1. Lesson 14 - Learning Intentions (After this lesson pupils should be able to): Explain the reasons for health inequalities in terms of: -Social class- Geographic location - Gender- Ethnicity Gender/biologicalfactors Hereditaryfactors Personallifestyle Ethnicorigin Socio- economic status Workingconditions Geographicallocation

2. Explaining Social Class Health Inequalities There is a wealth of evidence to show that the highest social classes enjoy better health, lower death rates and longer life expectancy than the poorest social classes. Why? Lower incomes – fewer life choices e.g. exercise, eating choices, etc. Stress of unemployment/low income/debt. ‘Hopelessness’/lack of opportunity. Lower incomes – fewer life choices e.g. exercise, eating choices, etc. Stress of unemployment/low income/debt. ‘Hopelessness’/lack of opportunity. Worse local environment – poorer quality housing (damp, overcrowding) in worse neighbourhoods (crime, fewer facilities, poorer choice of shops, etc.). Worse local environment – poorer quality housing (damp, overcrowding) in worse neighbourhoods (crime, fewer facilities, poorer choice of shops, etc.). Lifestyle choices – poorest groups tend to make poorest health choices: smoking, alcohol, drugs, exercise and diet. Poorest groups go in search of ‘feelgood factor’. Lifestyle choices – poorest groups tend to make poorest health choices: smoking, alcohol, drugs, exercise and diet. Poorest groups go in search of ‘feelgood factor’. Health services – poorest groups less likely to make use of health services; services in poorest areas often less good. Health services – poorest groups less likely to make use of health services; services in poorest areas often less good. Biology of poverty – poorest people growing up in poorest areas have their ‘body clock tick faster’. Biology of poverty – poorest people growing up in poorest areas have their ‘body clock tick faster’.

3. Explaining Geographic Health Inequalities There is a wealth of evidence to demonstrate that the people living in the wealthiest areas of the country enjoy better health, lower death rates and longer life expectancy than those living in the poorest areas. Why? Linked very closely to social class: Poverty greatest in west of Scotland, Wales, northern England, Northern Ireland and in large inner cities (London, Birmingham, Manchester, etc.). All areas of high unemployment and social deprivation. These areas have less professional/managerial jobs. Former manufacturing areas. Poverty greatest in west of Scotland, Wales, northern England, Northern Ireland and in large inner cities (London, Birmingham, Manchester, etc.). All areas of high unemployment and social deprivation. These areas have less professional/managerial jobs. Former manufacturing areas. Inner-city areas and peripheral social housing estates poorer than leafy suburbs or rural areas. Inner-city areas and peripheral social housing estates poorer than leafy suburbs or rural areas.

4. Explaining Gender Health Inequalities Women live longer than men by about 5 years but women have greater ill-health. Men have higher early death rates for almost all categories of death (but gap closing). Why? Men: take part in greater ‘risk-taking activities’ - generally smoke more, consume greater amounts of alcohol and eat more poorly, take part in dangerous sports and subject to more violence (‘ladette culture’ closing gap); less likely to visit GP or take or take preventative care; do more physical/stressful manual labouring jobs. Men: take part in greater ‘risk-taking activities’ - generally smoke more, consume greater amounts of alcohol and eat more poorly, take part in dangerous sports and subject to more violence (‘ladette culture’ closing gap); less likely to visit GP or take or take preventative care; do more physical/stressful manual labouring jobs. Women: biologically live longer therefore greater ill health as older; impact of having and bringing up children- physical and mental stress of caring for children and elderly relatives; poorer paid employment. Women: biologically live longer therefore greater ill health as older; impact of having and bringing up children- physical and mental stress of caring for children and elderly relatives; poorer paid employment.

5. Explaining Ethnic Health Inequalities The UK’s ethnic minority groups experience ill-health and life expectancy rates similar to Whites in terms of social class, geographic location and gender. However, there are also differences in health e.g. Asians suffer more heart disease and Asian/Africans more strokes. Why? Genetically some illnesses are more commonly found in ethnic minority groups e.g. sickle-cell anaemia and diabetes. Genetically some illnesses are more commonly found in ethnic minority groups e.g. sickle-cell anaemia and diabetes. Most ethnic minorities tend to make better lifestyle choices e.g. less likely to consume excess alcohol. Most ethnic minorities tend to make better lifestyle choices e.g. less likely to consume excess alcohol. Overall, poverty is greater amongst ethnic minority groups and as a result the health of people in these groups is poorer in many respects. Overall, poverty is greater amongst ethnic minority groups and as a result the health of people in these groups is poorer in many respects.

6. Causes of Health Inequalities 1. Explain the reasons for each of the following health inequalities: -Social class - Geographic location - Gender - Ethnicity 2. Reading: ‘Modern UK Social Issues’ pages 14-16, 46-49 and 76.