2: Health Inequalities Flashcards
Describe the relationship between health and socio-economic disadvantage.
Describe the relationship between health and variables including socio-economic position, ethnicity and gender in Britain today.
In the UK, health inequalities are evident between
those from different socio-economic groups.
Deprivation is strongly associated with (ill) health – the more deprived a person is, the larger the proportion of their life will be spent in ill health, & the more likely they will die at a younger age.
Give examples of social determinants of health ( SDH )
SDH - the non-medical factors that influence health outcomes
Describe the relationship between health and variables including socio-economic position, ethnicity and gender in Britain today
Economic Stability
Education Access and Quality
Health Care Access and Quality
Neighborhood and Built Environment
Social and Community Context
Describe approaches to measuring deprivation
Describe and evaluate some explanations for health inequalities
Index of Multiple Deprivation
Calculated from Census data – on 7 domains (Income, Employment, Health and disability, Education skills and training, Barriers to housing and services, Living environment, Crime)
Describe and give examples of explanations for health inequalities (explanations given in the Black report, along with psychosocial and income distribution explanations)
Describe and evaluate some explanations for health inequalities
Black Report explanation :
Artefact :
Health inequalities are evident due to the way statistics are collected (re measurement of class).
Concerns about quality of data and method of measurement.
Mostly discredited as an explanation.
Social selection:
Sick individuals move down social hierarchy, healthy individuals move up.
Chronically ill and disabled people are more likely to be
disadvantaged.
Behavioural-cultural :
Ill health is due to people’s choices/decisions, knowledge
and goals.
Useful explanation
Limitations - Behaviours are outcomes of social processes, not simply , individual choice , “Choices” may be difficult to exercise in adverse conditions , “Choices” may be rational for those whose lives are constrained by their lack of resources
Materialist selection :
Inequalities in health arise from differential access to material resources.
Lack of choice in exposure to hazards and 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
Evaluate the different explanations for health inequalities
Explanations not contained in black report
Describe and evaluate some explanations for health inequalities
Psychosocial :
Psychosocial pathways act in addition to direct effects of
absolute material living standards.
Some stressors are distributed on a social gradient - e.g. negative life events & job security.
Stress impacts on health via different pathways - Direct (physiological, immune system) & Indirect (health related behaviours, mental health).
Income distribution ( Wilkinson’s theory ):
Relative (not average) income affects health
Countries with greater income inequalities have greater
health inequalities
It is not the richest, but the most egalitarian societies
that have the best health
Describe inequities in access to healthcare
Describe and evaluate evidence on inequities in access to healthcare
More deprived groups have higher usage of GP services & emergency services but under use of preventative services & specialist services.
In deprived areas , there is normalisation of ill-health & manage health as a series of crises.
Difficulty marshalling the resources needed for negotiation and engagement with health services
Give explanations for evidence of poorer access to healthcare for patients from lower socioeconomic groups
Describe and evaluate evidence on inequities in access to healthcare
Much evidence about access is based on utilisation
(receipt of services) and can be difficult to interpret
Differences in service use are associated with social
disadvantage
Inequities in access are mediated by complex forms of
social advantage and disadvantage
