Download Inequalities in Health (class)

SOCIOLOGY - HEALTH
Inequalities and Health
Different groups of people in society have different patterns of
health and illness.
Sociology researches into the inequalities of the chances of
becoming ill and the subsequent healthcare that may
follow.
Culture and lifestyle can have an important impact on people’s
chances of illness or good health.
Sociologists have researched into those chances.
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SOCIOLOGY - HEALTH
Inequalities and Health
‘Health chances’ are the chances that an individual has of having
good health and hence a long life, or becoming ill and
consequently dying at an earlier age than would have been
expected.
There are two ways to measure health chances.
>Mortality statistics
>Morbidity statistics.
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SOCIOLOGY - HEALTH
Inequalities and Health
Mortality statistics
and
Morbidity statistics
What are
mortality
statistics?
These are the statistics
that measure death
rates.
They can be calculated
for different age groups
and can indicate how
many deaths are
expected per thousand
of the population in a
particular social group.
What are morbidity
statistics?
These are the
statistics that
measure the rates of
illness. For
example, how many
people are suffering
from coronary
heart disease in
various social
groups.
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Sociology – Health

Socio-economic class has been linked to health
inequalities for many years.
Sociology - Health

Edwin Chadwick published his ‘General Report
on the Sanitary conditions of the Labouring
Population of Great Britain’ in 1842.
Sociology – Health

This showed that the
average age at death
in Liverpool at that
time was 35 for gentry
and professionals but
only 15 for labourers
mechanics and
servants.
Sociology – Health

Although life expectancy has improved for all
classes in Britain since this time, inequalities
have remained.
SOCIOLOGY - HEALTH
Inequalities and Health
The Black Report (1980)
linked social class to
health.
It provided evidence that
health chances are not
equally distributed
throughout society.
At all ages, lower
social class
appeared to be a
determining factor
in mortality rates.
The lower the social
class, the higher the
death rate.
The health gap
appears to widen as
the years progress –
this is in spite of
the provision of the
NHS and care
within the
community.
Class appeared to be the
key to better health in this
report.
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SOCIOLOGY - HEALTH
Inequalities and Health
The Acheson Report
(1997)
.The UN’s World
Health Organisation
Report (2014)
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Sociology – Health

There are significant
differences in life
expectancy of at
least _____ years
between different
groups in society.
• Annually, some ____
deaths among people
younger than 65 could be
prevented if inequalities
in wealth narrowed to
1983 levels.
Sociology - Health

A boy from Lenzie, an affluent area in East
Dumbartonshire could expect to live up to ___
years longer than a boy from Calton, a
deprived area in Glasgow.
Sociology – Health
Sociology - Health


"It's not surprising that we see more cases of
heart disease, stroke, diabetes, asthma and
bronchitis than areas like Lenzie. “
Dr Jamieson said the reasons behind the deeprooted health problems in Calton were
numerous and complex but poverty played a
major part.
Sociology - Health

"The area also has serious problems with gang
and knife culture, and of course drug and
alcohol abuse, which are colossal contributors
to early death."
Sociology – Health
WHO's Commission on the Social Determinants of
Health
• A baby girl born in Leeds is more than twice as
likely to die in the first year of life than an infant
girl growing up in a Dorset town
Social class & mortality…
• Children from poorer backgrounds are __
times more likely to die from an accident
then better off children.
• A person born in social class 1 lives, on
average, about __ years longer than
someone in social class 5.
• About __% more babies are stillborn or die
in the first week of life in unskilled families
than in professional families.
Social class & morbidity…
• Working class people or the unskilled go
to the doctor more often than those in
professional jobs.
• There are clear differences in selfassessed health by occupation. __% of
higher managerial/professionals see
themselves as having good health while
only __% of the long term
unemployed/never worked groups see
themselves in good health.
• Social class differences are clear not only
in physical health but also in terms of
mental health.
• Those in the lowest social class are __x as
likely to suffer from a neurotic disorder as
those in the highest social class.
Health inequalities & social
class
• Despite significant improvements in health
there has been little reduction in the
“health gap” between the rich and the poor
since the 1800’s.
• The poor die younger than the rich and will
have more diseases and illnesses.
Life expectancy at birth for men and women by social class England and Wales
2002–5
Source: Office for National Statistics 2007, licensed under the Open Government License v3.0.
• Bridgend 19%
• Neath 23%
• Swansea
East 30%
• Aberavon 31%
What are the reasons for
inequalities in health …
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Determinants of health
SOCIOLOGY - HEALTH
Cultural and
behavioural
explanations
Inequalities and Health
The Black Report (1980) examined four
possible explanations of health inequalities.
Social
selection
explanation
Artefact
explanation
Structural and material
explanations
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SOCIOLOGY - HEALTH
Inequalities and Health
The social selection explanation
Let’s look at the four
explanations included
in the Black Report.
What is the social
selection explanation?
This is the view that social class
and health are related.
Illness is caused by low income
and poverty.
Healthy people are likely to be
more successful in life precisely
because they were healthy and
attended school.
They will be upwardly sociably
mobile and less likely to become
unemployed.
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SOCIOLOGY - HEALTH
Inequalities and Health
The artefact explanation
Let’s look at the four
explanations included in
the Black Report.
Some sociologists do not accept that
there is a correlation between health
and social class.
What is the artefact
explanation?
Statistical comparisons are seen to
exaggerate the extent of inequality
between those who are in poor health
(the working class) and the middle
class (who have better health).
Unskilled manual workers were an
older cohort in the report so this could
explain their poorer health.
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SOCIOLOGY - HEALTH
Inequalities and Health
Cultural and behavioural explanations
Let’s look at the four
explanations included in
the Black Report.
What are cultural and
behavioural explanations?
Disease is linked to the behaviour of
people in different classes.
Working class people have worse
health because they undertake healthdamaging behaviour, such as smoking,
drinking alcohol or eating high-fat
foods. Lack of exercise is a feature too.
There is also the argument that
culture influences health-damaging
behaviour.
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SOCIOLOGY - HEALTH
Inequalities and Health
Structural and material explanations
Let’s look at the four
explanations included in
the Black Report.
Social inequality and material
inequality are seen as the causes of
health inequalities, according to
Townsend in the Black Report.
What are structural and
material explanations?
Unemployment, poor housing or
homelessness, poor working
conditions, polluted or dangerous
working conditions can all affect
health.
Stress, respiratory disease and
working conditions can all influence
health adversely.
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Explain how the following material factors
could lead to ill-health:
• Long working hours
• Dangerous working environment
• Damp housing
• Low income
• Stress
SOCIOLOGY - HEALTH
Inequalities and Health
How do different social
groups use the health
services?
According to research, the
social class with the worst
health, the working class,
benefit less from the
health services.
The middle classes
use a wider range of
health care services.
However, research
has shown that
lower classes are
more likely to
become ill than the
middle class.
In 1979, the
Inequalities of Health
report showed that
poor health could be
attributed to poverty.
Poor housing, lack of
money and a lack of
knowledge were the
main contributing
factors, it concluded,
to poor health.
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SOCIOLOGY - HEALTH
Inequalities and Health
How do different social
groups use the health
services?
According to research, the
social class with the worst
health, the working class,
benefit less from the
health services.
The middle classes
use a wider range of
health care services.
They are also more
likely to have a
longer consultation
with the doctor and
ask for and receive
more information
about their medical
problem.
They are also
inclined to ask for a
second opinion, if
they are not
satisfied with the
first.
The middle classes
make more use of
preventative
measures and
screening.
Why?
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SOCIOLOGY - HEALTH
Inequalities and Health
How do different social
groups use the health
services?
According to research, the
social class with the worst
health, the working class,
benefit less from the
health services.
The middle classes can also use private
health schemes to deal with health
issues.
This will inevitably change their
relationship with their doctor because
they then become more like a paying
customer.
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SOCIOLOGY - HEALTH
In conclusion
• there are many inequalities in the health
status of individuals depending on class.
• There are also a variety of reasons put
forward for the differences in the statistics
of different groups.
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