Social inequalities - part 2 Flashcards
What is the health selection explanation for social inequalities?
Healthy move up the social hierarchy, unhealthy move down. Health status influences social position rather than vice versa, leading to a concentration of people at higher risk of premature death in low status occupations or unemployed or permanently sick or disabled.
How does discrimination work under the health selection model?
- Education - Training and employment
What is the evidence for the health selection theory?
Social gradient and long term conditions eg
What are the solutions in the health selection model?
Reduce discrimination. Improve access. Support ill and disabled people.
What is the individual behaviour explanation for health inequalities?
This view sees that social class differences in behaviour cause variations in health status. Ways of living – or life-styles - are presumed to vary systematically between people in different social positions, in particular that those further down the social gradient behave in unhealthy ways - smoke more, drink more alcohol, eat more fat and sugar, don’t exercise etc. This approach most favoured by politicians and much of health policy in the UK focuses on improving health by delivering interventions at the individual level
What is the evidence for the individual behaviour theory?
Correlation between cigarette smoking and occupation. Obesity by household income.
What are the solutions to the individual behaviour explanation?
Healthy lifestyle promotion. Anti-hypertensives, statins. Taking personal responsibility.
What is the materialist explanation?
Proponents, e.g. George Davey Smith. They identify where material causes affect health – for example those who have central heating in their homes which are free from damp are less likely to have health-threatening respiratory illness – this is true even when other factors like smoking are taken into account. Social gradient exist in people who are not smokers for example – although inequalities reduced & obesity an important but lesser factor.
What is the evidence for the materialist explanation?
Health problems are associated with poor housing.
What are solutions under the materialist explanation?
More equal income distribution (taxation) Improved access to education for least well off Increase healthcare resource for least well off
What is the psycho-social explanation?
Life expectancy in a country does not necessarily increase directly with national wealth – to support evidence for their theory of health inequalities. Richard Wilkinson & Kate Pickett in their book The Spirit Level argue that the larger the gap between the richest and the poorest in a country the higher the rate of both social problems and health problems.
What is the evidence for the psychosocial explanation?
Prevalance of mental ill health is higher in more unequal rich societies.
What were the Whitehall studies?
Study of social gradient and health in civil servants in London 10, 314 men and women (age 35-55) Survey: physical and mental health, type of work, health behaviours, adverse life events, social networks, height & weight…. Analyses by Civil Service grade (1-6) Clear stepwise social gradient in physical and mental health
What is status syndrome? (Marmot)
Social gradient in primates in terms of markers of cardiovascular risk and atherosclerosis.
What is the life course explanation?
The idea is that disadvantage or advantage cluster around a person from before they are born and that it is the accumulation of these factors that lead to differences in morbidity and mortality across SE groups.
