Socioeconomic Status (SES) and Health
social radiant theory
SES determines health status (favored theory that has empirical support)
when is FOF response adaptive?
short time acute occasions when perceived threat will go away in a short period of time
wealth
the accumulated value of all assets including home equity, value of savings and checkings accounts, vehicles, rental properties
poverty
the lack of money to meet basic needs
constrained choices
the limit we have on acquiring things
disadvantages of measuring poverty
the poverty thresholds are set very low; poverty thresholds do not vary by states
social class
things like power and prestige plus SES and the control of destiny, privilege
net worth
total value of all assets minus the total value of liabilities
advantages of measuring poverty
unlike income, takes account into family size
when is FOF maladaptive?
when it is chronic; cortisol is constantly being pumped into our system
who makes the most in general, no matter the circumstance?
white men
excess death
you should be able to predict how many people in a population will die
life expectancy of men high school grad. vs. college grad.
7 years
what is likely to lead to premature birth?
having a stress response that is constantly on
vigilance
having to be on guard, plays out in the biological stress response
social selection
health status causes socioeconomic status
which group has lowest rate of college attainment?
hispanics
advantages of measuring personal income
income can be clearly defined and measured; income can be standardized to compare across time or between countries
most common measures of SES
income, poverty, education, wealth
symptoms of fight or flight response
increased BP, increased HR< increased adrenaline
personal income
money obtained through employment, transfer programs, other sources
SES gradient in health
most robust association in health research
disadvantages of measuring personal income
often missing in surveyed research; doesn't take into account the number of people in the household; the most susceptible to downward drift (social selection); strongly affected by health status; sensitive to periods of unemployment and underemployment
whitehall studies in britian
originally only looked at white men; first to ID social gradient in health; SES increases health status increases
are racial/ethnic health inequities due to SES differences?
people of color have lower SES regardless of measurement
which 2 groups does chronic activation of the stress response affect the most?
people of color more likely to have prolonged activation; people living in poverty or SES status
allostatic load
physiologic (based on bio-markers) burden imposed by stress; can measure the continued burdens of stress response by cortisol and adrenaline
fight or flight response
physiological (bodily) response launched to a perceived threat
advantages of measuring educational attainment
rare to have missing data on educational attainment; unlike income it is relatively stable across the life course; not susceptible to downward drift
which 2 groups have highest poverty rates?
american indians and AA
2012 annual federal poverty guidelines
attributed to family size of 4; government family poverty line is very low
which nationality group has the same graduation rate as whites?
cubans
weathering
cumulative deterioration "wear and tear"
how does wealth matter for health?
cushion to help absorb unexpected medical shocks; life chances for people's children, accumulating social advantage or disadvantage
social determinants of health
major forces that shape health outcomes in communities
years of potential life lost
deaths that should not occur
