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In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
This book brings together the latest research findings from some of the most respected medical and social scientists in the world, surveying four pathways to understanding the social determinants of health.
At a time when social inequalities are increasing at an alarming rate, this new edition of Mel Bartleys popular book is a vital resource for understanding the extent of health inequalities and why they are proving to be persistent despite decades of growing knowledge and policies on the issue. As in the first edition, by examining influences of social class, income, culture and wealth as well as gender, ethnicity and other factors in identity, this accessible book provides a key to understanding the major theories and explanations of what lies behind inequality in health. Bartley re-situates the classic behavioural, psycho-social, and material approaches within a life-course perspective. Evaluating the evidence of health outcomes over time and at local and national levels, Bartley argues that individual social integration demands closer attention if health inequality is to be tackled effectively, revealing the important part that identity plays in relation to the chances of a long and healthy life. Health Inequality will be essential reading for students taking courses in the sociology of health and illness, social policy and welfare, health sciences, public health and epidemiology and all those interested in understanding the consequences of social inequality for health.
'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.
New Horizons in Health discusses how the National Institutes of Health (NIH) can integrate research in the social, behavioral, and biomedical sciences to better understand the causes of disease as well as interventions that promote health. It outlines a set of research priorities for consideration by the Office of Behavioral and Social Sciences Research (OBSSR), with particular attention to research that can support and complement the work of the National Institutes of Health. By addressing the range of interactions among social settings, behavioral patterns, and important health concerns, it highlights areas of scientific opportunity where significant investment is most likely to improve nationalâ€"and globalâ€"health outcomes. These opportunities will apply the knowledge and methods of the behavioral and social sciences to contemporary health needs, and give attention to the chief health concerns of the general public.
How can research on the social determinants of health be translated into real life public health practice? Challenging the research-practice gap, this text shows readers from a range of professions how their practice can help to minimise health inequalities. The social model of health embraces individual lifestyles, social and community networks, socio-economic, political and cultural influences and the plethora of factors that can impact on public health, for instance, education, work, welfare benefits, environment, housing, health and social care. All of these can have a significant effect on people’s experiences of health and well-being, and are often unrecognised sources of health inequalities. This innovative textbook outlines and discusses key public health principles and the social model of health. Drawing on a range of case studies and the international literature, it looks at how public health research has been applied to policy and practice. The book discusses the transferability that these findings have had and their capacity to influence and provide evidence for practice. Health and Inequality covers a broad range of social determinants of health, encountered throughout the life-course, including: Pre-birth and early years Breastfeeding and teenage mothers Health inequalities for mothers and babies in prison Children in full time education Sexuality, relationships and sexual health of young people Early adulthood Welfare rights and health benefits Women, employment and well-being Adults in later life Practical and clearly structured, this text will be useful to a range of health and social care professionals involved in public health work, particularly those undertaking courses on public health, health promotion or the social determinants of health.
Inequality in income, earnings, and wealth has risen dramatically in the United States over the past three decades. Most research into this issue has focused on the causes—global trade, new technology, and economic policy—rather than the consequences of inequality. In Social Inequality, a group of the nation's leading social scientists opens a wide-ranging inquiry into the social implications of rising economic inequality. Beginning with a critical evaluation of the existing research, they assess whether the recent run-up in economic inequality has been accompanied by rising inequality in social domains such as the quality of family and neighborhood life, equal access to education and health care, job satisfaction, and political participation. Marcia Meyers and colleagues find that many low-income mothers cannot afford market-based child care, which contributes to inequality both at the present time—by reducing maternal employment and family income—and through the long-term consequences of informal or low-quality care on children's educational achievement. At the other end of the educational spectrum, Thomas Kane links the growing inequality in college attendance to rising tuition and cuts in financial aid. Neil Fligstein and Taek-Jin Shin show how both job security and job satisfaction have decreased for low-wage workers compared with their higher-paid counterparts. Those who fall behind economically may also suffer diminished access to essential social resources like health care. John Mullahy, Stephanie Robert, and Barbara Wolfe discuss why higher inequality may lead to poorer health: wider inequality might mean increased stress-related ailments for the poor, and it might also be associated with public health care policies that favor the privileged. On the political front, Richard Freeman concludes that political participation has become more stratified as incomes have become more unequal. Workers at the bottom of the income scale may simply be too hard-pressed or too demoralized to care about political participation. Social Inequality concludes with a comprehensive section on the methodological problems involved in disentangling the effects of inequality from other economic factors, which will be of great benefit to future investigators. While today's widening inequality may be a temporary episode, the danger is that the current economic divisions may set in motion a self-perpetuating cycle of social disadvantage. The most comprehensive review of this quandary to date, Social Inequality maps out a new agenda for research on inequality in America with important implications for public policy.
Unequal Lives focuses on the connections between people's unequal health and people's unequal lives, and between health and socioeconomic inequalities
Why can't politicians seem to make policies that will reduce social inequality, even when they acknowledge that inequality is harmful?