SOCIAL ETHNIC

Social gradients in health Will tell you why I think we don’t fully understand this intersection at the moment. Almost always social gradients in health; except some illness like allergic diseases. All over the world, various indicators of SES. socioeconomic status

Social gradients in health Except: study Bhopal indicators and risk factors of coronary heart disease and diabetes. Confirmed in my study for preterm birth, low birth weight, smoking during pregnancy, maternal mental health in BiB and MCS. financial situation/ subjective poverty seemed to show most evidence of social gradients in health. So why? socioeconomic status

We are using the wrong indicators of SES Explanation 1 We are using the wrong indicators of SES Woman’s employment status Able to afford two pairs of all weather shoes Baby’s father’s employment status Able to afford enough money to keep home in decent state of decoration Mother’s education Baby’s father’s education Able to afford household contents insurance Subjective poverty Able to afford money to make regular savings of £10 a month Being in receipt of means tested benefits Able to afford money to replace any worn out furniture Up to date with bills Able to afford money to replace or repair major electrical goods Housing tenure Able to afford a small amount of money to spend on yourself each week Able to afford a holiday from home for at least one week once a year Able to afford a hobby or leisure activity Able to afford family and friends for a drink or meal at least once a month In winter are you able to keep home warm enough Often convenience measures. What if we use a lot of them, and create a variable of SES specifically designed for Pakistani ethnic group? Low birth weight, preterm birth, smoking during pregnancy, and maternal mental health

Disadvantage beyond SES & social capital Explanation 2 & 3 Disadvantage beyond SES & social capital Discrimination, social defeat, social disadvantage beyond income. Social capital; include when measuring social gradients.

37% Social and ethnic inequalities in health We know a lot about social ineq in health, and about ethnic ineq in health. But should we understand the combination of the two? 37% of birth in 2016 in England to ethnic minority parents, 2) mostly lower down the social ladder, 3) sometimes better health, sometimes worse (heart disease, diabetes). So in reality social and ethnic ineq in health are intertwined! That’s why we need to understand them as such. My name is Noortje, work at York and am interested in understanding intersection ethnic/social ineq, particularly maternal and child health. Births in England in 2016 to ethnic minority parents Disproportionally lower down the social ladder Sometimes better health, sometimes worse

Acknowledgements This presentation was based on a study with the Born in Bradford cohort: Uphoff, Eleonora P., Kate E. Pickett, and John Wright. "Social gradients in health for Pakistani and White British women and infants in two UK birth cohorts." Ethnicity & health 21.5 (2016): 452-467. And work by: Dr Lesley Fairley and colleagues Fairley, Lesley, et al. "Using latent class analysis to develop a model of the relationship between socioeconomic position and ethnicity: cross-sectional analyses from a multi-ethnic birth cohort study." BMC public health 14.1 (2014): 835. Ben Mallicoat, MSc Paper under review Ethnic density… social capital in addition to socioeconomic measures? Qualitative work needed