Inequalities in Health Appraisal
Inequalities in health have many factors but these can be argued against as to whether they are the actual cause. Social class is a factor, along with region, age, gender, ethnicity etc. Measuring the impact of social class is difficult because social classes have changed over the years, eg) working class living conditions have changed, and there is a delay in the onset of diseases, eg) Asbestos related illness. (NICE 2009)
However the Black Reports (1980) finding was that the death rate for men in the lower social classes was twice that for men in the higher social classes, and the gap between the two was increasing not reducing. It also showed that some people in the lower classes were experiencing worse health than in the 1950s, maybe giving evidence that the change in working class living conditions wasn’t such a contributory factor. The report showed that British rates of infant mortality were in some cases higher than those in many developing countries, which doesn’t point towards a class inequality. The Black Report identified four explanations of health inequalities, the artefact explanation, natural or social selection, the cultural/behavioural explanation and materialist or structural explanation. The artefact explanation stated that the relationship between class and health is artificial rather than real, arising either through the inadequate measurement of social class and health, or in the measurement of the relationship between the two. (UCEL 2003) The natural and social explanation involved the idea that health was a cause of social class position rather than a consequence, and that individuals are selected into higher classes, while the weakest go down the social scale to occupy the lowest position. The cultural/behavioural explanation defined culture as a set of specific behaviours (smoking, excessive drinking, unhealthy diet and physical inactivity) which have consequences for health. These behaviours...
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