Social Inequalities in Health

Question 1

What do social inequalities stem from?

Answer 1

Structured soial divisions that exist within societies across history and cultures

Question 2

What is the point of socio-economic classification?

Answer 2

Allows social scientists to investigate the effects that such differential ‘life chances’ have for social groups - in terms of education, work and health outcomes.

Question 3

What does the socio-economic model of health state?

Answer 3

Adopts broad position that social inequalities in health reflect differential risk exposure across lifespan.

This realtive health risk is primarily associated with an individual’s socio-economic class.

Question 4

What does the model of social determinants of health state?

Answer 4

That social structure has an impact on well-being/mortality/morbidity dependent on the following factors that play a role:

• Social environment
• Work
• Health behaviours
• Psychological changes
• Pathophysiological changes
• Early life, genes, culture

Question 5

Describe the Registrar-General’s Occupational Classification which was used up until 2000 to measure social class

Answer 5

1 Professional (doctors, lawyers, higher managers)

2 Intermediate non-manual (nurses, middle managers)

3 Junior non-manual (secretary, technician)

3b Skilled manual (carpenters, electricians)

4 Semi-skilled manual (postman, farmworker)

5 Unskilled manual (porter, cleaner, labourer)

Question 6

Describe the official social classification measure, which is now the NS-SEC and what it is based on

Answer 6

Based on occupation in relation to skill levels but on employment coniditions.

1. Higher managerial and professional occupations
2. Lower managerial and professional occupations
3. Intermediate occupations
4. Small employers + own account workers
5. Lower supervisory technical occupations
6. Semi-routine occupations
7. Routine occupations
8. Never worked + long-termed unemployed

Question 7

What is the difference between inequity and inequality?

Answer 7

Inequality refers primarily to the condition of being unequal, and it tends to relate to things that can be expressed in numbers. Inequity, in its main sense, is a close synonym of injustice and unfairness, so it usually relates to more qualitative matters.

Question 8

What did The Black Report (1980) argue caused poor health?

Answer 8

That it was primarily material circumstances that were main causes of social inequailities in health. This includes income, housing, education etc.

Other things: artefact, social/health selection and behaviour/cultural factors.

Question 9

What trends to the social classes show in health?

Answer 9

• Lower class, lower life expectancy
• Lower class, higher infant mortality rate

Question 10

Is there a correlation between income inequality and health problems?

Answer 10

Yes there is a correlation but there is less agreement about whether income inequality causes health and social problems independely of other factors.

Question 11

Give a reason for why income inequality has an effect on health problems

Answer 11

Anxiety about status might explain income inequality’s effect on health problems. If so, inequality is harmful because it places people in a hierarchy which increases competition for status, causing stress and leading to poor health and other negative outcomes.

Question 12

In summary, what are the research findings explaining inequalities in health?

Answer 12

• Socal and material context of social inequalities structures health outcomes
• Health risks associated with social disadvantage cluster and accumulate over time / longtudinally
• Inequalities in health should be seen as manifested across a social gradient rather than being an outcome of poverty alone

Question 13

Describe the difference between absolute and relative measures of inequality

Answer 13

EXAMPLE:

Mortality rate for ‘Routine’ class = 500 (/100,000) and mortality rate for ‘Higher Managerial and Professional’ class = 100 (/100,000).

This then changes, ‘Routine’ class = 450, ‘Higher mang’ = 75 deaths respectively

Here, the gap has shifted from 400 to 375, so the gap in equality has been reduced in terms of ABSOLUTE number of deaths. However, the deaths in the ‘Routine’ class are x5 as high than in the more advantaged class, and then in the second instance it’s now x6 high - so in relative terms, the health inequality has become larger.