Social Inequalties in Health

Question 1

Where does inequality lie?

Answer 1

• most of inequalities between people is social differences
• between social groups
• social stratification

Question 2

What is socio-economic class?

Answer 2

• used to investigate effects
• the stratification has for diff social groups
• e.g. unequal life chancer
• socioeconomic class relates to health issues

Question 3

How do GPs address social inequalities?

Answer 3

• GPs responsible for addressing social inequalities
• in catchment area
• through clinical commision groups

Question 4

What things affect health?

Answer 4

 Social structure = material factors (e.g. income) + social environment (e.g. pollution)
 Work and social environment determine health behaviors (pathophysiological changes) and psychological changes ( brain.
 Ends with well-being/ mortality + morbidity
 Everything = determinant of health
 Health behaviors is included e.g. exercise and smoking
 Genes (e.g. cancers)
 Early life (e.g. if born prematurely)
 Culture (links to diet etc.)

Question 5

What is the Black Report (1980)?

Answer 5

• examines association between social class and health

- showed morbidity and mortality were not randomly distributed among the population

Question 6

What are the explanations of the finding of the Black Report 1980?

Answer 6

• Artefact
  = health problems are result of individual behaviour
• Social/Health selection
  = people with poor health are downwardly mobile

- Behavioural/cultural factors 
= focus on class differences in health beliefs and behaviour
= low class more likely to smoke, drink, poor nutrition

- Material circumstances - MAIN CAUSE OF SOCIAL INEQUALITY
= social diff in income
= diff in diet
= diff housing
= stressful working environment

Question 7

What are the main health outcomes that exist between different social classes in the UK?

Answer 7

• Life expectancy increasing for all classes
  = increases faster in higher social class
• Mortality and morbidity has decreased for every social class.
  = mortality rates higher in lower class
• The gap in inequality, has been reduced in terms of the absolute number of deaths involved.
• Gap in health equality in relative terms, has become larger.

Question 8

What is relative inequality?

Answer 8

• ratios

- can check income diff in diff social classes

Question 9

What is the Acheson report 1998?

Answer 9

• The report recommended interventions to reduce health inequalities between upper and lower classes
  • Medical care
  o At level of morbidity to prevent early death
  o Improve access to healthcare

• Preventative approaches
o To change individual risk

• In workplace
o To improve psychological conditions, reduce unemployment

• In social structure
o Reduce social and economic inequalities, provide good food at cheaper prices, provide better housing

Question 10

How do you measure social class?

Answer 10

• Registrar Generals Occupational Classification

- NS SEC

Question 11

What is Registrar Generals Occupational Classification?

Answer 11

This is based on relative status of occupation e.g.
• 1= professional (doctor)
• 5= unskilled manual (porter, cleaner)

Question 12

What is NS SEC?

Answer 12

Uses occupation based on employment conditions and relations
• 1 = higher managerial and professional occupations
• 8 = never worked and long-termed unemployment