INEQUALITIES IN HEALTH

Morbidity and Social Class

• Stark differences in morbidity rates across classes.

• Professional Men

  • Professionals: 17% reported long-standing illness.

  • Unskilled workers: 48% reported long-standing illness.

  • Professionals report lower cases of long-standing illness

• Professional Women

  • Professionals: 25% reported long-standing illness.

  • Unskilled workers: 45% reported long-standing illness.

  • Professional women report lower cases of long-standing illness

Morbidity and Gender

• Women report more illnesses than men.

• Study in seven European countries (1998):

  • Professionals and administrators had a lower prevalence of illness.

  • Skilled and unskilled manual workers had a significantly higher prevalence.

Mortality and Social Class

• Mortality rates tend to be higher in lower social classes.

• For example, even though heart disease was the leading cause of death among men in the 1980’s-90’s, it was still more common among lower class men.

Mortality and Gender

• Illnesses affect genders differently.

• Men are more likely to die from heart disease and prostate cancer.

• Women are more likely to die from breast cancer.

Mortality and Ethnicity

• Afro-Caribbean men are more likely to suffer strokes.

• Asian men are more likely to die from heart disease.

Mortality and Geography

• Countries experiences different causes and rates of deaths.

• Trinidad & Tobago, Cuba, Argentina: Highest cancer mortality rates in the Americas.

• Mexico, Nicaragua, El Salvador: Lowest cancer mortality rates.

Explaining Health Inequalities

Cultural Factors

• Lower classes engage in riskier health behaviors:

  • Higher smoking rates.

  • Poorer diets (more sugar, fat, and processed food).

  • Higher alcohol consumption.

• Critics argue that the poor engage in such behavior as a result of their circumstances and as a coping mechanism.

• Capitalism and inequality prevent the poor from affording healthy lifestyles.

Materialist/Structural Approach

• Based on Marx and Engels’ theories.

• Health is influenced by broader political, economic, and social structures.

• Acknowledges the differences in behavior in the less affluent that results in poor health, but claims that it is not the true reason for the higher rates of illness.

• Instead, it is due to the way in which society is organized to disadvantage certain groups.

Social and Economic Factors Affecting Health

• They point to several factors that cause the poor to experiences greater rates of illnesses and diseases.

1. Residence (Martin et al., 1987)

   • Poor housing conditions increase respiratory diseases.

2. Income (Carstairs & Morris, 1989)

   • Poor diet is often due to financial constraints rather than cultural choices.

   • Doyal & Pennell: Poor cannot afford nutritious food.

   • Food industry prioritizes profits, producing low-quality, high-sugar, and high-salt foods.

3. Cost of Food (Lobstein, 1995)

   • Healthy food is more expensive in poorer areas.

   • Unhealthy food is cheaper in lower-income neighborhoods.

4. Food Retail Structure (Department of Health, 1996; Wrigley, 1998)

   • Small shops have declined, replaced by large supermarkets.

   • Supermarkets are not accessible to the poor due to their location.

5. Workplace and Working Conditions

   • Doyal & Pennell (1979): Factory workers exposed to harmful chemicals and asbestos.

   • Clapp et al. (2005): 12% of cancer deaths are workplace-related.

   • Meldrum et al. (2005): 12-20% of lung disease deaths are workplace-related.

6. Capitalism and Profit-Driven Health Risks

   • Doyal & Pennell: Tobacco companies target lower-income groups through advertising.

   • Smoking is marketed as stress relief, increasing rates among the poor.