The biological explanation states that groups in society are biologically different and so experience different standards of health as a natural process. People who suffer from illness sink to the bottom classes of society, while those who are physically and mentally strong rise to the top. People who experience poor health find it more difficult to get a good job and therefore ‘class doesn’t cause ill heath, ill health causes class’.
The Cultural and Behavioral explanation is concerned with choice and attitudes. Norms and values are different among the working class. The choices lower classes make will be very different to those of higher classes. These choices may be about medicine, diet or lifestyle. Howlett and Ashley say that middle class people have a better understanding when it comes to medical care and they are therefore more likely to breastfeed, have vaccinations or attend antenatal classes. When it comes to leisure and lifestyle, Robert’s says that the middle class choose to exercise more as a result of being able to afford gym memberships etc. They also take part in a wider range of social activities thus resulting in lower stress and maintaining their health. A criticism of this approach is that it may not always be a choice. Lower classes maybe forced into an unhealthy lifestyle, as they cannot afford to eat and live healthily. It’s much cheaper to fill a family on junk food than it is on a balanced diet. Demand is also an issue, whether they actually want it. Working class people are less likely to visit the Doctor, less likely to attend screening programs, they’re less able to take the time off work because they cant afford to and transport is difficult for them. Also, middle class people demand more time with the doctor because they are more confident and assertive and more likely to notice ill health.
The Material and structural approach is concerned with people’s position in the social hierarchy and focuses on wealth and access and poverty. The people positioned lower in the social structure don’t have the money to be healthy or to live in a nice house and have a better standard of living. Graham states that working class women are more likely to smoke to relive stress of their heavily demanding schedules, therefore leading to poorer health. Moser says that unemployed Men and women are likely to die younger than those in employment, which would partly explain the higher mortality rate among the lower class. Also, the type of work working classes get in to is a lot more dangerous. Factories and building sites are more likely to cause injury than banks and schools due to their physicality and use of chemicals. Provision also affects health care inequalities. Services on offer are not provided in the same way to different groups of people. For example the postcode lottery. This determines the different level of treatment you’re given depending on where you live. Also inequality is the ‘Inverse care law’, which is the idea that Doctors don’t want to set up surgeries in deprived areas as they find it easier to interact with middle class patients. Finally there’s private healthcare. The argument is that it’s seen as unfair because you shouldn’t get higher treatment standards just because you can afford it.
Sociologists think that the Material and structural argument is the strongest, because wealth is the biggest factor affecting a person’s position in society and their social class. The material situation of the poor is what determines their poorer health in comparison to higher classes.
by
sallyann554 (student)
