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Social Inequality: Evidence and Patterns

Class inequality in health and life expectancy

  • 3 things to know
  • Component 3 Section A

Overview

Relationship between social class and health in the United Kingdom, social gradient in health and black Report.

What you need to know

Answer each one before you reveal it.

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Key term

What is the social gradient in health?

Key term

What four explanations did the Black Report consider?

Key term

What is the social selection explanation, and what is the objection to it?

Questions from this subtopic

Each one with the model answer underneath.

  1. 1

    What is the relationship between social class and health in the United Kingdom?

    Model answer

    Health improves at every step up the social scale. People in higher occupational classes live longer, spend more of their lives in good health, and have lower rates of most major diseases than those below them.

  2. 2

    What is the social gradient in health?

    Model answer

    The social gradient is the finding that health improves steadily at each level of the social hierarchy. Health does not simply divide the poor from everybody else. Marmot's work made the gradient central to the study of health inequality.

  3. 3

    What was the Black Report?

    Model answer

    The Black Report was published in 1980. The report documented substantial differences in mortality between occupational classes in Britain. Those differences had not narrowed since the founding of the National Health Service.

  4. 4

    What four explanations did the Black Report consider?

    Model answer

    The artefact explanation, that the gap is a product of how the statistics are constructed; social selection, that ill health causes low class position rather than the reverse; cultural or behavioural explanations, resting on differences in diet, smoking and exercise; and material or structural explanations, resting on income, housing and working conditions.

  5. 5

    Which explanation did the Black Report favour, and why?

    Model answer

    The report favoured the material or structural explanation, arguing that differences in income, housing, working conditions and environment accounted for most of the gap and that behaviour was itself shaped by those conditions.

  6. 6

    What is the artefact explanation, and what is the objection to it?

    Model answer

    The artefact explanation holds that the gap is exaggerated by changes in how classes are defined and counted. The objection is that the gradient appears whatever classification is used and in many countries, so it cannot be a statistical accident.

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