“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
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, http://www.nganampahealth.com.au/products.php 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. [pic] Henry, 2001.