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Health Inequalities Causes of health inequalities


Health Inequalities

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Geographical Inequalities Social Class Inequalities Gender Inequalities Ethnic Inequalities Age Inequalities Role of Lifestyle What do all of these terms refer to?


Geography ∗ North South Divide ∗ Male death rates due to Heart Disease: England 309; Scotland 382 ∗ Prevalence of health conditions higher: e.g. Female diabetes: England 57; Wales 62; Scotland 89 ? Why do you think that there is a north/south divide in health? ? Web links http://satfat.notlong.com (per 100000 pop)

(per 100000 pop)

 http://news.bbc.co.uk/1/hi/health/6033023.stm


The Health Profile of England 2007 ∗ Some excerpts from this report:

In this image, Northern England is shown as blue, The Midlands as green, and Southern England and East Anglia as yellow

∗ 25.1 per cent of adults in the North East are binge drinkers, compared to 15.4 per cent in London; ∗ 23.9 per cent of adults in the North East are obese, compared to 19.2 per cent in the South West. The most obese region is the East Midlands (25.1 per cent); ∗ 17.3 per cent of people in the North East are income deprived, compared with 8.4 per cent of those in the South East; ∗ The North East has the highest rates in England for early death from cancer and deaths from smoking-related diseases; ∗ The proportion of men in the North East who think their health is "not good" is almost double that in the South East; ∗ The under-18 conception rate is highest in the North East, at 51.2 per 1,000 girls compared with 33.6 per 1,000 in the East of England and the South East ∗ "There is a consistent north/south divide, with poorer health in the north of England in comparison to the south in almost all cases," the report states. Source: Telegraph 22 Oct 2007


Geography to blame? ∗ Does geography CAUSE health inequalities? ∗ Drumchapel and Bearsden (Cupar and Cowdenbeath): Close areas but big health differences. ∗ Is expenditure lower in the north? (No. England's NHS spends less and has fewer staff per capita than the health services in the devolved countries. Scotland has the highest rates of doctors and nurses in the UK, but maintains the worst levels of health.)

∗ There ARE geographical patterns to health inequalities, but geography doesn’t CAUSE health inequalities. ? If Geography is NOT to blame, what causes inequalities in health between the north and the south?


Mr Smythe and Mr Jones ∗ Mr Smythe is a financial director. Mrs Smythe is expecting their 3rd child. ∗ They live in a pleasant suburb ∗ They own their own home, in an area populated with similar professional people. ∗ Many recreational amenities, good schools and a new health centre. ∗ They have a healthy diet ∗ They use preventative health services more than the Joneses

∗ Mr Jones is an unskilled labourer. Mrs Jones works as a cleaner. ∗ They live in a high rise flat in the middle of the city. ∗ Few play areas and parks. ∗ GP is over-subscribed with patients. ∗ Mrs Jones has poorer diet than Mrs Smythe, and she is twice as likely to die in childbirth. ∗ Mrs J’s children are more likely to be involved in serious accidents including road traffic accidents. ∗ The Joneses are more likely to consult a GP after the onset of illness rather than to have gone for preventative medical screening.


Poverty and the North South Health Gap ∗ 42,000 fewer people would die each year if the death rate for manual workers was the same for the death rate for non-manual workers. ∗ People from deprived urban areas are far more likely to smoke and to suffer poor health, asthma, obesity and high blood pressure. ∗ Bearsden is wealthy and Drumchapel is not. ∗ Average life expectancy of a male in Calton Ward Glasgow is 53.9 years. See weblink:  http://www.guardian.co.uk/society/2006/jan/21/health.politics

? Does geography or poverty explain the differences between rich and poor areas such as Bearsden and Drumchapel? Take notes.  Your notes could use the following headings:    

What is the north south divide Evidence of the north south divide Health variation between regions Health variation within regions


Age Factors ∗ The elderly tend to need most health care. ∗ The older you get the more health care you need. ∗ This doesn’t mean that all of the elderly are ‘unhealthy’. ∗ Read pages 37-38 of Health and wealth inequalities  Weblinks:  http://news.bbc.co.uk/1/hi/uk/4043187.stm

 Take notes as you read. You could use the following headings for your notes:  Extent of good/poor health and longstanding illness/disability in the elderly  The health Gradient

What can the elderly expect in later life?


Ethnic Factors ∗ Some health conditions are more likely to affect particular ethnic groups. ∗ Sickle cell disease, for example, is much more common in Black people than other groups. ∗ Read bottom of page 38 to page 41 of H&W booklet.  Take notes as you read. Suggested headings:      

Population as a whole Bangladeshis Indians Pakistanis Black Caribbean Chinese

 Weblinks:  http://www.guardian.co.uk/society/2004/feb/06/me ntalhealth.politics (Claims that minorities are poorly served by the NHS).


Gender Factors ∗ ∗ ∗ ∗ ∗ ? ∗

Women live longer Experience poorer health 14% women have restricted activity compared to 11% men Smoking rates among young women – lung cancer Women more likely to live in poverty Why are women more likely to experience poverty? Read from the bottom of page 41 to p.43 of Health and Wealth inequalities booklet.  Weblinks:

 http://www.bbc.co.uk/health/womens_health/  http://www.liv.ac.uk/lstm/hsr/GG-5.html#2.2 (Skim read relevant sections)  http://www.staff.city.ac.uk/apryce/gender.htm  http://www.eldis.org/go/topics/resource-guides/health/gender-andhealth

 Take notes as you go. Suggested headings:  Biological health differences  Use of medical services by gender


Lifestyle Factors ∗ Obesity ∗ Diet ∗ Exercise ∗ Smoking ∗ Drinking and Drug use ∗ Sexual health ? Are these factors to blame for the differences in health outcomes? ? Are these individual choices or is there a social cause? ? Is there a link between these factors and poverty? ? Read pages 44-47 ? Search the web for relevant resources ? Take notes as you read. Suggested headings: ? Alcohol consumption ? Smoking ? Drug use ? Diet ? Sexual health and pregnancy


Summary ∗ Many factors can affect a person’s health: ∗ Lifestyle factors (smoking, diet, etc) ∗ Age ∗ Gender ∗ Ethnicity ∗ Geography ∗ Social class

Inequalities in health and wealth  

Health wealth inequalities UK