HadSoc Session 3

Question 1

How is individual SES measured?

Answer 1

Census data –> complex calculation –> NS-SEC group 1-8

Question 2

How is the SES of an individual measured by geographical residential area?

Answer 2

Census data–> 7 domains –> index of multiple deprivation

Question 3

What are the 8 NS-SEC groups?

Answer 3

1: higher managerial and professional
2: lower managerial and professional
3: intermediate
4: small employers and own account holders
5: lower supervisory and technical
6: semi-routine
7: routine
8: long term unemployed/never worked

Question 4

What is seen in health trends as you move from higher to lower SES?

Answer 4

Increase in self-reported poor health, infant mortality and a decrease in both life expectancy and healthy life expectancy

Question 5

What are the effects of deprivation on health?

Answer 5

More deprived –> larger proportion of life in health and more likely to die younger

Question 6

What provides evidence for explanations regarding inequalities in health?

Answer 6

Census data, Black report, Acheson report, Whitehall studies, Marmot report

Question 7

What are the Whitehall studies?

Answer 7

Long-running cohort studies of civil servants investigating health, risk factors and job

Question 8

What is the artefact explanation?

Answer 8

That health inequalities are due to the way statistics are collected e.g. Self reported occupation promoted in comparison to occupation recorded at death

Question 9

What are the limitations of the artefact explanation?

Answer 9

Mostly discredited as if anything data collection leads to an underestimate of inequalities

Question 10

What is the social selection explanation for health inequalities?

Answer 10

Direct cause between health and social position as sick individuals move down groups but healthy can move up

Question 11

What are the limitations of the social selection exactions of inequalities in health?

Answer 11

Studies suggest it only makes a minor contribution and a higher proportion of people with slowly progressive diseases are not seen in the lower classes as would be expected

Question 12

What is the behavioural-cultural explanation for health inequalities?

Answer 12

Ill health is due to people’s choices/decisions, knowledge and goals

Question 13

What pattern supports the behavioural-cultural explanation for health inequalities?

Answer 13

People from disadvantaged backgrounds tend to engage in more health-damaging behaviours and people from advantaged backgrounds are more likely to engage in health-promoting behaviours

Question 14

What does the behavioural-cultural explanation provide an opportunity for?

Answer 14

Health education

Question 15

What are the limitations of the bean behavioural-cultural explanation of health inequality?

Answer 15

Doesn’t have a SES components which affects behaviours by social pressures, creating adverse conditions or providing environment in which behaviour is rational

Question 16

What is the danger with using the behavioural-cultural explanation for health inequality?

Answer 16

Can lead to victim blaming

Question 17

Which is the most plausible explanation for health inequality?

Answer 17

Materialist

Question 18

What is the materialist explanation for health inequality?

Answer 18

Inequalities in health arise from differential access to material resources - low income etc lead to lack of choice in exposure to hazards and adverse conditions –> accumulation of factors across life course

Question 19

What is the limitation with the materialist explanation for health inequality?

Answer 19

More research is needed to find the precise routes through which material deprivation –> ill health

Question 20

Which explanations for health inequality arose from the Black Report?

Answer 20

Artefact, social selection, behavioural-cultural and materialist

Question 21

What is the psychosocial explanation for inequality in health?

Answer 21

Psychocial pathways act in addition to direct effects of material living standards as there is a social gradient of psychosocial factors

Question 22

How does the distribution of some stressors on a social gradient lead to poor health?

Answer 22

Stress impacts directly (physiological and immune effects) and indirectly (health-related behaviours, mental health)

Question 23

What is the income distribution explanation for health inequality?

Answer 23

Relative income affects health therefore countries with greater income inequities have greater health inequalities so the most egalitarian, not richest societies have the best overall health

Question 24

Why does greater income inequality lead to higher levels of stress and thus poorer health?

Answer 24

Increases social evaluative threat due to threats to status and feeling devalued

Question 25

What is the difference between inequality and inequity?

Answer 25

Inequality= things are different, inequity= unfair and avoidable inequalities

Question 26

Is it possible to have inequality without inequity?

Answer 26

Yes e.g. matching resources to population

Question 27

How are inequities in access to healthcare measured?

Answer 27

Utilisation studies

Question 28

What is the limitation of measuring inequities in healthcare access?

Answer 28

Doesn’t measure lack of access through lack of knowledge/individual barriers

Question 29

What do studies in inequities in access to healthcare show?

Answer 29

Deprived groups seem to have higher use of GP and emergency services and lower use of preventative measures and specialist services

Question 30

What is the explanation behind the higher rates of GP and emergency service use in more deprived groups?

Answer 30

Manage health as a series of crises, normalise ill health, reluctant to assume ‘ill’ role, need event-based consulting for legitimisation, difficulty marshalling resources for access, lack of cultural alignment between services and lower SES and tendency to use more ‘porous’ services

Question 31

What is the health of each individual related to?

Answer 31

SES, constraints in which they live, ethnicity, gender and age

Question 32

What are the general trends seen in gender inequalities in health?

Answer 32

Males have higher mortality rate with more suicide and more violent deaths. Females have a higher life expectancy but higher reported poor mental health and higher rates of disability and limiting long-standing illness

Question 33

How do gender and sex cause diversity and inequality in health?

Answer 33

Gender: social factors such as roles, social norms, discrimination and interaction with HCPs
Sex:biological factors such as hormonal and reproductive differences

Question 34

What factors interplay in diversity and inequality in health?

Answer 34

SE context and factors, ethnicity, culture, access, genetic/biological factors, life course, cumulative factors (inc migration), risk, exposure, protective factors, response and recognition and healthcare quality and quantity

Question 35

How can health be measured?

Answer 35

Mortality, life expectancy, hospital records, ONS surveys and self-report surveys