1. SOCIAL
ETHNIC

2. 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

3. 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

4. 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

5. 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.

6. 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

7. 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):
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