Getting Under the Skin: Children’s Health Disparities as Embodiment of Social Class (original) (raw)
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Introduction: Special Issue - Social Inequality and Health
American Behavioral Scientist, 2013
This special issue of the American Behavioral Scientist begins to address some new directions for research on social stratification, inequality, and health. On February 24–25, 2011, the National Institutes of Health helped sponsor a small meeting of social scientists to engage in a discussion to (a) highlight recent new developments in the social and biological sciences that may enhance social stratification theory, (c) identify how inequality may transmit across generations, (d) discuss new methods for studying social stratification and health, and (e) identify directions for the next generation of stratification and health studies. After the conference, some of the participants were invited to write a paper about the topics drawn from the conference recommendations. The papers compose the contents for this special issue.
Social Determinants of Health and Education: Understanding Intersectionalities During Childhood
2020
This chapter explores the conceptual understandings of health and learning, as well as the health benefits of learning, to address the social factors that determine existing inequalities in these outcomes. Inequalities in health and learning start in early life, are transmitted intergenerationally, and are fuelled by the intersectionality of disadvantage into which children are born. To provide a more comprehensive understanding of the channels by which social determinants reproduce inequalities, the chapter builds on the ecological model developed by Feinstein and colleagues (2008) to make explicit the conditions, forces and systems, that impact the formation and persistence of inequalities. The chapter concludes with the importance of addressing the social factors and processes that cause the reproduction of existing inequalities in health and learning within specific contexts. The intent, here, is to promote a more equitable social agenda.
Social disparities among youth and the impact on their health
Adolescent Health, Medicine and Therapeutics, 2015
Social disparities among youth have been recognized as an important influence on disease risk later in the life cycle. Despite this, social problems are seldom assessed in a clinical setting. The primary objective of our study was to evaluate the impact of social disparities on the health of youth. Methods: A self-directed, web-based screening system was used to identify social disparities along seven social domains. Participants included youth, aged 15-24 years, recruited from an urban hospital clinic. The main outcome variable, self-rated health, was captured on a 5-point Likert scale. Univariable and multivariable regression models adjusted for sex, age, and race/ethnicity were implemented to assess the association between social problems and self-rated health. Correlation between social disparity problems was estimated using phi coefficient. Results: Among 383 participants, 297 (78%) reported at least one social problem. The correlation among social disparity problems was low. Social disparities had an independent effect on self-rated health, and, in a fully adjusted model, disparities in health care access and food insecurity remained significant. The presence of even one social problem was associated with a decrease in overall health (β=0.68, P,0.01). Conclusion: There is a high burden of social disparities among our youth urban hospital population. The presence of even one social problem increases the risk of worsening self-rated health. Evaluating the social disparities among youth in the medical setting can help elucidate factors that negatively affect patients' health.
Public health reports (Washington, D.C. : 1974), 2013
Public health literature suggests that population health is largely influenced by social determinants of health (SDH), defined as the complex interplay of social and economic systems, including the social and structural conditions in which people are born, grow, live, and work, as well as the systems that are designed to address people's health problems. 1-3 SDH include, but are not limited to, conditions for early childhood development, education, daily living environments, social networks, health services, and economic and social conditions of communities. 4 SDH are shaped by the level of income, power, and resources available at global, national, and local levels. Research suggests that SDH are responsible for most national and global health disparities and inequities, 3 commonly represented at higher incidence, prevalence, and burden of health problems in certain geographic regions and among racial/ethnic, socioeconomic, or gender groups. 5 The application of SDH to address health disparities in the United States is a relatively new approach that emerged in the early 2000s. 6 However, most of this work has focused on adults, with very little attention directed toward children. 7 Because health disparities often take root in early childhood and persist over time, 8,9 addressing health disparities and inequities though SDH must begin in childhood. In the U.S., health disparities are likely to occur among racial/ethnic minority people because these populations are more likely to be in poverty, face stressors related to disadvantage, and live in communities with fewer resources. The environmental disadvantage accumulates and is likely to lead to experiences of greater social and economic obstacles to health. 8 Many racial/ethnic minority children experience multiple physical and mental health disparities, including higher likelihoods for suboptimal health status, obesity, asthma, behavioral problems, and emotional difficulties. These children are also more likely to attend schools with poorer quality environments and to have limited access to adequate care and services. 10-12 It is projected that racial/ethnic minority people will become the majority of the U.S. population in 2050 (comprising 60% of the population). 13 Because of the rapid population growth and the increasingly important role that children in racial/ethnic minority groups will play in the U.S. economy and civil society during the coming decades, focusing attention
Rethinking the health consequences of social class and social mobility
Social Science & Medicine, 2018
The task of studying the impact of social class on physical and mental health involves, among other things, the use of a conceptual toolbox that defines what social class is, establishes how to measure it, and sets criteria that help distinguish it from closely related concepts. One field that has recently witnessed a wealth of theoretical and conceptual research on social class is psychology, but geographers' and sociologists' attitude of diffidence toward this " positivistic " discipline has prevented them from taking advantage of this body of scholarship. This paper aims to highlight some of the most important developments in the psychological study of social class and social mobility that speak to the long-standing concerns of health geographers and sociologists with how social position, perceptions, social comparisons, and class-based identities impact health and well-being. DOI: https://doi.org/10.1016/j.socscimed.2017.11.037
An Approach to Studying Social Disparities in Health and Health Care
American Journal of Public Health, 2004
Objective. We explored methods and potential applications of a systematic approach to studying and monitoring social disparities in health and health care. Methods. Using delayed or no prenatal care as an example indicator, we (1) categorized women into groups with different levels of underlying social advantage; (2) described and graphically displayed rates of the indicator and relative group size for each social group; (3) identified and measured disparities, calculating relative risks and rate differences to compare each group with its a priori most-advantaged counterpart; (4) examined changes in rates and disparities over time; and (5) conducted multivariate analyses for the overall sample and "atrisk" groups to identify particular factors warranting attention. Results. We identified at-risk groups and relevant factors and suggest ways to direct efforts for reducing prenatal care disparities. Conclusions. This systematic approach should be useful for studying and monitoring disparities in other indicators of health and health care.