Lecture 17 -- SES Disparities in Health

Lecture 17 -- SES Disparities in Health - SES Disparities...

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SES Disparities in Health
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Lots of Research An expanding debate, especially regarding mechanisms Encompasses a variety of disciplines But the basic idea is old Adler and Ostrove 1999
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Associations are General Importance of generality Importance of distinctions among features of SES and among specific diseases Convenience and dominance of schooling Interactions between features of SES Diseases amenable to care Found for clinical and self-report measures
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Associations are Gradual Income gradient in health Same is true of GDP and mortality Schooling and mortality (among men) “years of formal schooling completed is the most important correlate of good health” (Grossman, 2003, p. 32). Little evidence for credentialing effect Partly but not entirely mediated by income
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Whitehall Study of Whitehall Civil Servants, Michael Marmot Sparked the psychosocial revolution
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Associations Have Grown Pappas, Queen, Hadden & Fisher (1993) Widening differentials, especially for men, between 1960 and 1986
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New Evidence
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Importance of Heart Disease Widening differentials by heart disease mortality Similar increases in mortality differentials found in England and Wales, so it’s not entirely health insurance
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Interactions with Age Cumulative advantage: growing significance of risk factors Age-as-leveler declining significance of risk factors Disadvantaged spend more years with disability
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Some Explanations and Disciplinary Differences Economists’ explanations Fewer resources Less incentive to preserve health Psychologists’ explanations Psychosocial stress/culture Hierarchy Statisticians’ explanations Selection Childhood conditions turn into adult SES Contamination Personal characteristics underlie both health and SES Reverse Causation Adult health determines adult SES
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Lecture 17 -- SES Disparities in Health - SES Disparities...

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