Health and Social Class

Health and social class, from a sociological perspective, refers to the idea that there are inequalities in morbidity and mortality among upper and lower social classes. These health inequalities suggests not only neutral health differences between different social classes, but also implies that for the most part social class inequalities in health are artificial, undesirable, and avoidable. Therefore, it appears that many health inequalities in modern societies can be considered to be unfair [ Lahelma, Eero. "Health and Social Class." Blackwell Encyclopedia of Sociology. Ritzer, George (ed). Blackwell Publishing, 2007. Blackwell Reference Online. 31 March 2008 http://www.blackwellreference.com.libproxy.lib.unc.edu/subscriber/tocnode?id=g9781405124331_chunk_g978140512433114_ss1-18 ] .

ocioeconomic Indicators

Inequalities in social classes for morbidity and mortality exist for occupational class and other important socioeconomic indicators, for instance educational attainment, individual and household income, and wealth are essential socioeconomic indicators. For the most part, these inequalities follow a hierarchical pattern, referred to as the health inequalities invariance. The health inequalities invariance implies the idea that the lower the social class, the poorer the health. For instance, Americans living under the federal poverty line suffer 54,000 excess deaths per year (about the same number of deaths as automobile accidents); but if the threshold for comparison is changed to the wealthiest 20% of Americans versus the bottom 80% of Americans, this difference increases to 361,000 annual deaths (more than any other presently known risk factor). [ Muennig P, Franks P, Jia H, Lubetkin E, Gold MR. The income-associated burden of disease in the United States. Social Science & Medicine 2005;61(9):2018-26 ] Each socioeconomic indicator represents general and particular parts of what makes up the concept of social class. Thus, socioeconomic indicators cannot be ranked according to the impact they have on social class inequalities in health. Moreover, a person’s social class becomes more easily defined through out there life, because education is accomplished first, which contributes to occupational class, and together these two factors contribute to income. As a result, multiple socioeconomic factors form the overall social class inequalities in health, together [ Lahelma, Eero. "Health and Social Class." Blackwell Encyclopedia of Sociology. Ritzer, George (ed). Blackwell Publishing, 2007. Blackwell Reference Online. 31 March 2008 http://www.blackwellreference.com.libproxy.lib.unc.edu/subscriber/tocnode?id=g9781405124331_chunk_g978140512433114_ss1-18 ] .

Causes Contributing to Health Inequalities between Social Classes

In addition, to the evidence provided for social class inequalities in morbidity and mortality, there are also many causes that contribute to health inequalities. The main causes of health inequalities include selection and social mobility, early and adult living conditions, health behaviors, and health care [ Lahelma, Eero. "Health and Social Class." Blackwell Encyclopedia of Sociology. Ritzer, George (ed). Blackwell Publishing, 2007. Blackwell Reference Online. 31 March 2008 http://www.blackwellreference.com.libproxy.lib.unc.edu/subscriber/tocnode?id=g9781405124331_chunk_g978140512433114_ss1-18 ] .

Social mobility health can directly or indirectly contribute to social class positions. In addition, the natural selection explanation assumes that people are taken into particular social classes based on their inherited health, thus making some health inequalities unpreventable. The social selection explanation assumes that some social factors, for example parental social class, may factor into a person’s health and social class. Social selection may also add to the production of health inequalities, such as a disabled person being discriminated in the labor market, causing him/her to descend down the social ladder [ Lahelma, Eero. "Health and Social Class." Blackwell Encyclopedia of Sociology. Ritzer, George (ed). Blackwell Publishing, 2007. Blackwell Reference Online. 31 March 2008 http://www.blackwellreference.com.libproxy.lib.unc.edu/subscriber/tocnode?id=g9781405124331_chunk_g978140512433114_ss1-18 ] .

Poor living conditions as a child may also have consequences for later life health inequalities. For instance, the effects of a child living in poverty, both through material living conditions and psychological living conditions, may play a role in causing adult health inequalities. Also, poor living conditions as an adult, such as poor housing, poor work conditions, and a lack of resources, can cause health inequalities between social classes. Furthermore, poor psychological living conditions as an adult, for instance stress and having limited social contacts and support, can also cause health inequalities among social classes [ Lahelma, Eero. "Health and Social Class." Blackwell Encyclopedia of Sociology. Ritzer, George (ed). Blackwell Publishing, 2007. Blackwell Reference Online. 31 March 2008 http://www.blackwellreference.com.libproxy.lib.unc.edu/subscriber/tocnode?id=g9781405124331_chunk_g978140512433114_ss1-18 ] .

Poor health behaviors among the lower social class cause health inequalities. These types of poor health behaviors include smoking, excessive drinking, not exercising, and an unhealthy diet. Smoking in particular is an important health-compromising behavior that probably accounts for a large part of inequalities in morbidity and mortality [ Lahelma, Eero. "Health and Social Class." Blackwell Encyclopedia of Sociology. Ritzer, George (ed). Blackwell Publishing, 2007. Blackwell Reference Online. 31 March 2008 http://www.blackwellreference.com.libproxy.lib.unc.edu/subscriber/tocnode?id=g9781405124331_chunk_g978140512433114_ss1-18 ] .

Health care is viewed by many sociologists to play a minor role in creating health inequalities between social classes. However, there have been instances when treatments are unequally distributed among patients, which therefore indicate it may play a role in adding to health inequalities [ Lahelma, Eero. "Health and Social Class." Blackwell Encyclopedia of Sociology. Ritzer, George (ed). Blackwell Publishing, 2007. Blackwell Reference Online. 31 March 2008 http://www.blackwellreference.com.libproxy.lib.unc.edu/subscriber/tocnode?id=g9781405124331_chunk_g978140512433114_ss1-18 ] .

For more information, you could also read "The Status Syndrome" by Micheal Marmot.

Reducing Social Inequalities in Health

There are some topics that need to be addressed in order to reduce social inequalities in health. First, although poverty is a cause of health inequalities, we need to stop associating poverty with social class. Accidents also cause health inequalities, because accidents at home and the workplace tend to occur more in the lower class. Therefore, safety at home and work needs to be addressed, in addition to risk taking behavior. Also, attitudes need to be changed. This is because lower class people need to behave in ways that benefit them, not the way their peers or certain celebrities do. This can best be exemplified by despite their friends and celebrities smoking, they do not ["Health and Social Class." Patient Plus. 4 Aug. 2006. 31 Mar. 2008 ] .

Reducing social class inequalities in health still remains largely an open question. However there are even more steps that can be made. Because health inequalities are deeply inherent, prevention of health inequalities should be initiated early in life. Through promoting equality in society, for instance encouraging equal opportunities for education, more resources will most likely be made available for lower classes, including more equality in health. Health and welfare policies need to be created to encourage these ideas. In addition, there needs to be more promoting, especially among the lower classes, for better living and working conditions. Members of the lower classes also need to improve their health behaviors. Furthermore, there needs to be less discrimination against people with poor health and disabilities, in order to reduce health inequalities between upper and lower classes [ Lahelma, Eero. "Health and Social Class." Blackwell Encyclopedia of Sociology. Ritzer, George (ed). Blackwell Publishing, 2007. Blackwell Reference Online. 31 March 2008 http://www.blackwellreference.com.libproxy.lib.unc.edu/subscriber/tocnode?id=g9781405124331_chunk_g978140512433114_ss1-18 ] .

ee also

*Health Disparities
*Morbidity
*Mortality
*Social Mobility
*Social Status
*Poverty
*Socioeconomic status
*Inequality in disease

References

Further reading

(1) "Health and Social Class." Patient Plus. 4 Aug. 2006. 31 Mar. 2008 .

(2) Lahelma, Eero. "Health and Social Class." Blackwell Encyclopedia of Sociology. Ritzer, George (ed). Blackwell Publishing, 2007. Blackwell Reference Online. 31 March 2008 http://www.blackwellreference.com.libproxy.lib.unc.edu/subscriber/tocnode?id=g9781405124331_chunk_g978140512433114_ss1-18