The Unequal Distribution of Health Chances

Social Inequalities in Health

In this course, Professor Michael Calnan (University of Kent) explores social inequalities in health. In the first lecture, we think about the unequal distribution of health chances and some examples of how this is mapped across a population. In the second lecture, we look at how to explain social inequalities in health, including the materialist, relative deprivation and cultural/behavioural/lifestyle explanations. Next, we think about equity and inequality in the context of the provision of and access to healthcare. In the fourth and final lecture, we think about how experiences and the prevalence of mental distress can be mapped socially, including by gender and ethnicity.

The Unequal Distribution of Health Chances

In this lecture, we think about the unequal distribution of health chances, focusing in particular on: (i) the fact that disease prevalence varies on both an individual and societal group level; (ii) the link between social hierarchy and health/life chances; (iii) social stratification, which results in social inequality; (iv) the three types of health inequality being the health status of a poor group, the health gap between a poor and non-poor group, and the gradient of illness/mortality rates across a population, defined by Graham in 2004; (v) the case that, while overall life expectancy improved from the 1970s to the 21st century, the gap between life expectancies in poor and rich groups remained stable; (vi) differentiating between life and healthy life expectancy, which are both influenced by income; (vii) the case that, while women still live longer than men on average, the gap in the last few decades has narrowed; (viii) the stalling of life expectancy improvement trajectories across all income levels in higher income countries, with older women from poor areas actually showing a decreased life expectancy; (ix) a potential link between austerity politics and life expectancy stalling; (x) Clare Bambra’s work, which found a North-South divide in life expectancy, with those living in the South of England having a higher life expectancy; (xi) Clare Bambra’s research, which found that life expectancy could be mapped across London based on district of residence; (xii) the link between being of a minority ethnic identity and having a lower sense of wellbeing; (xiii) intersectionality in health, which promotes the idea that factors such as area of residence, income, gender and ethnicity interact to produce health outcomes; (xiv) the fact that deaths by COVID-19 amplified these inequality outcomes, showing that individuals from deprived areas were much more likely to die from the disease than those from affluent areas, more so than with other conditions.