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Class and Health

Class and Health. Chapter 6. Main points. There are enduring differences between social classes in relation to health. In terms of early mortality, morbidity and a range of other health indicators, disadvantaged groups have considerably poorer outcomes than advantaged groups.

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Class and Health

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  1. Class and Health Chapter 6

  2. Main points • There are enduring differences between social classes in relation to health. • In terms of early mortality, morbidity and a range of other health indicators, disadvantaged groups have considerably poorer outcomes than advantaged groups. • Substantial relative poverty is prevalent in the UK, with high levels of child poverty in many areas. • The psycho-social perspective highlights how societies lacking in social cohesion have poor health, while the neo-material perspective emphasises access to resources.

  3. What is class? • Class is more than, for example, accent or modes of dress. • Class refers to dynamic power relationships between people and control over various resources. • Class societies exhibit greater fluidity (mobility) than feudal or caste societies.

  4. Trends in health inequality • A class I man can expect to live seven years longer than a man in class V (ONS 2004: 79). • Generally, people in the lower social classes can expect to encounter more illness, disability, chronic illness and early death than those in the higher social classes.

  5. The class and health gradient

  6. Selected causes of early mortality

  7. Absolute poverty Seeing poverty in terms of the absolute basics of food, shelter and clothing that are required to sustain life. Relative poverty Seeing poverty as having sufficient resources to participate in a given society at a given time. Types of poverty

  8. Eating on a low income (JRF 1994) • Cost of food more important than other factors. • Inability to buy items in bulk. • ‘Bad’ food choices for children as a way to economise. • Fragmentary knowledge of food issues. • Advice on healthy eating considered infeasible.

  9. Psycho-social explanations • Associated with Wilkinson (1996). • Once a society reaches a certain material level it is relative differences that are critical in determining health. • Negative emotional responses pass through biological pathways, leading to poor health.

  10. Roseto, Pennsylvannia, USA. Mid-1930s deaths from heart disease were 40% lower than elsewhere. Diet, smoking and exercise not factors. Strong social cohesion appears to be the most likely explanation. Roseto (Wilkinson 1996)

  11. Neo-material explanations. • Critical of psycho-social explanations. • Emphasise that deeper structural factors are important. • Access to resources, such as housing, food and education makes a substantial difference to health. • Political ideologies, particularly neo-liberalism, greatly increase poverty and inequality.

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