Topic 2:Health Chances by social group Flashcards
The Black Report (1980) .
🪜
The Labour government commissioned it to investigate variations in health across different social classes.
Findings:
Differences in mortality rates across social groups- those in the lower social groups suffer higher rates of mortality.
Inequalities in accessing health services, and low rates of uptake by the working classes.
Inequalities were widening after the establishment of the NHS in 1948.
Acheson Report (1998).
🪜
Found that scientific evidence supports health inequalities to be explained by socio-economics.
Solutions to health inequalities need to be social, economic, cultural and political- just as the problems are.`
Take action on a broad front
The Marmot Review (2010) .
🪜
The health gap has grown between wealthy and deprived areas
Where you live matters to your health- living in a deprived area of the North East is worse for your health than living in a similarly deprived area in London, where life expectancy is almost 5 years less.
Improvements in life expectancy have stalled, and women in the most deprived areas have declined.
Rich live longer
The poor live longer with ill health than the rich.
Hilary Graham (2004)♂ ♀
Government need to address the effects of policy on the population as a whole and recognise the consequences of policies on different groups.
Women are more likely to go without food and heating to save money in times of financial difficulties, which could contribute to more health issues.
Has anything changed since the Marmot report 14 years ago?.
🪜
Health inequalites continue to widen across England
Economic climate made worse since 2008 and welfare reforms
Effects or reorganisation have meant that health inequalities have slipped from many agendas.
.
🪜 WC are more likely to…. compared to MC.
Have a higher infant mortality rate
Suffer from serious medical conditions such as heart disease, strokes and cancer
die before retirement age than that of the national average.
Cultural Deprivation theory
Lower social classes have inferior norms, values, skills and knowledge which prevent them from accessing healthcare.
WC leader unhealthy lives, e.g. smoking and drinking.
Less likely to take advantage of NHS public health measures such as vaccinations.
.
🪜Howlett and Ashley (1991)
MC are more informed about health and have more understanding about health issues, resulting in them leading healthier lifestyles.
Shaw et al. (2008) 🪜
Disagree with cultural explanations of health.
Believe differences in health and illness are caused by the social structure of society.
MC are wealthier than the WC because society gives them less chance to be healthy- healthier diets and gyms are expensive, and smoking and drinking can be in response to stressful lives.
Ethnicity and health deprivation🌍
The rate of heart disease is higher in men and women who are Indian
Sickle-cell anaemia in those of African origin.
Morality versus Morbidity in men and women.♂ ♀
More men die earlier because of manual labour jobs (morality)
Women live longer with disabilities or in ill health and go to the doctors more often (morbidity)
Covid-19 on health inequalities🪜
Life expectancy in England dropped in 2020 for the first time since 2000
Economic effects on those who were already poor.
Death rates from Covid 19 in the most deprived areas almost double rates in the least deprived areas.
For those born in the __% most deprived areas, rates of premature birth increased by around __% post-2012 🪜
20%
25%
The social determinants of health
Developed by Dahlgreen and Whitehead (1991)
General socioeconomic, cultural, and environmental conditions- Language barriers
Living and working conditions- Missing doctor appointments for work, pollution, hazardous conditions
Social and Community Influences- scepticism in BAME communities around the vaccine
Individual lifestyle factors and personal choices- smoking, drinking, non-nutritional fast food
Age, sex, and hereditary factors- Indian people are more likely to get type 2 diabetes
WHO on air pollution
4.2 million deaths from air pollution outdoors, 3.8 million indoor
Ella lissi-Debrah, first recorded death in the UK due to air pollution
Bartley and Blane (2008), overview.
Social class inequalities persist for all major diseases.
Identified 4 major models used to explain social class inequalities in health.
Bartley and Blane 4 major models.
Used to explain social class inequalities in health.
Behavioural: There are Social Class differences in health because of promoted behaviours such as diet, drugs, alcohol, tobacco, use of contraception, immunisation, and antenatal services. This reflects B+F’s definition of how people’s lifestyles affect health.
Materialist: Impact of living in poverty. Consequent exposures to health risks include poor-quality housing, run-down estates, poor diet, and health hazards.
Psycho-social: Social inequality affects how people feel and then that can affect body chemistry. Refer to the Whitehall Study.
Life-course model: Health reflects the combination of social, psycho-social and biological factors that a person has experienced throughout their life, for example, health is influenced by what happens to a child in utero and early childhood. E.g those with a poor childhood are more likely to have health problems arise when they are grown. Refer to the Marmot review and the WACES.
Buck and Frosini (2012)
‘Clustering of unhealthy behaviours over time’
People’s lifestyles- whether they smoke, drink, what they eat- affect health and mortality
Supports the behavioural model.
🪜 White Hall Study of British Civil Servants.
Cohort study following BCS, longitudinal study. Provided detailed info on risk factors such as weight, cholesterol, smoking and blood pressure.
Found inequalities in health and mortality between differing employment grades, found that risk factors (lifestyle factors) accounted for less than a third of the observed social class health inequality.
The rest was due to perceived inequalities and class differences.
Welsh Adverse Childhood Experiences Study (2015)
Highlights the impact of adverse childhood experiences on individuals developing poor health in later life.
ACEs stressful experiences during childhood that directly harm a child such as abuse, or affect the environment in which they live, such as growing up around abuse.
AO3 to the 4 models of health described by Bartley and Blane.
Behavioural: If you grow up in households with these behaviours, you are more likely to develop them e.g. not knowing how to cook.Is this model just blaming the poor? Ling Et Al (2012) found that MC professionals often displayed problematic drinking patterns but were in denial about it.
Materialist: Government interventions have improved health, e.g. FSM. New Right- Social Class and health differences are natural due to ‘survival of the fittest’.
Psycho-social:
Life-course model: Introducing healthy lifestyles on those who used to have poor health still helps them and their life chances.
University of California about women and drugs (medical)♂ ♀
Study found women are more likely to suffer adverse side effects from medicine than men- because drug doses have always been tested on men rather than both men and women.
Canadian Institutes of Health about clinical research for women.♂ ♀
Trends were improving
From 2015-6, women made up 43% of participants in clinical trials globally.
Women’s Health Research at Yale about clinical research for women.♂ ♀
2015
Drew attention to a study for a drug to be used by women, and 23/25 participants were men.
