Book contents
- Frontmatter
- Contents
- List of tables and figures
- Foreword
- Acknowledgements
- Glossary
- Dedication
- 1 Introduction
- 2 The health gap
- 3 Explaining the gap
- 4 The widening gap
- 5 Narrowing the gap – the policy debate
- References
- Appendix A Premature mortality, poverty and avoidable deaths for each Parliamentary Constituency in Britain by Member of Parliament and their Party 1991-95
- Appendix B Technical details for estimating numbers living in poverty
- Appendix C Does the spatial distribution of social class explain geographical inequalities in health?
- Index
3 - Explaining the gap
Published online by Cambridge University Press: 05 July 2022
- Frontmatter
- Contents
- List of tables and figures
- Foreword
- Acknowledgements
- Glossary
- Dedication
- 1 Introduction
- 2 The health gap
- 3 Explaining the gap
- 4 The widening gap
- 5 Narrowing the gap – the policy debate
- References
- Appendix A Premature mortality, poverty and avoidable deaths for each Parliamentary Constituency in Britain by Member of Parliament and their Party 1991-95
- Appendix B Technical details for estimating numbers living in poverty
- Appendix C Does the spatial distribution of social class explain geographical inequalities in health?
- Index
Summary
Summary
• Social circumstances across the entire life-course – from birth through to late adulthood – influence people’s health and wellbeing.
• The characteristics of the areas in which people live, as well as their individual characteristics, influence their health.
• Health differentials are primarily related to the lifetime material well-being of social groups, not to the psychological effects of position within hierarchies.
• Different socio-economic indicators – income, wealth, educational attainment and occupational group – are all related to and help explain people’s health status.
• Educational attainment, as an indicator of socio-economic position, is primarily related to health through the advantages it gives people in their later socio-economic trajectories, not simply because education encourages healthy behaviours.
• Health inequalities are produced by the clustering of disadvantage – in opportunity, material circumstances and behaviours related to health – across people’s lives.
• Health-related behaviours – such as smoking and diet – are strongly influenced by the social environment in which people live. People do not have equal choices about how they live their lives.
• Increasing inequalities in health over recent decades reflect the increasing polarisation of life chances – of opportunities, of material circumstances and of behaviours related to health.
• Reducing health inequalities requires that the underlying causes of these inequalities are tackled.
Introduction
Chapter 2 demonstrated the existence of large inequalities in health within Britain and Chapter 4 will show that these inequalities are increasing. This is true for both sexes, for different age groups and for morbidity as well as mortality. Chapter 5 will also show that there are inequalities in the provision and uptake of some medical services. There are large and often increasing inequalities in the many factors which could underlie observed health differentials, ranging from income, threat of unemployment and unfavourable characteristics of residential areas, through to cigarette smoking. However, simply demonstrating that there are strong associations does not prove causal links. In this chapter, a more analytical approach is used to investigate (to the extent that this is currently possible) the causes of inequalities in health.
One way to begin to understand which aspects of the social environment produce inequalities in health is to explore which indicators of socio-economic position are the key measures which differentiate between people at different levels of risk of ill-health and death. Socioeconomic circumstances across the entire life-course – from infancy to old age – are of importance.
- Type
- Chapter
- Information
- The Widening GapHealth Inequalities and Policy in Britain, pp. 65 - 106Publisher: Bristol University PressPrint publication year: 1999