Sociological factors leading to class-based health inequality
Social Institutions refers to groups of persons who have come together with a common goal. The major social institutions influencing people include: religion, family, economic, education and political. A class can be defined as a sociological indicator of unequal distribution of power and wealth across social structure. On the other hand, health inequalities can be defined as avoidable and unjust differences across the population which affect people? health. This paper will describe the influence of social institutions on class-based health inequalities. Firstly, the paper will describe the sociological factors leading to class-based health inequality. Secondly, the paper will discuss how sociological class model influence class-based health inequality. Thirdly, the paper will describe sociological theories related to class-based health inequalities. Finally, there will be an explanation on how to end sociological class-based health inequality.
Sociological factors such as political, economic, and social factors have an influence on the distribution of illness and health. This focuses on how poor working and living conditions particularly inadequate nutrition, housing, employment opportunities, lack of education, discrimination and poverty directly influence illness. Class analysis is used to address health inequalities by analyzing the roles played by unemployment and employment. Employment may have both negative and positive impact on health depending on the nature of employment. Those employee working in the mining industry have high occupational morbidity and mortality rates due to high risks associated with their work. Unemployment also has health consequences among them high rates of chronic illness. Class analysis and structural approaches can be used to describe how prescription of policy based on social factors for example welfare measure to address the promotion of health-inducing work, improve workplace safety and poverty. Lack of social capital and psychosocial factors are linked to increased class-based health inequality in developing countries (Layte & Whelan, 2014).
Social capital refers to networks and social relations that exist among communities and social groups and provide access to opportunities and resources for mutual benefits. Social capital depends on an expectation of reciprocity, trust, altruism and the level of community participation. Access to social capital improves health outcome through the provision of social interaction and lowering stress through democratic participation in community life (Tester, 2013).
According to Kirkpatrick (2016), social capital is not a property of an individual but rather a community property. It involves both the community and state interplay by fostering anxiety and insecurity. Majority of studies have not addressed the influence of social capital though union involvement is a collective action and is evidence of democratic participation and social cohesion in community life. Social capital as a sociological factor has an influence on class-based health inequality by focusing on capital as a prerequisite for unemployment and poverty in the community. Access to social institutions for example education, social services, and employment opportunities provide better conditions of health-enhancing environments and social capital.
The social gradient of health focuses on psychosocial factors and incomes inequality. Increased levels of depression, anger, insecurity, anxiety, and stress in the community are associated with widening income inequality. This negatively impacts health outcomes among both those who experience the inequalities and the poor in the community. According to the social gradient of health, level up of employment improves health standards according to public service hierarchy. The social gradient of health affect all levels of people regardless of their class. This includes white collar workers, relatively well-paid workers and the poor are all affected by the social gradient of health. Even though there is a health gap between the poor and the wealthy, there is a graded relationship between each step up and health on socioeconomic hierarchy thereby health standards improving the higher you go along social hierarchy (Theodossiou & Zangelidis, 2009).
Influence of sociological class model on health inequality
Health inequality among social classes focuses particularly on socioeconomically disadvantaged groups. People´s health gradually deteriorates as you go down the social hierarchy. This means that every social class has a different health status and the higher you go across the class, the better the health standards. Class-based health inequalities are linked to poorer health regardless of employment status. Both the working class and poor all experience health inequality across social hierarchy (Vallgårda, 2008).
Social style of life reinforced and associated with the class is characterized by the behavior of people within the community and their impact on health outcomes. Working class individuals are associated with some health-related behaviors such as smoking. There is a complex interrelationship between behavior, social structure, and culture. This results in a close link between ill health or health inequality and class among social groups (Eckersley, 2015).
The sociological analysis focuses on factors that reproduce and produce class differences. There are three class models which are based on Weberian and Marxist consisting of working class, middle class, and upper class. Among the characteristics which define these classes include; wage labor, qualifications, ownership of marketable skills, scarce economic resources control and ownership.
Upper Class: This is a sociological class model referring to those individuals who manage and own economic resources for example workspaces, technology, and raw materials. Individuals in this class are assumed to have high incomes thereby being in a position to control how work is carried out and work.
Middle Class: Individuals in a middle class are considered to possess some skills and qualifications which enable them to get better working conditions and earn higher wages compared to unskilled workers. Example of people in this group includes self-employed individuals, small business owners, teachers, and health professionals.
Working Class: This group of individuals consists of non manual and manual unskilled workers who earn their income from selling their labour power.
The concept of the class model is used to reflect on the real life situation where people share the same working and living conditions. Among indicators used to identify class inequality among the population is wealth distribution among social classes which may include household wealth.
In the sociological analysis, the class is used in shaping individual access to social rewards, for example, health, education, employment, behaviors, and beliefs.
Classification of class model results into a relationship between poor health and manual occupation. This results in high morbidity and mortality rate among disadvantaged groups due to assumed behaviors or lifestyle. This may include behaviors such as obesity, overweight, and smoking. The disadvantaged groups end up being victims of their behaviors because they might not afford health services as a result of low-income status.
Health inequalities among social classes can be grouped into five major groups; psychosocial, materialist, cultural, natural and artefact (Dahl & Malmberg-Heimonen, 2010).
Artefact explanation. In this group of health inequalities, the link between health and class is artificial which is a result of an inability to make a correct measurement of social phenomena. Artefact explanation of class-based health inequality addresses the assumption where healthcare and class are measured in social research and explains that methods of measurement can influence either positive or negative on the size of health inequality from the research.
Sociological theories related to class-based health inequalities
Natural explanations. This explanation states that health and social inequalities came as a result of biological inferiority. The explanation affirms the existence of class and health inequality but assumes that inequality is inevitable and natural which means that there is nothing which can be done about it. According to the explanation, poor occupational achievement and educational performance are associated with poor health early in life.
This explanation defines health inequality by determining related behaviors such as poor dietary intake, excessive alcohol consumption, drug taking and smoking which are considered the primary cause of illness. The explanation further states that assumption individual behavior of social processes, social relations, ignoring social the context and social vacuum affect their lives. Among conditions which affect individual health and is outside individual control includes working environment and stress. According to the explanation, individual exposure to risky environments influence their behaviors which end up having an impact on their general health (David, 2010).
This explanation focuses on the role of political, economic and social factors in determining the distribution of illness and health within society. The main focus of this explanation is to explain how poor living conditions, lack of education, discrimination, employment opportunities, and poverty is influence health directly. The explanation explains the role played by unemployment and employment when addressing health inequalities among society. Those people who work in a better working environment will be less likely to expose themselves to work-related hazards, unlike those people who provide manual labor and work in the unsafe environment leading to their exposure to work-related hazards such as injuries which end up affecting their health negatively (Polyakov, 2014).
According to this explanation, increased levels of depression, insecurity, anger, anxiety, and stress are associated with unemployment which thereby affects health negatively. The explanation suggests that health continued across occupational hierarchy leading to health inequality which affects both those who are well paid and those in poverty. But the explanation also suggests that as you go up the social hierarchy, people? health improves while when you go down the hierarchy health status reduces within the social classes (Piaget, Smith & Brown, 2011).
According to this theory, biological inferiority leads to health and social inequalities. The theory explains the relationship between health and class but assumes the cause of inequality is natural thereby being inevitable. Furthermore, occupational achievement and poor educational performance result in poor health status among people in early life leading to social and health inequality. Poverty causes social disadvantage leading to health inequality among people (Marciano & Koppl, 2009).
According to this theory, social isolation, poor housing, unemployment, and poverty leads to social disadvantage among people or groups within society. Social exclusion maybe as a result of a criminal record or disability which leads to negative social reactions. This prevents the disadvantaged people from participating in political processes and social institutions (Freedman, Williams & Beer, 2016).
Conclusion
To help reduce social class based health inequality, there is a need for individual strengthening through health education to give people more knowledge on health risks associated with their behaviors. Knowledge of poor health behaviors can help people in societies to understand how simple health risks can be prevented to avoid spending more on treatment. Health education can also address the need for community members to identify environmental health hazards which can cause harm to them especially among people who are living in poor areas.
Improvement of both working and living conditions through preventive services, affordable recreation facilities, nutritious food, and safer workplaces can also help in reducing social inequalities through making these services affordable to all people regardless of their income status or employment status. Better working and living conditions help in reducing infectious diseases like communicable diseases which affect people who stay in over populated areas. Provision of safe housing and improved workplace preventive equipment can help in reducing diseases and injuries.
Finally, there should be an encouragement on cultural change and macroeconomic through income maintenance especially for people in poverty state. Training and education programs can be initiated to encourage income-generating activities among all people to reduce on poverty rate which increases the risk of health illnesses. Income redistributions can also help in reducing social class inequalities through a fair taxation policy among the social classes and income rate.
References
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David, M. (2010). Methods of interpretive sociology. Australia: SAGE.
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Theodossiou, I., & Zangelidis, A. (2009). The social gradient in health: The effect of absolute income and subjective social status assessment on the individual’s health in Europe. Economics & Human Biology, 7(2), 229-237. doi: 10.1016/j.ehb.2009.05.001
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