Even in the most affluent countries, people who are less well off have substantially shorter life expectancies and more illnesses than the rich. Not only are these differences in health an important social injustice, they have also drawn scientific attention to some of the most powerful determinants of health standards in modern societies. They have led in particular to a growing understanding of the remarkable sensitivity of health to the social environment and to what have become known as the social determinants of health.
Some topics that might have an affect include the lifelong importance of health determinants in early childhood, and the effects of poverty, drugs, working conditions, unemployment, social support, good food and transport policy.
Poor social and economic circumstances affect health throughout life. People further down the social ladder usually run at least twice the risk of serious illness and premature death as those near the top. Nor are the effects confined to the poor: the social gradient in health runs right across society, so that even among middle-class office workers, lower ranking staff suffer much more disease and earlier death than higher ranking staff.
Stressful circumstances, making people feel worried, anxious and unable to cope, are damaging to health and may lead to premature death. Social and psychological circumstances can cause long-term stress. Continuing anxiety, insecurity, low self-esteem, social isolation and lack of control over work and home life, have powerful effects on health. Such psychosocial risks accumulate during life and increase the chances of poor mental health and premature death. Long periods of anxiety and insecurity and the lack of supportive friendships are damaging in whatever area of life they arise. The lower people are in the social hierarchy of industrialized countries, the more common these problems become. Socioeconomic Status
Socioeconomic status (SES) is a broad term that is used to describe factors about a person's lifestyle including occupation, income, and education. It is important for researchers to consider SES when conducting health studies. This is because people of different SES levels may have very different access to medical care, healthy food, and physical activity opportunities. These are all factors that can affect health and must be accounted for when studying risk of different diseases and conditions.
The relationship between socioeconomic status (SES) and physical and mental health, morbidity, disability, and mortality has been long and extensively documented. While the overall relationship of SES to mortality may attenuate in older ages, socioeconomic position continues to be linked to the prevalence of disability and chronic and degenerative diseases, including cardiovascular disease, many cancers, and Alzheimer's disease. Low SES may result in poor physical and/or mental health by operating through various psychosocial mechanisms such as poor or "risky" health-related behaviours, social exclusion, prolonged and/or heightened stress, loss of sense of control, and low self- esteem as well as through differential access to proper nutrition and to health and social services. In turn, these psychosocial mechanisms may lead to physiological changes such as raised cortisol, altered blood-pressure response, and decreased immunity that place individuals at risk for adverse health and functioning outcomes. Not only may SES affect health, but physical and mental health may have an impact upon the various components of SES (e.g., education, income/wealth, occupation) over the life course. For example, bouts of serious illness may result in a significant and sustained loss of wealth. Social Factors
There are quite a few social or societal factors that can affect the status of a person’s level of both health and fitness. Health is a state of wellbeing and freedom from disease that is perceived by a person. Fitness can be seen as the relative ability of an individual or population to survive and reproduce in a given environment. Some cultures or societies view body types and images in certain ways – for instance weight is seen as a positive thing in cultures where food is scarce and some countries and societies weight and especially obesity is not only seen as something that is undesirable, but also a threat to the health of an individual. Also some countries view fitness or the level of reproduction, in different ways. Some cultures encourage and respect higher birth amounts in families and other cultures do not feel this way.
Also the types of food that are consumed in different cultures and societies can affect the health and wellbeing of an individual. Eating junk food which can be seen as status is some societies can be detrimental for the health of the individual and society. Just look at all the children who think it is great to super size that meal. Obesity can be looked at like a social factor in health and wellbeing when it comes to eating what is being viewed as being positive or that shows affluence.
The effects also of a culture and the types of food and climate that they live in can also affect health and longevity. Certain societies that are isolated have found that they have a longer average lifespan than most. Studies have looked at the factors involved and find not only eating patterns played a part, but also that their attitudes and behaviours also are a facet of the entire picture. In this culture they physically work hard on their land as well as their lives being very constant and in this case there is very little “added” stress in their life. They have stresses, but they are socially accepted and acknowledged and people just see it as part of life. They also eat according to what is in season and fresh.
Social level and the affect of socio-economic status can play a role in health. In most research done the higher level of socioeconomic classes reflects at a higher level of health and longevity. Much of this comes from the fact that there is a higher level of education and health care that is available for this class level. Socially this class structure is also more involved in health care from infancy on. They want the best for their children – and can afford it. It is not that other societies or people don’t want the best; it is just that many people in society can not afford it or don’t have access to it.
A good start in life means supporting mothers and young children: the health impact of early development and education lasts a lifetime. Observational research and intervention studies show that the foundations of adult health are laid in early childhood and before birth. Slow growth and poor emotional support raise the lifetime risk of poor physical health and reduce physical, cognitive and emotional functioning in adulthood. Poor early experience and slow growth become embedded in biology during the processes of development, and form the basis of the individual’s biological and human capital, which affects health throughout life.
Poor circumstances during pregnancy can lead to less than optimal foetal development via a chain that may include deficiencies in nutrition during pregnancy, maternal stress, a greater likelihood of maternal smoking and misuse of drugs and alcohol, insufficient exercise and inadequate prenatal care. Poor foetal development is a risk for health in later life.
Infant experience is important to later health because of the continued malleability of biological systems. As cognitive, emotional and sensory inputs programme the brain’s responses, insecure emotional attachment and poor stimulation can lead to reduced readiness for school, low educational attainment, and problem behaviour, and the risk of social marginalization in adulthood. Good health-related habits, such as eating sensibly, exercising and not smoking, are associated with parental and peer group examples, and with good education. Slow or retarded physical growth in infancy is associated with reduced cardiovascular, respiratory, pancreatic and kidney development and function, which increase the risk of illness in adulthood.
Poverty, relative deprivation and social exclusion have a major impact on health and premature death, and the chances of living in poverty are loaded heavily against some social groups. Absolute poverty – a lack of the basic material necessities of life – continues to exist, even in the richest countries of Europe. The unemployed, many ethnic minority groups, guest workers, disabled people, refugees and homeless people are at particular risk. Those living on the streets suffer the highest rates of premature death.
Relative poverty means being much poorer than most people in society and is often defined as living on less than 60% of the national median income. It denies people access to decent housing, education, transport and other factors vital to full participation in life. Being excluded from the life of society and treated as less than equal leads to worse health and greater risks of premature death. The stresses of living in poverty are particularly harmful during pregnancy, to babies, children and old people. In some countries, as much as one quarter of the total population – and a higher proportion of children– live in relative poverty
In general, having a job is better for health than having no job. But the social organization of work, management styles and social relationships in the workplace all matter for health. Evidence shows that stress at work plays an important role in contributing to the large social status differences in health, sickness absence and premature death. Several European workplace studies show that health suffers when people have little opportunity to use their skills and low decision-making authority.
Having little control over one’s work is particularly strongly related to an increased risk of low back pain, sickness absence and cardiovascular disease. These risks have been found to be independent of the psychological characteristics of the people studied. In short, they seem to be related to the work environment. Studies have also examined the role of work demands. Some show an interaction between demands and control. Jobs with both high demand and low control carry special risk. Some evidence indicates that social support in the workplace may be protective.
Further, receiving inadequate rewards for the effort put into work has been found to be associated with increased cardiovascular risk. Rewards can take the form of money, status and self-esteem. Current changes in the labour market may change the opportunity structure, and make it harder for people to get appropriate rewards.
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Our principal and staff have written dozens of reference books as supplementary texts to complement studies in our school
These books are mostly available as ebook, through our online bookstore. They include the following titles. You can click on any of these titles to go to the bookstore and see more details, on that title (including a free download of some of the pages).