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Explaining the Social Class-Health Link. Dr Dominic Upton. The four explanations. Artefact Social selection Behavioural/Cultural Materialist. Artefact explanation. . The process by which mortality/morbidity and social class are measured results in an inaccurate representation.

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Presentation Transcript
the four explanations
The four explanations.
  • Artefact
  • Social selection
  • Behavioural/Cultural
  • Materialist
artefact explanation
Artefact explanation.
  • The process by which mortality/morbidity and social class are measured results in an inaccurate representation.
  • No evidence for such a position given the consistency of the findings.
social selection
Social selection.
  • Health determines social class through a process of health-related mobility in which the healthy are more likely to move up the social hierarchy and the unhealthy move down.
  • Some evidence, but unlikely to be the complete picture.
behavioural explanation
Behavioural explanation.
  • Social class differences in behaviours that damage or fail to promote health and, which at least in principle are subject to individual choice.
behavioural explanation6
Behavioural explanation.
  • Suggests that those in social class V smoke more (demonstrated), drink more (evidence variable), exercise less (only in leisure time), and have a poorer diet (probably accurate).
evidence for the behavioural explanation
Evidence for the behavioural explanation.
  • Smoking: Those in social class V smoke more than those in social class I.
  • Exercise: Those in social class I exercise more in their leisure time than those in social class V.
  • Diet: Social class V have worse diet than those in social class I.
  • Alcohol: Worse drinking habits in social class V.
choice and lifestyle
Choice and lifestyle.
  • People smoke, drink and eat poorly because it is easy and relatively cheap way of dealing with stress.
  • Not individual choice, but are forced to because of their lives and circumstances.
how much does lifestyle explain
How much does lifestyle explain?
  • Studies suggest that 25% of the variance is explained by the lifestyle choice differences between the classes.
  • Major explanation must be some other factor.
materialist explanation
Materialist explanation.
  • Hazards which are inherent in society and to which some people have no choice but to be exposed given the present distribution of income and opportunity cause the health inequalities.
  • This is the explanation the Black report favoured.
materialist explanation11
Materialist explanation.
  • Housing.
  • Income.
  • Stresses of living.
other explanations
Other explanations.
  • Cultural compatibility
  • Use of health service
  • Social skills of patient and health care professional
  • Bias and expectations of the health care professional
  • Outcomes of the medical consultation
conclusion
Conclusion.
  • Carroll et al (1996):"The SES-health gradients might be regarded as a key test of the frequently evoked but imperfectly articulated biopsychosocial model of health championed by the newly formalised discipline of health psychology" (p. 36)
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