Flashcards in Session 3 - Inequalities in Health Deck (21):
Give ---- factors which effect health
What is social class?
A segment of the population, distinguished from others by similarities in labour market position and property relations
Give four different measurements of socioeconomic status
Give two example measures of individual socioeconomic classification
Regitrar general scheme
National statistic socio-economic classification
What is an area beased measure of socioeconomic status?
Townsend deprivation score
What is the townsend depriviation score?
o Census data
o 4 variables
o Limitations include heterogeneity and transient populations
The identification with a social group – membership of a collectivity – on the basis of shared values, beliefs, customs, traditions, language and lifestyles.
Give four health factors associated with ethnicitiy
o Highest percentage prevalence in men of South Asian origin
o Lower prevalence in Black Minority Ethnic (BME) groups
o Infant Mortality
o Higher rates in women of Pakistani and Black Caribbean origin
o Mental Health
o People from Black Minority Ethnic (BME) groups are more likely to be diagnosed with mental illness
o Highest reported percentage of poor mental health is in women of Pakistani and Black Caribbean origin
Compare three things about the life expectancies and health of men and women
Men - Higher mortality Women - Higher life expectancy
Men - More suicide and violent death Women - More mental health issues
Women - Higher rates of disability
Give four theories for health inequality as outline by the black report
Social selection explanation
Behavioural - Cultural explanation
What is an artefact explanation?
o Health inequalities are evident due to the way statistics are collected (measurement of class)
o Concern about the quality of data and method of measurement
o Mostly discredited as an explanation, as if anything data problems lead to under, not over estimation of inequalities.
What is a social selection explanation?
o Direction of causation is from health to social position
o Sick individuals move down social hierarchy, health individuals move up
o Chronically ill and disabled people are more likely to be disadvantaged
o Plausible explanation but contribution only minor
What is a behavioural-cultural explanation?
o Ill health is due to people’s choices/decisions, knowledge and goals
o People from disadvantaged background tend to engage in health-damaging behaviours, where people from advantaged backgrounds tend to engage in health-promoting behaviours.
o Useful explanation – e.g. Health Education
o Limitations of Behavioural-Cultural Explanation
Behaviours are outcomes of social processes, not simply individual choice
Choice may be difficult to exercise in adverse conditions
Choice may be ration for those whose lives are constrained by their lack of resources
What is a materialist explanation?
o Inequalities in health arise from differential access to material resources
o Low income, unemployment, work environments, low control over job, poor housing conditions
o Lack of choice in exposure to hazards and adverse conditions
o Accumulation of factors across life-course
o Most Plausible
o Limitations of Materialist Explanation
o Further research needed as to precise routes through which material deprivation causes ill-health
Which is the most powerful of the four black report explanations?
When things are different
Inequalities that are unfair and avoidable
Give two features of the healthcare of more deprived groups?
o Lower rates of use of Preventive (e.g. screening, asthma) and Specialist Services (e.g. cancer treatments)
Outline how low socioeconomic status can affect access to healthcare
o Tendency to manage health as a series of crises
o Normalisation of ill health
o Event-based consulting may be required to legitimise consultations
o Difficulty marshalling the resources needed for negotiation and engagement with health services
o Tendency to use more ‘porous’ services
o Doctor’s judgements of technical and social eligibility affects referrals and offers
Outline how being a member of an ethnic minority afffects access to healthcare
o Higher use of primary care (some groups)
o Higher use of mental health consultations (South African Female Elders)
o Lower receipt of specialist services
o Variations between and within ethnic groups; be careful to avoid simplistic classifications
o Language and Social Networks may deter help-seeking
o Stigmatisation and Stereotyping
o Association between ethnicity and socioeconomic status