An Analysis of the Social Gradient of Health in Relation to the Australian Indigenous Population

Topics: Indigenous Australians, Indigenous peoples, Health care Pages: 10 (2818 words) Published: February 12, 2012
An Analysis of the Social Gradient of Health in Relation to the Australian Indigenous population

“The demonstration of a social gradient of health predicts that reducing inequality itself has health benefits for all, not simply for the impoverished or deprived minorities within populations.” (Devitt, Hall & Tsey 2001)

The above quote from Devitt, Hall and Tsey’s paper is a relatively well grounded and well researched statement which draws on contemporary theoretical sociological concepts to support the assertion that reducing inequality is the key to improving health for all. However the assertion that the demonstration of a social gradient of health predicts that a reduction in inequality will lead to health benefits for all is a rather broad statement and requires closer examination. The intention of this essay is to examine the social gradient of health, whose existence has been well established by the Whitehall Studies (Marmot 1991), and, by focusing on those groups at the lower end of the social gradient, determine whether initiatives to address inequalities between social classes will lead to health benefits for those classes at the lower end of the social scale. The effectiveness of past initiatives to address these social and health inequalities will be examined and recommendations made as to how these initiatives might be more effective.

The social gradient described by Marmot and others is interrelated with a variety of environmental, sociopolitical and socioeconomic factors which have been identified as key determinants of health. These determinants interact with each other at a very complex level to impact directly and indirectly on the health status of individuals and groups at all levels of society;

“Poor social and economic circumstances affect health throughout life. People further down the social ladder usually run at least twice the risk of serious illness and premature death of those near the top. Between the top and bottom health standards show a continual social gradient.” (Wilkinson & Marmot 1998)

In Australian society it is readily apparent that the lower social classes are at greater disadvantage than those in the upper echelons of society; this has been discussed at length in several separate papers on the social gradient of health and its effects on disadvantaged Australian groups (Devitt, Hall & Tsey 2001, Robinson 2002, Caldwell & Caldwell 1995).Within the context of the social gradient of health it can be inferred that Indigenous groups, for example, are particularly susceptible to ill health and poor health outcomes as they suffer inordinately from the negative effects of the key determinants of health. A simple example of this is the inequality in distribution of economic resources: “Average Indigenous household income is 38% less than that of non-Indigenous households.” (AHREOC 2004). The stress and anxiety caused by insufficient economic resources leads to increased risk of depression, hypertension and heart disease (Brunner 1997 cited in Henry 2001). Higher social status and greater access to economic resources is concomitant with a reduction in stress and anxiety levels, as individuals in these groups have more control over economic pressures which create this stress. This simple comparison proves that the social gradient of health accurately reflects how socioeconomic determinants affect the health of specific social classes at the physiological level.

An extension of the research into the social gradient and the determinants of health is the examination of the pathways through which specific social groups experience and respond to these determinants. These ‘psychosocial pathways’ incorporate psychological, behavioural and environmental constraints and are closely linked to the determinants of health; “Many of the socio-economic determinants of health have their effects through psychosocial pathways.” (Wilkinson 2001 cited in Robinson 2002). These pathways have been...

References: Brunner, E. 1997. ‘Stress and the Biology of Inequality’. British Medical Journal. No. 314, pp 1472-1476.
Castro, A. 2000. ‘Personal Communication’. No other details available.
Colman, A. 1997. ‘Anti-racism Course’, Youth Studies Australia, Vol. 16, Issue 3, p.9, viewed 22nd August 2005, EBSCOhost Database Academic Search Premier, item: AN 12878155.
Colman, A. & Colman, R. 2003. ‘Education Agreement’, Youth Studies Australia, Vol. 22, Issue 1, p.9, viewed 22nd August 2005, EBSCOhost Database Academic Search Premier, item: AN 9398334.
Dale, G. 1999. ‘Jabby Don’t Smoke, Developing Resources to Address Tobacco Consumption in Remote Aboriginal Communities’, Paper presented to the Eleventh National Health Promotion Conference, Perth. 23-26th May.
Devitt, J., Hall, G., Tsey, K. 2001. ‘An Introduction to the Social Determinants of Health in Relation to the Northern Territory Indigenous Population’, Occasional Paper. Co-operative Research Centre for Aboriginal and Tropical Health. Darwin.
Flick, B., Nelson, B. 1994. ‘Land and Indigenous Health’, Paper No. 3, Native Titles Research Unit, Australian Institute of Aboriginal and Torres Strait Islander Studies, Canberra.
Gilchrist, D. 1998. ‘Smoking Prevalence among Aboriginal Women’, Aboriginal and Islander Health Worker Journal, Vol. 22, No. 4, pp.4-6.
Henry, P. 2001. ‘An Examination of the Pathways through Which Social Class Impacts Health Outcomes’. Academy of Marketing Science Review, vol. 3, pp 1-26.
Ivers, R. 2001. ‘Indigenous Australians and Tobacco; A Literature Review’, Menzies School of Health Research and the Cooperative Research Centre for Aboriginal and Tropical Health, Darwin. pp.67-80, 93-107.
Lawnham, P. 2001. ‘Indigenous Push at UWS’, The Australian, 27th June, 2001. p.34, viewed 22nd August 2005, EBSCOhost Database Academic Search Premier, item: AN 200106061025662941.
Marmot, M.G., Davey Smith, G., Stansfield, S., Patel, C., North, F., Head, J., White, I., Brunner, E. and Feeney, A. 1991. ‘Health Inequalities among British Civil Servants: the Whitehall II Study’, Lancet, 337, 1387. reading 1.5.
Mayer, S. 2001. What Money Can’t Buy: Family Income and Children’s Life Chances. Harvard University Press, Cambridge, Massachusetts.
National Tobacco Campaign. 1999. ‘Australia’s National Tobacco Campaign: Evaluation report Volume 1’. Commonwealth Department of Health and Aged Care, Canberra.
Nganampa Health Council. 2005. Nganampa Health Council, Alice Springs. Viewed 23rd August 2005,
Pamuk, E., Makuc, D., Heck, K., Reubin, C., Lochner, K
Price, R., & McComb, J. 1998. ‘NT and Australian Capital Cities Market Basket Survey 1998’. Food and Nutrition Update, THS, Vol. 6, pp.4-5.
Robinson, G. 2002. ‘Social Determinants of Indigenous Health’, Seminar Series, Menzies School of Health Research. Co-operative Centre for Aboriginal Health.
Valadian, M. 1999. ‘Distance Education for Indigenous Minorities in Developing Communities’, Higher Education in Europe, Vol. 24, Issue 2, p.233, viewed 22nd August 2005, EBSCOhost Database Academic Search Premier, item: AN 6693114.
Henry, 2001.
Continue Reading

Please join StudyMode to read the full document

You May Also Find These Documents Helpful

  • Indigenous Health Essay
  • Population health Essay
  • Evaluation Studies on Tobacco Smoking Health Promotion Programs for the Indigenous Australian Population Essay
  • Essay about Health Disadvantages Indigenous Australians
  • Essay about Primary Health Care
  • Essay about Indigenous Australians and Torres Strait Islanders
  • Legislation, policies and procedures in relation to health and social care Essay
  • health and social Essay

Become a StudyMode Member

Sign Up - It's Free