Lecture 6

Lecture 6 - PART I. SETTING UP THE PROBLEM How do we...

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PART I. SETTING UP THE PROBLEM How do we measure social inequalities?
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Figuring out health inequality (Bartley 2004) Studying health inequality demands comparisons between groups Statistical explanation Goal is prediction of the observed outcome with a set of explanatory variables When studying social inequalities in health, identifying groups that are more at risk We can ‘build’ explanations by adding variables to identify pathways between inequality and health BUT none of that tells us what underlying mechanisms put these groups at risk (why are they motivated to act in this way, how that exposure results in physiological changes in the body): need for fundamental biological and qualitative research. Spuriousness and Confounding When a third factor is the real cause of an association between two variables Ex: For school children, height is strongly correlated with reading skills.
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Standardization Age is a strong (and unavoidable!) determinant of health and mortality AND of social status Standardization corrects for the possibility that a given group looks healthier/unealthier because of its age distribution: basic biological fact, not social cause Examples: How can age confound the relationship between socioeconomic status and health? Income groups above 40 years old: The lower income (poorer) groups are more likely on average to be retired, older Occupational differences: unskilled services jobs tend to be occupied by younger individuals, while professional occupations tend to be occupied by older individuals – age differences may mask deleterious effects of unskilled service jobs
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Commonly used mortality rates Crude mortality rate: Number of deaths per X thousand population. Florida has a higher crude mortality rate than Alaska: does that mean that the environment is more deleterious in Florida? Age-specific mortality rate: Number of deaths for a specified age group per X thousand population in the same age group. Standardized mortality rate (SMR)
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Lecture 6 - PART I. SETTING UP THE PROBLEM How do we...

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