The Health Divide Is Britain really two nations?

Recent Headlines “ Drive to tackle healthcare gulf” “ North – South health divide widening” “ Is Glasgow bad for your health?” “ Poorer Scottish men die younger” “ Poor less likely to survive cancer” “ Scottish health figures make grim reading”

The Black Report 1979 health of the nation overall had improved gap between health of rich and poor was getting bigger the inequalities started at birth and continued all through life professional class people could expect to live five years longer than unskilled manual class the differences were result of different social and economic conditions.

And since…….? The Health Divide 1987 Deprivation - Inequality and the North 1988 Tackling Inequalities in Health - An Agenda for Action The Acheson Report 1998 The Widening Gap - Townsend Centre for International Poverty Research. All of these reports reinforce the same conclusion- poor people die younger an are less healthy

Gender/biologicalfactors Hereditaryfactors Personallifestyle Ethnicorigin Socio- economic status Workingconditions Geographicallocation There are many influences on an individual’s health. Factors which influence health

Why? Diet Exercise Stress Housing Occupation Lifestyle choices – use/abuse of substances Education Gender Ethnic group

DIET – ‘Lower social classes tend to… Have a poorer dietHave a poorer diet Are more obeseAre more obese Have less time to prepare healthy foodHave less time to prepare healthy food Shop in more expensive shops – convenience storesShop in more expensive shops – convenience stores Be more influenced by food advertisingBe more influenced by food advertising

Exercise – how much people take is affected by…. amount of free time available, cost of leisure - club fees, entry fees, equipment etc. popular culture encouraging spectating as a pastime rather than participating (e.g. football in the west of Scotland)

Stress debt, inability to pay bills,debt, inability to pay bills, pressures of consumer society - 'must haves’ e.g. expensive trainerspressures of consumer society - 'must haves’ e.g. expensive trainers unemployment - the rate of attempted suicide amongst the short-term unemployed has been shown to be 10 times as high as for people in work.unemployment - the rate of attempted suicide amongst the short-term unemployed has been shown to be 10 times as high as for people in work. Not just the business tycoon

Housing overcrowding - disease spreads more quicklyovercrowding - disease spreads more quickly dampness – often leading to or aggravating respiratory diseasesdampness – often leading to or aggravating respiratory diseases stress of living in poor areas - low esteem, violence, anti-social behaviour of neighbours, limited chances of getting out to a 'good' area with sell-off of best council housing under the ‘right to buy’ schemestress of living in poor areas - low esteem, violence, anti-social behaviour of neighbours, limited chances of getting out to a 'good' area with sell-off of best council housing under the ‘right to buy’ scheme

Manual work unhealthier due to… contact with harmful substancescontact with harmful substances working in dangerous situations - heights, machinery etc.working in dangerous situations - heights, machinery etc. stress from low pay, low esteem, repetitive boring tasksstress from low pay, low esteem, repetitive boring tasks increased chance of redundancyincreased chance of redundancy Asbestosis victim – high incidence in Clydebank

Lifestyle ‘choices’ men in Social Class 5 are FOUR TIMES more likely to die from lung cancer than Men in Social Class 1. Women in Social Class 5 are THREE AND A HALF times more likely to die of coronary heart disease than women in Social Class 1 Middle classes – ‘deferred enjoyment’ Lower classes – ‘immediate enjoyment’

Education – the more you have the more likely you are to… understand / act upon health warnings, campaignsunderstand / act upon health warnings, campaigns know what to ask for and how to get it from the health serviceknow what to ask for and how to get it from the health service be in a good job and so have higher income etc be in a good job and so have higher income etc