The black report argues that poor progress in health applies to wide sections of the working class.
People who experience poor health find it difficult to get a jobs, and therefore is a vicious circle, not just with the individual, but as a society. This is social selection.
Mormot etal (1984) found that amongst those with no detectable diseases at the start of career there were still greater death rates amongst men in the lower grades of civil service.
Behavioural/Cultural explanation of social class and health inequalities blames the person because of life style, e.g. working people smoke and drink too much, eat the wrong food, take little exercise. Careful people would not waste their money. Whilst P. Townsend (Black report) accepts that life style plays a part they consider less important than structural factors e.g. job.
Mormot found that amongst smokers the risk of lung cancer strongly relates to the job held. The cultural model explains twenty-five per cent of health inequalities.
Sociological view the social democratic view. Being poor will probably end up with poor health, sub-standard housing (which is damp, overcrowded (dangerous) homes) Working conditions are poor, more accidents, more stress, more drinking and smoking, higher risk of unemployment and less health equality. This argument is structural/Material. This accounts for seventy-five per cent of health inequality according to P. Townsend.
