The biological mechanisms that result from lower ses/being poor. There are bad helath outcomes that literally result from being poor

e.g. Cortisol levels raise when one is poor, greater stress cuases cortisol levels to rise

What is the health-wealth/social gradient in health?

What are some of the mechanisms through which this gradient in health operates?

One's health follows ones ses: if you are of low ses you are likely to have poor health; while if you are of high ses you are likely to have good health, lower mortality, lower mobidity.

Mechanisms: One's education, their income, their acces to health care (??) 

NO, education does not explain mortality rates.

How social class "gets under your skin" determines it (i.e. cortisol levels).

Infants born to black women are 3x more likley to die than white women.

True or False: According to Sir Michael Marmot (video), behaviors explain about half of the social gradient in mortality.

False, his Whitehall studies showed only about 1/4 of the social gradient was caused by one's behaviors (e.g. smoking, obesity, etc.). Instead his research showed that one's health is largely determined by their social class.

that one's social class determined

The social factors and physical conditions of the environment in which people are born, live, learn, work, play, and age, that affects ones health. Includes one's ses but not only that.

There are significant association b/t these resources & health coutcomes.

Upstream distal factors

e.g.  availability of resources to meet daily needs such as educaiton and job opportuties, living wates, helathy foods, etc; exposure to crime, quality schools, transportation options, social support, etc.

Social Causation Hypothesis

(Lec. 13)

One's S.E.S. determines their health.

(e.g. high SES, more likely to have better helath.)

Mechanisms: Lower SES may be associated with lower access to health care, less access to health foods, etc.

Healths affects what one's SES will be. 

"Social drift" hypothesis: Unhealthy persons "drift down" to poverty

Mechanisms: childhood health affeects one's adult SES indirectly via health's affect on the indvidiuals's ability to achiever higher SES status (e.g. via educational atainment) 

a distal cause

Believe that one's SES is a "fundamental cause" of disease. That social factors operate both directly (e.g. not being able to afford health care) to influence health and indirectly (i.e. by influenceing behavior) to affect health. It is a more distal view of health.

The social causation hypothesis & the health selection hypothesis.

These two hypotheses play against each other (check definitions)

The structuralist approach is represented in upstream intervention b/c it too approaches intervention by looking at the structure of various things, social,political, environmental, and /or economic.

The behavioralist approach is represented in downstream because it also tries to improve health by changing bpeople's behavior.  i.e. rehab, counseling

(from my own thoughs & pbs)

The Civil Rights Laws allowed blacks to begin to get to get better jobs which would improve their helath in the long run.

Medicare is a social policy.

Medicaid is a social policy

Welfare programs can improve health