Social class is the main determinant of health disparities and prolonged existence. Individuals with higher social class, regularly measured their earnings or occupation, are more likely to have longevity, fewer rates of chronic disease and are not less likely to suffer accidental injury (Kawachi, Daniels, & Robinson, 2005).
How does social class impact population health?
Social class is a real health determinant and the effects are mostly due to material conditions. Social class and position create health imbalances by shaping individuals’ experience to nearly all psychosocial and environmental risk factors for health.
The critical dissimilarity between supposed materialist interpretations and psychosocial ones centers on the importance of real differences in resources for health. The psychosocial interpretation attends to real differences but sees their impact as deriving from the social meaning of the differences rather than the differences themselves (Kawachi, Daniels, & Robinson, 2005).
A materialist interpretation, in contrast, insists that health inequalities are shaped by real resource differences that are the products of social and economic conditions. These differences influence one’s likelihood of facing various life problems, experiencing psychosocial stress, and adopting different health-promoting or health-damaging behaviors. While income and educational achievement are two indicators of one’s position in the social pecking order, from a materialist viewpoint, they shape the real conditions of life that have an impact on one’s health and well-being (Barbeau, Krieger, & Soobader, 2004).
For example, income level influences an individual’s ability to buy a quality home in a neighborhood where crime, noise, pollution, and vermin are kept to a minimum and safe parks, excellent medical facilities, and markets well stocked with fresh fruits and vegetables are conveniently located. Likewise, people use education to situate themselves in occupations that are safe and that include health insurance as a benefit. Therefore, the unequal distribution of actual resources creates social class gradients in health.
In what ways does social class relate to the seeking of early medical care?
It is vital to assess environmental factors such as social class because they are critical variables in illness and adjustment (receiving early medical care). Becker and Newsom (2003) described several theorized mechanisms (e.g., the additive burden theory and the event-proneness theory) connected to the higher levels of psychopathology among members of the lower social-economic status that also relates to social class to the seeking of early medical care. These mechanisms have since been applied to physical illness (Becker, & Newsom, 2003).
Social class is related to particular social situations and personal dispositions that put one at risk for illness, and stressful events related to those illnesses, as well as access to medical care and adjustment-related services. For example, poverty may be associated with poorer nutrition and health care, creating developmental risks for illness among lower social class individuals. Furthermore, poorer medical care (e.g., no immunizations or antibiotics) and living in an area where others are also receiving poor or no medical care put lower social class individuals at risk for being exposed to more illnesses.
Poverty breeds more poverty-larger families, less food, less education (without education there is no empowerment), child labor and the cycle repeats (Barbeau, Krieger, & Soobader, 2004). However, lack of money stops the low social economic individual from seeking early medical care.
Most low-class individuals are more likely to seek medical care when their symptoms are unfamiliar, appear to be serious, last longer than expected, or disrupt their work or social activities (Darity, 2003). In this way, social class can be related to the seeking of early medical care. However, higher socioeconomic groups are reported to have fewer symptoms and better health, but when sickness occurs, members of these groups are more likely to seek medical care on time than lower-income people are.
Barbeau, E. M., Krieger, N., & Soobader, M. J. (2004). Working class matters: Socioeconomic disadvantage, race/ethnicity, gender, and smoking in NHIS 2000. American Journal of Public Health, 94, 269-278.
Becker, G., & Newsom, E. (2003). Socioeconomic status and dissatisfaction with health care among chronically ill African Americans. American Journal of Public Health, 93, 742-748.
Darity, W. A. (2003). Employment discrimination, segregation, and health. American Journal of Public Health, 93, 226-231.
Kawachi, I., Daniels, N., & Robinson, D. E. (2005). Health disparities by race and class: Why both matter. Health Affairs, 24(2), 343-352.