Transcript Health Inequalities

The Cause of
Health Inequalities
The Black Report
(1980)
This was ground-breaking in that it
identified a clear gap in health
between the social classes.
How might economic
inequality affect health?
In groups create a detailed mind-map
demonstrating the ways in which
economics might affect health and why.
Poverty, Social
Class & Health
Growing up in Scotland report:
Poverty breeds ill-health
See Next Slide
http://www.heraldscotland.com/growing-up-in-scotland-report-poverty-breeds-ill-health1.900474
 Four-year-olds in deprived areas are more likely to
have poor diets and be less active.
 It showed 41% of children in poor areas had eaten a
takeaway in the past week, compared with 23% of
children in affluent areas.
 It also showed that children who were breastfed
generally had good health.
 Mothers with more qualifications and affluent
backgrounds were more likely to breastfeed their
children.
The above is a summary of the main points in the article.
Social Class
Equally Well: Report of the
Ministerial Task Force on Health
Inequalities
http://www.scotland.gov.uk/Publications/2008/06/25104032/0
Social Class- Diet
There is now a higher degree of obesity in Scotland than
anywhere except Mexico and the US. (The Herald 13
August 2010).
http://news.bbc.co.uk/1/hi/health/8412796.stm
Increase in junk food?
Decrease in physical activity?
What social classes are most affected?
Summarise this
article
 Summarise the main statistics from the
following article:
http://news.bbc.co.uk/1/hi/scotland/8384429.stm
Social Class Alcohol
An increase in drinking among
middle-age and older groups.
Stressful jobs?
Can afford to do it?
Scots 'drink 46 bottles of vodka'
http://news.bbc.co.uk/1/hi/8463333.stm
 Adults in Scotland are drinking the equivalent of 46
bottles of vodka each in a year, a study has
suggested.
 People in Scotland drank 25% more alcohol per
head of population than individuals in England and
Wales, the figures suggested.
http://www.heraldscotland.com/scots-eighth-on-alcohol-consumptionworld-league-table-1.903359
Social Class Smoking
Smoking is seen by many as a ‘coping mechanism’, a little
pleasure in what may be a thoroughly depressing
existence. That might explain why the lower social classes
tend to smoke more than the professional classes. The
irony is, they are the ones who can’t really afford to
smoke. This could tie in with the high proportion of
Bangladeshi men who smoke as they are also the most
deprived ethnic group.
Clearly, the number of people smoking is
declining, however, the lower social
classes are still far more likely to smoke.
Smoking accounts for almost a quarter of all deaths in
Scotland.
In 2005, 52% of adults aged 25-49 with
no qualifications smoked compared with
16% amongst those with a Degree.
Social Class –
Increased Wealth
Rich, fatty foods.
Ability to eat out more often – no control over calorie
count
Social Class –
Lifestyle Choices
Do you choose to eat McDonald’s
and take-aways more/less often
because of your social status?
The Acheson Report
(1998)
‘They were unhealthy. They did not live as long
and they suffered more from lung cancer,
coronary heart disease, strokes, suicide and
violent accidents than their richer peers. These
inequalities had steadily worsened over the
preceding twenty years. They were more likely
to have their cars stolen and their homes
vandalised. They ate less iron, calcium, dietary
fibre and vitamin C. They were fatter’.
Geography – Life
Expectancy
Calton & Lenzie
http://www.youtube.com/watch?v=-icKkIO2HCw
Separated by only a few miles, Calton and
Lenzie could not be any further apart.
With a life expectancy gap of 28 years,
what has caused this?
Consider some of the other factors we’re
looking at – they all apply.
http://news.scotsman.com/glasgow/-If-you-are-born.4439094.jp
http://www.bbc.co.uk/learningzone/clips/lifestyle-choices/5079.html
Video Clip
Geography –
Lifestyle Choices
Alcohol Consumption Drug Use Diet Exercise – is gym membership now a
‘middle-class’ hobby?
Geography Unemployment
Clearly, certain parts of the country have
been affected quite significantly by the
recession and unemployment. There’s a
link between unemployment and health.
http://www.tuc.org.uk/economy/tuc-17402-f0.pdf
See Next Slide
The Social Exclusion Task Force evidence includes
research that shows problems in all these areas:
 Unemployment increases the risk of marital dissolution by 70%.
 Studies in a number of countries have shown that losing one’s job
can trigger problem drinking for 1 in 5 men and 2 in 5 women.
 The evidence of a link between unemployment and suicide is
particularly strong.
 The Samaritans have described emotional health issues as the
“hidden face” of the recession and at the end of 2008 warned that
“the deepening financial and economic crises could lead to an
increase in suicide rates nationwide as people face
unemployment, mounting debt and housing insecurity.
http://www.tuc.org.uk/economy/tuc-17402-f0.pdf
Geography –
Access to healthy
food
Deprived areas tend to be
dominated by poor quality shops
that lack fruit and vegetables
and often supply low cost ‘ready
meals’ that are high in calories,
saturated fats and salt.
Geography Healthcare Provision
Access to healthcare is not the same throughout the
country. The term ‘postcode lottery’ refers to restricted
access to certain treatments depending upon where you
live. For example, access to the cancer drug Avastin.
Also, access to health services such as a Doctor’s or
Dentist’s Surgery may not be close enough and transport
could be an issue.
Where you live can have a huge impact on the level of healthcare
provision you receive. The term ‘Postcode Lottery’ refers to the
availability of certain treatments dependent on where you live.
The table below demonstrates how cancer survival rates
fluctuate throughout the UK in 2010.
http://www.dailymail.co.uk/health/article-1288282/Map-UK-cancer-survivors-shows-record-numbers-Britons-living-disease.html
Age
Clearly, the elderly are more likely to encounter
health problems, than those significantly
younger than them.
What illnesses/health issues would we typically
associate with age?
Age and Smoking
Smoking rates
tend to decrease
with age
Race
What role does race play in terms of
health?
 Increased risk of rickets
http://news.bbc.co.uk/1/hi/health/8570542.stm
 Black Caribbean men have a much higher risk of
stroke
 The publication, Ethnic Differences in Cardiovascular Disease
2010, reports that 27% of deaths in men born in South Asia and
living in the UK are from heart disease, compared with 18% in
men born in the UK.
 in 2005, infant mortality in both the
Pakistani and Caribbean groups was twice
that of the White British group.
 Asian and Black ethnic groups accounted
for over 11 per cent of live births in
England and Wales in 2005, and 17 per
cent of infant deaths.
 Babies in the Pakistani and Caribbean groups had particularly
high infant mortality rates, 9.6 and 9.8 deaths per 1,000 live births
respectively. This was double the rate in the White British group of
4.5 deaths per 1,000 live births.
Race - Smoking
Smoking amongst ethnic minorities is higher
than it is amongst whites and there may be a
cultural aspect to this. On average, around 22%
of White people smoke in the UK.
http://info.cancerresearchuk.org/cancerstats/types/lung/smoking/
Smoking amongst ethnic minorities is higher
than it is amongst whites and there may be a
cultural aspect to this. On average, around 22%
of White people smoke in the UK.
Race - Alcohol
Most minority ethnic groups have higher rates of abstinence and
lower levels of drinking compared to people from white
backgrounds.
Abstinence is high amongst South Asians, particularly
those from Pakistani, Bangladeshi and Muslim
backgrounds. But Pakistani and Muslim men who do drink
do so more heavily than other non-white minority ethnic
and religious groups.
People from Indian, Chinese, Irish and Pakistani
backgrounds on higher incomes tend to drink above
recommended limits.
http://www.jrf.org.uk/sites/files/jrf/ethnicity-alcohol-literature-review-summary.pdf
Race - Poverty
We already know there’s a clear link
between race and poverty. What impact
does poverty have on health?
Video Clip
http://www.bbc.co.uk/learningzone/clips/summary-of-health-inequalities-in-theuk/5080.html
Gender – Life
Expectancy
Life expectancy of women in the UK is 82 and
men 78. Is this because men currently at this
age are more likely to have worked longer and in
more physically demanding jobs. Many women
would not have worked in order to look after their
family, although this is changing.
Can you think of any physically demanding jobs
that men would do that women are less likely to?
Gender – Alcohol
An increase in drinking amongst women
This may be a result of increased advertising, more
women working and increased independence.
The proportion of women who binge-drink almost
doubled between 1998 and 2006
Video Clip
http://www.bbc.co.uk/learningzone/clips/alcohol-and-binge-drinking-the-harmfuleffects/6028.html
http://www.jrf.org.uk/media-centre/alcohol-trends-in-britain
Men do drink more than women
However, women are more likely to ‘binge
drink’ in the younger age group.
Gender – Men Less Likely
to Consult Doctor
Men are less likely to consult a doctor than women.
Why?
Pride
Ignorance
Embarassment
Culturally unacceptable