Chapter 11: CAGE(s) and Health
Jobs segregated by sex on the basis of traditional gendered ideologies.
Black and women of colour face majority of the discrimination at work…work
divided between men and women depending on their ability to do so.
Definition of Heath (according to World Health Organization): It is a state of
complete physical, mental and social well-being and not merely the absence of disease
Mental Health: It is a psychological state that someone who‘s functioning at a
satisfactory level of emotional or behavioural adjustment; it is a state of well-being in
which individual realize his/her abilities.
Mental illness: 2 ways – 1.) Neuro-sciences 2.) Social side: personal stresses. Eg. How
people have experienced trauma. How we interact with people; Capitalism is created.
2 key ways to measure how population is doing in terms of health and wellness:
>>Morbidity: rate of incidence of a disease.
>>Mortality rate: what you die of? When?
Health care: Eg. OHIP…state has interest in economy being productive.
Inequality in Health: Some current Perspectives and Critiques
Why there are inequalities in health?
Inequalities examined through biology of the individual and the workings of
the medical system.
An individual‘s behaviour in the form of lifestyle choices (drinking, smoking,
obesity etc.) was also believed to have a significant impact on health.
Socio-economic status played a significant role in health experiences and that
smoking, exercise, immoderate eating and so forth accounted only moderately
for socio-economic inequalities in heath.
Psychosocial risk factors: a system of exposures, resources, and situational variables
believed to have an impact on health; they include mastery or sense of control, self-
esteem, ease or availability of social supports, negative life events, and daily exposure
to stress or exposure to traumatic event.
Fundamental causes of disease risk: focus on factors like access to knowledge, money,
power, prestige and social connections and how they can influence exposure to health
risks and preventive measure to explain association between inequality and health.
Health: Changes over time
Understanding changes in:
Patterns in morbidity and mortality
Conceptions of health and care
Health care delivery: ongoing project. Eg. Universal health care
Health services should be offered without barriers. Determinants of Health
Individual level determinants of health:
Lifestyle behaviour and choices: diet and nutrition; exercise; substance abuse
Critique: why it (above statement) has impact on our social well-being?
Because the ways in which social structure in which we live set our social
Structural level determinants of health:
Class, gender, race and ethnicity, immigration
Social community networks
Impact on health: unemployment, lack of income and education.
Stress: physiological impact and psychological impact
GOOGLE!!!...health and images---things that affect health
Mortality, Morbidity and Mental Health
Social Class and SES (Socio-economic status)
Life expectancy (a measure that takes current health conditions into account) shows
that income makes a difference in health.
The highest the income, the better the health and vice versa.
People in low income group face more health issues, inequitable social conditions in
workplace, neighbourhoods and regions affect health throughout the life course.
Mortality rates in different regions: high mortality rates due to injuries and
occupational hazards for men in rural areas.
The presence of manufacturing and industry creates jobs but the risk of toxins and
pollutions from these sources may create health risks.
Health status is correlated with income level and it deteriorates with incremental
declines in income.
As per investigation of socio-economic gradient, regions where incomes are more
variable, death rates are higher.
Montreal ranks higher than other major Canadian cities in unemployment rate and
poverty index and lower on almost every health indicator.
Low income populations were 16 times more likely to attempt suicide than high-
The higher the SES level, the better the health status.
SES variations in health.
Higher socio-economic status enables individuals to marshal greater flexible resources
in protecting their health and stronger relationship between preventable causes of
mortality and SES compared with less preventable forms of mortality.
Individuals with higher SES are better able to avoid health risks. Those who struggle with existing health issues, face difficulties in stable employment
Older workers, because of their health issues have negative impact on their income
level and socio-economic status since they are not able to work with the same pace
(speed) as they used to.
Poverty leads to violence in family, health issues, and mental stress.
In Canada, low income earners have higher rates of morbidity and lower life
expectancies than those with higher incomes.
Everyone‘s ―chances‖ of being poor are not equal, and one‘s marital status, gender,
age, race and ethnicity, are integrally bound up with one‘s class and socio-economic
The prevalence of mental illness also varies according to social advantage: the poor,
the young, ethnic minorities and blacks have higher rates of mental illness than the
well-to-do, older persons, ethnic majorities, and whites.
The experience of stress in various forms affects physical and mental health.
2 main streams in current stress research:
Extent to which different societal groups (income, race, age)are exposed to
chronic strains and stressful events and document the effect of inequality on
population mental health.
Focuses more on individual perceptions of stress and the resources at hand for
maintaining mental health.
Importance of the 2 concepts in explaining the associations between socio-economic
disadvantage and health: Structural aspects prone to influence mental health and the
People with less power in society are more exposed to ongoing life stresses and strains
and often have fewer resources and social supports to help them cope.
Class-linked stress: Stress exposures that are largely dependent on social status.
Example: working class and lower-income individuals are more frequently employed
in physical stressful jobs.
Greater income inequality in society, greater morbidity rate and higher mortality rate.
Race and Ethnicity
The kind of risk factors people face.
Race and ethnicity intersects with SES.
Aboriginal health: aboriginal people in Canada face many health challenges, and their
rating on a variety of health status measures is worse than those of non-aboriginals.
Health care delivery
Number of chronic conditions is higher in aboriginal populations.
Aboriginals much more likely to have cardiovascular disease than those of
European ancestry. Difference in primary causes of morality between aboriginal and non-
aboriginal people in Canada: for aboriginals, leading cause of death is from
injury, while injuries sit as the 4 leading cause of death for other groups.
Age matters for aboriginals…more injuries.
Aboriginal people have higher mortality rate than non-aboriginals..
The high mortality and morbidity rates of aboriginal populations in Canada are
accompanied by high rates of poorer mental health.
Depression rates higher in aboriginal population.
Homicide and suicide are causes of death for aboriginal Canadians, particularly
for adults, but even for teens and young children.
Isolation, poverty, racism, and post-colonial legacies of abuse continue to
affect the health of aboriginal people.
Immigrants to Canada are selected on the basis of health, and ‗healthy-immigrant
effect‘ plays an important role in studies of health and ethnicity.
Diminishing health advantage of immigrant populations to lifestyle factors such as diet
and physical activities and to social isolation and lack of access to health care.
Visible minority groups in Canada rated higher on health measures than non-visible
minorities and aboriginals.
Authors found out that Canadian born south Asians and Chinese have longer life than
foreign-born counterparts. This is because of the social structural and lifestyle
Racism and discrimination are 2 important factors to consider when examining the
relationships between ethnicity and health.
Those who experienced racially-motivated (racial discrimination) verbal abuse were
60% more likely to report having fair or poor health.
Racism and racial discrimination…higher risk of depression and psychological
Depression…higher risk of racial discrimination.