The Cause of The Cause of Health Inequalities Health Inequalities

The Black Report The Black Report (1980)(1980)This was ground-breaking in that it This was ground-breaking in that it identified a clear gap in health identified a clear gap in health between the social classes.between the social classes.

How might economic How might economic inequality affect health?inequality affect health?

In groups create a detailed mind-map In groups create a detailed mind-map demonstrating the ways in which demonstrating the ways in which economics might affect health and why.economics might affect health and why.

Poverty, Social Poverty, Social Class & HealthClass & HealthGrowing up in Scotland report: Growing up in Scotland report: Poverty breeds ill-healthPoverty breeds ill-health

http://www.heraldscotland.com/growing-up-in-scotland-report-poverty-breeds-ill-health-1.900474

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Four-year-olds in deprived areas are more likely to Four-year-olds in deprived areas are more likely to have poor diets and be less active. have poor diets and be less active.

It showed 41% of children in poor areas had eaten a It showed 41% of children in poor areas had eaten a takeaway in the past week, compared with 23% of takeaway in the past week, compared with 23% of children in affluent areas. children in affluent areas.

It also showed that children who were breastfed It also showed that children who were breastfed generally had good health.generally had good health.

Mothers with more qualifications and affluent Mothers with more qualifications and affluent backgrounds were more likely to breastfeed their backgrounds were more likely to breastfeed their children.children.

The above is a summary of the main points in the article.The above is a summary of the main points in the article.

Social ClassSocial Class

Equally Well: Report of the Equally Well: Report of the Ministerial Task Force on Health Ministerial Task Force on Health InequalitiesInequalities

http://www.scotland.gov.uk/Publications/2008/06/25104032/0

Social Class- DietSocial Class- Diet

There is now a higher degree of obesity in Scotland than There is now a higher degree of obesity in Scotland than anywhere except Mexico and the US.anywhere except Mexico and the US. (The Herald 13 (The Herald 13 August 2010).August 2010).

http://news.bbc.co.uk/1/hi/health/8412796.stmhttp://news.bbc.co.uk/1/hi/health/8412796.stm

Increase in junk food?Increase in junk food?

Decrease in physical activity?Decrease in physical activity?

What social classes are most affected?What social classes are most affected?

Summarise this article

Summarise the main statistics from the Summarise the main statistics from the following article:following article:

http://news.bbc.co.uk/1/hi/scotland/8384429.stmhttp://news.bbc.co.uk/1/hi/scotland/8384429.stm

Social Class - Social Class - AlcoholAlcoholAn increase in drinking among An increase in drinking among middle-age and older groups. middle-age and older groups.

Stressful jobs?Stressful jobs?

Can afford to do it?Can afford to do it?

Scots 'drink 46 bottles of Scots 'drink 46 bottles of vodka'vodka'

http://news.bbc.co.uk/1/hi/8463333.stmhttp://news.bbc.co.uk/1/hi/8463333.stm Adults in Scotland are drinking the equivalent of 46 Adults in Scotland are drinking the equivalent of 46

bottles of vodka each in a year, a study has bottles of vodka each in a year, a study has suggested.suggested.

People in Scotland drank 25% more alcohol per People in Scotland drank 25% more alcohol per head of population than individuals in England and head of population than individuals in England and Wales, the figures suggested.Wales, the figures suggested.

http://www.heraldscotland.com/scots-eighth-on-alcohol-consumption-http://www.heraldscotland.com/scots-eighth-on-alcohol-consumption-world-league-table-1.903359world-league-table-1.903359

Social Class - Social Class - SmokingSmokingSmoking is seen by many as a ‘coping mechanism’, a little Smoking is seen by many as a ‘coping mechanism’, a little pleasure in what may be a thoroughly depressing pleasure in what may be a thoroughly depressing existence. That might explain why the lower social classes existence. That might explain why the lower social classes tend to smoke more than the professional classes. The tend to smoke more than the professional classes. The irony is, they are the ones who can’t really afford to irony is, they are the ones who can’t really afford to smoke. This could tie in with the high proportion of smoke. This could tie in with the high proportion of Bangladeshi men who smoke as they are also the most Bangladeshi men who smoke as they are also the most deprived ethnic group.deprived ethnic group.

Clearly, the number of people smoking Clearly, the number of people smoking is declining, however, the lower social is declining, however, the lower social classes are still far more likely to classes are still far more likely to smoke.smoke.

Smoking accounts for almost a quarter of all deaths in Scotland.

In 2005, 52% of adults aged 25-49 with In 2005, 52% of adults aged 25-49 with no qualifications smoked compared with no qualifications smoked compared with 16% amongst those with a Degree.16% amongst those with a Degree.

Social Class – Social Class – Increased WealthIncreased WealthRich, fatty foods.Rich, fatty foods.Ability to eat out more often – no control over calorie Ability to eat out more often – no control over calorie count count

Social Class – Social Class – Lifestyle ChoicesLifestyle ChoicesDo you choose to eat McDonald’s Do you choose to eat McDonald’s and take-aways more/less often and take-aways more/less often because of your social status?because of your social status?

The Acheson Report The Acheson Report (1998)(1998)

‘‘They were unhealthy. They did not live as long They were unhealthy. They did not live as long and they suffered more from lung cancer, and they suffered more from lung cancer, coronary heart disease, strokes, suicide and coronary heart disease, strokes, suicide and violent accidents than their richer peers. These violent accidents than their richer peers. These inequalities had steadily worsened over the inequalities had steadily worsened over the preceding twenty years. They were more likely preceding twenty years. They were more likely to have their cars stolen and their homes to have their cars stolen and their homes vandalised. They ate less iron, calcium, dietary vandalised. They ate less iron, calcium, dietary fibre and vitamin C. They were fatter’.fibre and vitamin C. They were fatter’.

Geography – Life Geography – Life ExpectancyExpectancy

Calton & LenzieCalton & Lenzie

http://www.youtube.com/watch?v=-icKkIO2HCw

Separated by only a few miles, Calton and Separated by only a few miles, Calton and Lenzie could not be any further apart. Lenzie could not be any further apart. With a life expectancy gap of 28 years, With a life expectancy gap of 28 years, what has caused this?what has caused this?

Consider some of the other factors we’re Consider some of the other factors we’re looking at – they all apply.looking at – they all apply.

http://news.scotsman.com/glasgow/-If-you-are-born.4439094.jp

Geography – Geography – Lifestyle ChoicesLifestyle ChoicesAlcohol Consumption - Alcohol Consumption - Drug Use -Drug Use -Diet - Diet - Exercise – is gym membership now a Exercise – is gym membership now a ‘middle-class’ hobby?‘middle-class’ hobby?

http://www.bbc.co.uk/learningzone/clips/lifestyle-choices/5079.html

Video Clip

Geography - Geography - UnemploymentUnemploymentClearly, certain parts of the country have Clearly, certain parts of the country have been affected quite significantly by the been affected quite significantly by the recession and unemployment. There’s a recession and unemployment. There’s a link between unemployment and health.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 – Geography – Access to healthy Access to healthy foodfoodDeprived areas tend to be Deprived areas tend to be dominated by poor quality shops dominated by poor quality shops that lack fruit and vegetables that lack fruit and vegetables and often supply low cost ‘ready and often supply low cost ‘ready meals’ that are high in calories, meals’ that are high in calories, saturated fats and salt.saturated fats and salt.

Geography - Geography - Healthcare ProvisionHealthcare Provision

Access to healthcare is not the same throughout the Access to healthcare is not the same throughout the country. The term ‘postcode lottery’ refers to restricted country. The term ‘postcode lottery’ refers to restricted access to certain treatments depending upon where you access to certain treatments depending upon where you live. For example, access to the cancer drug Avastin.live. For example, access to the cancer drug Avastin.

Also, access to health services such as a Doctor’s or Also, access to health services such as a Doctor’s or Dentist’s Surgery may not be close enough and transport Dentist’s Surgery may not be close enough and transport could be an issue.could be an issue.

Where you live can have a huge impact on the level of Where you live can have a huge impact on the level of healthcare provision you receive. The term ‘Postcode Lottery’ healthcare provision you receive. The term ‘Postcode Lottery’ refers to the availability of certain treatments dependent on refers to the availability of certain treatments dependent on where you live. The table below demonstrates how cancer where you live. The table below demonstrates how cancer survival rates fluctuate throughout the UK in 2010.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

AgeAge

Clearly, the elderly are more likely to encounter Clearly, the elderly are more likely to encounter health problems, than those significantly health problems, than those significantly younger than them.younger than them.

What illnesses/health issues would we typically What illnesses/health issues would we typically associate with age? associate with age?

Age and SmokingAge and Smoking

Smoking rates Smoking rates tend to decrease tend to decrease with agewith age

RaceRace

What role does race play in terms of What role does race play in terms of health?health?

Increased risk of ricketsIncreased risk of ricketshttp://news.bbc.co.uk/1/hi/health/8570542.stmhttp://news.bbc.co.uk/1/hi/health/8570542.stm

Black Caribbean men have a much higher risk of Black Caribbean men have a much higher risk of strokestroke

The publication, The publication, Ethnic Differences in Cardiovascular Disease Ethnic Differences in Cardiovascular Disease 20102010, reports that 27% of deaths in men born in South Asia and , reports that 27% of deaths in men born in South Asia and living in the UK are from heart disease, compared with 18% in living in the UK are from heart disease, compared with 18% in men born in the UK. 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 - SmokingRace - Smoking

http://info.cancerresearchuk.org/cancerstats/types/lung/smoking/

Smoking amongst ethnic minorities is higher Smoking amongst ethnic minorities is higher than it is amongst whites and there may be a than it is amongst whites and there may be a cultural aspect to this. On average, around 22% cultural aspect to this. On average, around 22% of White people smoke in the UK.of White people smoke in the UK.

Smoking amongst ethnic minorities is higher Smoking amongst ethnic minorities is higher than it is amongst whites and there may be a than it is amongst whites and there may be a cultural aspect to this. On average, around cultural aspect to this. On average, around 22% of White people smoke in the UK.22% of White people smoke in the UK.

Race - AlcoholRace - 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 - PovertyRace - Poverty

We already know there’s a clear link We already know there’s a clear link between race and poverty. What impact between race and poverty. What impact does poverty have on health?does poverty have on health?

http://www.bbc.co.uk/learningzone/clips/summary-of-health-inequalities-in-the-uk/5080.html

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Gender – Life Gender – Life ExpectancyExpectancyLife expectancy of women in the UK is 82 and Life expectancy of women in the UK is 82 and men 78. Is this because men currently at this men 78. Is this because men currently at this age are more likely to have worked longer and in age are more likely to have worked longer and in more physically demanding jobs. Many women more physically demanding jobs. Many women would not have worked in order to look after their would not have worked in order to look after their family, although this is changing.family, although this is changing.Can you think of any physically demanding jobs Can you think of any physically demanding jobs that men would do that women are less likely to?that men would do that women are less likely to?

Gender – AlcoholGender – AlcoholAn increase in drinking amongst womenAn increase in drinking amongst women

This may be a result of increased advertising, more This may be a result of increased advertising, more women working and increased independence.women working and increased independence.

The proportion of women who binge-drink almost The proportion of women who binge-drink almost doubled between 1998 and 2006doubled between 1998 and 2006

http://www.jrf.org.uk/media-centre/alcohol-trends-in-britain

http://www.bbc.co.uk/learningzone/clips/alcohol-and-binge-drinking-the-harmful-effects/6028.html

Video Clip

Men do drink more than Men do drink more than womenwomen

However, women are more likely to However, women are more likely to ‘binge drink’ in the younger age group.‘binge drink’ in the younger age group.

Gender – Men Less Likely Gender – Men Less Likely to Consult Doctorto Consult Doctor

Men are less likely to consult a doctor than women. Men are less likely to consult a doctor than women. Why?Why?

PridePrideIgnoranceIgnoranceEmbarassmentEmbarassmentCulturally unacceptableCulturally unacceptable