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Unformatted text preview: Chapter 3: Chapter Socioeconomic Status (SES) and Health HIV/AIDS and Poverty HIV/AIDS Thabo Mbeki (president of South Africa) Thabo and AIDS deniers and Kofi Annan (former Secretary-General of Kofi the UN): the – “Africans are vulnerable to [HIV/AIDS, TB, Africans and other IDs] because they are poor, undernourished, and too often uninformed of basic precautions…” basic SES SES SES (Socioeconomic Status): a person’s (or person’s family’s) position in a society based on social, economic, and educational characteristics economic, No one measure for individuals / households, No individuals but includes ownership, occupation, neighborhood, etc. neighborhood, Human Development Index (HDI): estimate of estimate national development based on life expectancy, literacy, and income per capita literacy, Poverty Poverty > 1 billion people (1 in 6 people) live on billion <$1 per day <$1 “Subsistence farming” 1995 WHR (World Health Report – annual publication of WHO): “Extreme poverty is the world’s biggest killer.” the % of population living on less than $2 a day, 2003 of Measuring Household Poverty Measuring Income: take-home pay Wealth: accumulated worth and “stuff” accumulated (house, car, TV, radio, livestock, etc.) (house, Households with low income generally Households have low wealth, so there are few resources to draw on if someone develops a severe illness severe Health & Poverty Health Unsafe housing Crowding Near waste, etc. but far from schools & clinics, Near etc. etc. Lack of safe drinking water, water for washing, Lack and sanitation facilities and Limited access to fuel for cooking, boiling water Limited access to communication and Limited transportation transportation No money for prevention of illness Substandard health care Comparison of infant mortality (per 1000 live births) in the richest and poorest 20% of the population in 140 120 100 80 Poores t 20% Ric hes t 20% 60 40 20 Infant Mortality Rate (per 1000 live births) 0 Egy pt Indones ia Braz il Banglades h Uganda Malawi Economic Indicators Economic Gross Domestic Product (GDP) Gross National Income (GNI) Gross National Product (GNP) “per capita” Purchasing Power Parity (PPP): “Big Mac Purchasing Index” Index” GNI per capita, 2005 GNI Missing 0 – 499 500 – 999 1000 – 4999 5000 – 10000 > 10000 GDP and life expectancy 90 80 70 60 United States 50 40 Life expectancy 30 20 High income countries tend to have long life expectancy. Cameroon Low income countries tend to have low life expectancy. 10 0 0 10000 20000 G DP 30000 40000 Economic Indicators Economic Economic indicators ignore: – – – Sustainability / environmental damage Distribution of wealth Quality of life (standard of living) Gini Index: measure of the inequality of measure distribution of incomes within a country. distribution – 0 = perfectly equal; 100 = perfectly unequal – Namibia: 70.7 (richest 10% makes 128.8x more than Namibia: poorest 10%) poorest – United States: 40.8 – Denmark: 24.7 (richest 10% makes 8.1x more than Denmark: the poorest 10%) the Employment Employment Benefits may include income, health Benefits insurance, housing, food allowances, schooling for children. schooling Low skilled workers have dangerous jobs, Low little compensation, and little or no job security. security. Health status: unemployed < manual Health laborers < skilled workers < professionals laborers Higher mortality rates from all causes, not Higher just work-related illnesses just 180 160 SMR (standardized mortality ratio) in England and Wales 140 0 20 18 120 0 16 100 0 14 80 0 Unskilled workers have a much higher risk of death than other workers 12 60 0 80 20 Professional workers 40 1921- Mortality Ratio Standardized1930- 1942 1949- 1959- 1970- 1981- 1991have 1953 1963 1972 1938 1993 a much lower risk 1923 1932 of death than other 20 0 IV: Partly Sk illed III: Sk illed II: Managerial and Tec hnic al VI: Unofesed nal P r s k i l l s io IV: Part ly Sk illed 10 40 0 Standardized Mortality Ratio 60 0 V: Uns k illed workers 1921- 1930- 1942 1949- 1959- 1970- 1981- 19911923 1932 1953 1963 1972 1938 1993 SMR compares groups to the total population, which is assigned an SMR of 100. Exampleseof jobs within III: Sk ill d each socialeclass: Tec hnic al II: Manag rial and V: Unskilled: laborers I: P rof s s ional IV: PartlyeSkilled: farm workers, machine tool operators IIIM: Manual Skilled: carpenters, drivers IIIN: Non-manual Skilled: cashiers, shop assistants II: Managerial and Technical: teachers, nurses, sales managers I: Professional: doctors, accountants Occupation Occupation It may be nearly impossible for a person to It improve his/her occupational status. improve – Example: traditional caste system in India Education is the most likely path to higher Education social status. social Literacy / Education Literacy Functional literacy: ability to understand ability written words well enough to complete normal daily tasks normal Educational level: years of school; Educational degrees / certificates / diplomas completed completed What are some ways that you use the What written word to get health information and navigate health systems? navigate Female Literacy & Health Female Maternal literacy strongly associated with Maternal HH / child health status HH – Improved care practices (example: ORT for Improved diarrhea) diarrhea) – Increased knowledge of contraception and Increased family spacing family – Decreased fertility (# children) – Decreased under-5 mortality rates – Decreased barriers to accessing health care Knowledge of ORS for Diarrhea Knowledge Under-5 Mortality Rates Under-5 Knowledge of Any Contraceptive Method Knowledge Any Problem in Accessing Health Care Any Number of girls enrolled in primary and secondary school for every 100 boys enrolled, 2004 school Summary Summary LITERACY / EDUCATION JOB SKILLS HEALTH INCOME ...
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This note was uploaded on 09/23/2011 for the course GCH 100 taught by Professor Corso during the Fall '11 term at George Mason.

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