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Health, Aging and Society
Elena Neiterman

CHAPTER FIVE Introduction: -hierarchy can be observed along a number of different dimensions such as economic, educational, gender, and social status variations, among others -conflict theory perspective and social justice perspective say that hierarchical structure is indicative of inequality -there is a positive & consistent relationship between good health and location further up hierarchy -people who have more wealth tend to be healthier, and people who have less wealth tend to have poorer health -the overall degree of equity or inequity within society affects the well-being of everyone within the society, including both those at the top and those at the bottom of the income hierarchy -materialist approach to the social determinants of health: this perspective states that human health depends fundamentally on available, accessible, and good-quality nutritious food, clean water, good transportation, employment, housing and essential components of life -income is central to health in the materialist view and 2 aspects of this are important:  Income sufficiency or adequacy: for things such as the purchase of food, shelter, transportation, and leisure activities  Income stability: so that the money is available consistently and predictably from month to month and from year to year -material circumstances can also influence health directly through assaults to the physical body (such as spread of infections) -poorer people are also more likely to cope by engaging in some behaviours that may have health threatening results such as high carbohydrate and low protein diets and an absence of exercise -neomaterialist approach: this perspective acknowledges the importance of a basic level of material adequacy but then centres its attention on the significance of the relative distribution of material and social goods in societies; once a certain degree of material adequacy has been reached, then equity and perceived equity become essential to the overall health of a population -life course approach to health outcomes overlaps with the previous three emphases but draws attention to the fact that impoverishment, inequity, a lack of redistributive policies, social exclusion, and negative social comparisons all are exacerbated when they occur to and among children and then, in one way or another, continue throughout life -pathway effects set children onto a course resulting from unhelpful or helpful early experiences -latency effects refer to early developmental effects that may influence later life -cumulative effects are the accumulation of disadvantage or advantage over a lifetime and include combinations of both latency and pathway effects that lead to health and or disease in the adult Political Explanations for Inequality and Poor Health: -health inequities result from forces and decisions at the global and national political and economic levels An Operating Model for the Social Determinants of Health: -inequity causes different life chances and experiences, as well as unequal access to fundamental social resources such as food, recreation, satisfying work and adequate shelter -the rates of sickness and death is different since there is unequal access for people who differ in, for example, age, race, sex, income etc. -differences in mortality and morbidity are related to political-economic systems at the level of the nation-state as well as to national cultural differences -there are cultural differences in the interpretation of symptoms and behaviours associated with health and illness CHAPTER FIVE -social-structure positions such as gender and age are related to health outcomes; this means people who are in different positions in an invisible but effective hierarchical social structu
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