How does social inequality impact health | SBS Life
Social environments that are less divisive, less undermining of . The bidirectional relationships between health and both income and wealth suggest the need for more . WLS and the British birth cohorts represent the best of what is currently. Facts, articles and research findings about social inequality in health. to examine whether system-level healthcare interventions, specifically health equity tools, underlying the relationships between diverse types of social factors and their. The evidence for the effect of social inequality on population health and mortality is there is a gradient between social class position (usually measured by occupation, The strength of the relationship raises a host of questions: What are the.
Even after adjusting for job experience and training, blacks are more likely than whites to be exposed to occupational hazards and carcinogens at work Robinson, Hazardous waste sites are more likely to be located in poor, minority urban and rural communities than in other residential areas Bullard, ; Camacho, ; Cole and Foster, ; Commission for Racial Justice, National data reveal that blacks and Hispanics are disadvantaged compared to whites on indicators of both access to ambulatory medical care and the quality of the care received Blendon et al.
Even after adjustment for health insurance and clinical status, whites are more likely than blacks to receive coronary angiography, bypass surgery, angioplasty, hemodialysis, total knee arthroplasty for osteoarthri tis, intensive care for pneumonia, and kidney transplants Giles et al. Subjective Experience of Racism and Stigmatization A small but growing literature indicates that chronic and acute experiences of discrimination in the lives of minority group members is a source of stress adversely affecting their physical and mental health.
Laboratory studies reveal that exposure to discrimination leads to cardiovascular and psychological reactivity Anderson, ; Armstead et al. Negative emotional responses associated with racism, particularly those that are chronic, are also associated with adverse health outcomes Ryff and Singer, in press.
Epidemiological data indicate that at least under some conditions racial discrimination is positively related to blood pressure among African Americans Krieger, ; Krieger and Sidney, Other recent epidemiological studies reveal that perceptions of discrimination are adversely related to other measures of physical and mental health for a broad range of population groups Kessler et al. Two recent studies have found that perceptions of discrimination make an incremental contribution over education and income in accounting for racial differences in self-reported measures of physical health Williams et al.
A stigma of inferiority may create certain expectations, anxieties, and reactions that can affect the motivation, performance, and psychological well-being of some proportion of minority group members Steele, Research across a broad range of societies reveals that socially stigmatized groups score lower on standardized tests Fischer et al.
A minority group member's endorsement of the dominant society's negative stereotype of the minority group may also have health consequences.
Social inequalities in health - NIPH
African Americans who believe that blacks are inferior have higher levels of psychological distress and alcohol use Taylor and Jackson, ; Taylor et al. The National Study of Black Americans shows that African Americans who endorse negative stereotypes of blacks as accurate are more likely to report poorer physical and mental health than those who rejected those stereotypes Williams and Chung, in press.
Inclusion of Discrimination and Stigmatization in Longitudinal Health Studies Longitudinal Health Studies The National Survey of Black Americans Jackson, provides a useful source of measures of alienation that can be linked to self-reported chronic conditions and disease.
Longitudinal data are available for a subsample of this survey, and they provide a basis for constructing pathways to various health outcomes associated with perceived discrimination. The longitudinal assessments in this survey do not compare with those in the British birth cohorts or in WLS. Comparative analyses of the fine-grained assessments of perceived discrimination in African, Hispanic, and Asian subpopulations and its connection to other forms of adverse and compensating psychosocial experience have not been conducted.
Social determinants: how class and wealth affect our health
Although discrimination and stigmatization are associated with a range of negative health outcomes, these features have not been integrated into characterizations of the pathways of adversity and advantage across multiple life domains that lead to specification of how health outcomes come about.
Understanding pathways of resilience in the face of discriminatory challenges will likely contribute important insights into why some do well and others do poorly in the face of persistent challenges. A large proportion of the Hispanic and especially the Asian American populations is foreign born.
The health profile of these groups reflects in part the impact of immigration. However, with increasing length of stay in the United States and adaptation to mainstream behavior, the health status of immigrants declines Vega and Amaro, ; Marmot and Syme, For example, several behaviors that adversely affect health, such as the use of cigarettes and alcohol, have been shown to increase with length of stay and acculturation for Hispanic populations. Thus, it is likely that the health advantages evident for some subgroups of the Asian and Hispanic populations may diminish over time.
Resources The lower levels of suicide for African Americans compared to whites is consistent with other mental health data and reflect a well-documented paradox. Blacks tend to have higher levels of ill health for most measures of physical health and are disadvantaged compared to whites on measures of subjective well-being, such as life satisfaction Hughes and Thomas, At the same time, blacks have comparable or lower rates of psychiatric illness Kessler et al.
Thus, despite disproportionate exposure to a broad range of conditions that are risk factors for mental health problems, blacks do not have higher rates of suicide or higher rates of mental illness than whites.
Strong family ties, religious involvement, and participation in other as yet unspecified cultural resources have been nominated as potential factors that buffer minority populations from at least some of the adverse consequences of social adversity Williams, Research that conceptualizes and operationalizes the specific beliefs and behaviors that may be promotive of health is an important frontier of research on social inequalities and health. Socioeconomic status and health.
The challenge of the gradient. Annals of the New York Academy of Sciences. Socioeconomic status and health in industrialized nations: Social, psychological and biological pathways. Minority proximity to whites in suburbs: An individual-level analysis of segregation. American Journal of Sociology. Evidence for decline in disability and improved health among persons, aged 55 to 70 years: The Framingham Heart Study. American Journal of Public Health. PMC ] [ PubMed: Racial differences in stress-induced cardiovascular reactivity and hypertension: Current status and substantive issues.
Access of Hispanics to health care and cuts in services: Social class, life expectancy and overall mortality. Milbank Memorial Fund Quarterly. Relationship of racial stressors to blood pressure responses and anger expression in black college students. Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease.
British Medical Association Journal. Socioeconomic determinants of mortality in Latin America. Population Bulletin of the United Nations. Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda County residents. American Journal of Epidemiology. Access to medical care for black and white Americans: A matter of continuing concern. Journal of the American Medical Association. Environmental Justice and Communities of Color.
Sierra Club Books; The Role of Social Factors. Kaiser Family Foundation; Maternal care during infancy regulates the development of neural systems mediating the expression of fearfulness in the rat. Environmental Injustices, Political Struggles: Race, Class and the Environment.
Duke University Press; A status report on the health status of Asian Pacific Islander Americans: Comparisons with Healthy People Objectives. From the Ground Up: New York University Press; Commission for Racial Justice.
Toxic Wastes and Race in the United States: United Church of Christ; Health loss due to unobserved morbidity: A design based approach to minimize nonsampling error in active life expectation estimates.
Calculation of Health Expectancies: Harmonization, Consensus Achieved and Future Perspectives. Council on Ethical and Judicial Affairs. Black-white disparities in health care. Rising Inequality in America. Russell Sage Foundation; A household survey of child mortality determinants in Malaysia. Population and Development Review. Oxford University Press; Inequalities in Income and Inequalities in Health: National Bureau of Economic Research; Department of Health and Social Security.
Department of Health and Social Security; Women's reactions to discrimination from members of the same or opposite sex.
Socioeconomic status, health inequalities and non-communicable diseases: a systematic review
Journal of Research in Personality. Personality-based hardiness as a buffer for discrimination-related stress in members of Toronto's Chinese community. Canadian Journal of Behavioural Science. Measuring socioeconomic mortality differentials over time. Effects of early-life conditions on adult mortality: National trends in educational differentials in mortality. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults.
American Journal of Preventive Medicine. Mortality among minority populations in the United States. Cracking the Bell Curve Myth. Princeton University Press; Nongenomic transmission across generations of maternal behavior and stress responses in the rat. Studying Lives Through Time: American Psychological Association; b. Race and sex differences in rates of invasive cardiac procedures in US hospitals: Data from the National Hospital Discharge Survey. Archives of Internal Medicine.
Violence in American cities: Young black males is the answer, but what was the question? Social Science and Medicine. Literacy and health status in developing countries.
Annual Review of Public Health. Twelve-year follow-up of respondents in a sample survey in peninsular Malaysia. University of Wisconsin; The Class of after 35 years: Overview and preliminary findings. A Social Science Perspective. The increased risk for specific psychiatric disorders among persons of low socioeconomic status. However, this relationship is not exempt from methodological problems that may bias the establishment of direct effects between the variables studied.
Thus, further research is necessary to investigate the role of socioeconomic variables, their composition and distribution according to health status, particularly on non-communicable diseases.
Subjects and methods To shed light on this field, here a systematic review is performed using PubMed, the Cochrane Library and Web of Science. A 7-year retrospective horizon was considered until 21 July Results Twenty-six papers were obtained from the database search.
Five of the 26 studies analyzed used aggregated data compared to 21 using individual data. Eleven considered income as a study variable, while 17 analyzed the effect of income inequality on health status 2 of the studies considered both the absolute level and distribution of income. The most used indicator of inequality in the literature was the Gini index.
Conclusion Although different types of analysis produce very different results concerning the role of health determinants, the general conclusion is that income distribution is related to health where it represents a measure of the differences in social class in the society. The effect of income inequality is to increase the gap between social classes or to widen differences in status. A comprehensive approach to health highlights its close relationship with social and economic conditions, the physical environment and individual lifestyles.
This is known as the inverse care law. Anna left school with very few qualifications. Like her economically disadvantaged peers, Anna was always more likely to do poorly in school and to drop out earlier than students in the wider population. These teens grow into adults who have lower incomes and are less empowered to provide for themselves and family. The growth of temporary, part-time and informal work in high-income countries has affected working conditionswith declining job control, financial security and access to paid family leave and flexible working hours.
Anna works in a call centre for a large telecommunications company. Her job involves dealing with customer complaints all day, every day. She has no control over the nature of her work or how it gets done, other than to use the mute button on the call. Anna is financially reliant on her single wage. She cannot afford to buy her own place, which is why she lives at home with her mother. House prices are partly to blame for this social disconnection.
The land value gradient growth in many Australian cities in recent years is reinforcing a very strong social stratification of choice and opportunity for generations to come.
The quality of working conditions is related to mental health.