Social Class, Status, Privilege, Poverty and Privilege

3 Most Accepted Material/Social Resource Based Measures

Income/Wealth, Educational Credentials, Occupation

Prestige-Based Access to Goods, Services and Knowledge based measures of SES

Home ownership/Housing Type/Condition

Access to Healthcare

Neighborhood disadvantage/Geographic Area, Built Environment

What is Involved in Allyship

connecting families with resources, addressing social care needs, and showing respect

Effects of Low SES: Physical health

BMI, frailty, allostatic load, arthritis.

Effects of Low SES: Cardiovascular Health

High blood pressure, cardiac mortality.

Effects of low SES: mental health

Suicide attempts, alcohol misuse, psychological wellbeing

Effects of low SES: Oral health

Dental Caries(tooth decay or cavities)

What is Socioeconomic Status?

A measure of one’s combined economic and social status, including both resource-based and prestige-based measures.

Defining Privilege

The unearned social power, advantages, entitlements, dominance, and benefits made available to certain groups by formal and informal institutions.

Disrespectful Maternity Care

ignoring patient concerns, biased assumptions, or lacking cultural competence

Barriers to Care for Low-SES Patients

Financial Barriers(uninsured, high copays, etc)

Unemployment

Living Conditions

Limited Resources

Respectful Communication with Low-Income Families

Self-awareness of biases and assumptions

Speak respectfully and avoid accusations/assumptions

Don’t be judgmental or tell clients how and what to feel

Ask open-ended questions and ask for permission to share information.

Structural Interventions in Poor Communities

Connecting families with financial, social, and/or educational community resources (e.g., using Findhelp.org by inputting zip codes to address social care needs).

Factors Impacting Health of Poor Children in Poor Families

Family and social environment

Physical Environment

Economic Circumstances

Access to healthcare

Factors Impacting Health of Poor Children in Poor Families: Family and Social Environment

Stress, chaos, adverse childhood experiences (ACEs), abuse/neglect.

Factors Impacting Health of Poor Children in Poor Families: Physical Environment

Lead, air pollution, contaminated water, smoke, crime, overcrowding

Factors Impacting Health of Poor Children in Poor Families: Economic Circumstances

Poverty, food/housing insecurity, lack of health insurance

Factors Impacting Health of Poor Children in Poor Families: Healthcare access

Transportation barriers, expense of traveling, reliance on ER visits.

Social Class Definition

A social group or positioning in a social hierarchy based on having access to material and social resources that afford power and status; fluid and intersecting with other identities.

Social Class Resources

Education, financial assets, occupation, neighborhood safety, quality of schools, family socialization, gyms, parks

Social Class power

Ability to influence others.

Social Class esteem

Esteem or respect given by others.

Economic Instability (SDOH)

Low income levels, employment status, high housing costs, food insecurity/hunger, work-related injuries, and poverty status.

Educational Access and Quality (SDOH)

Low educational level, low high school completion/graduation rates, low college attendance, poor literacy/health literacy, poor math skills, and no access to early intervention.

Adverse Childhood Experiences (ACEs)

Events during childhood resulting in physical/emotional trauma (abuse, household substance abuse, poverty, caregiver mental health conditions, witnessing domestic violence, or family instability).

Low SES Health Behaviors

Associated with early smoking, high-energy-dense food, low physical activity, and drug abuse

High SES health behaviors

Associated with fruit/vegetable consumption, regular breakfast, and dairy products.

The Role of the Nurse (Low SES)

Primary, secondary, and tertiary Prevention actions

Primary prevention in Low SES

Assess needs for assessment and education

Secondary prevention in low SES

Screenings and inspections

Tertiary prevention in low SES

Eliminate barriers to healthy behaviors, encourage early intervention, vaccinations, handwashing, and growth/development tracking.

Social Disadvantage

A state of low income, limited education, poor living conditions, or limited social support.

How Privilege is Unearned

Born into a rich higher social/or economic class with structural and systematic advantages in wealth, property, and inheritances granted based on social class/status.