Social Class as a Determinant of Health


Over the years, society has been divided into three classes; the upper class is associated with riches and luxurious lives. The middle class is associated with income levels that sustain their lives but are not sufficient to sustain a luxurious life. The lower class is associated with individuals that struggle to make ends meet daily. The capitalist economic model that has been assumed in the developed economies has also influenced the recurrent inequality in health among the people in the different social classes. This paper looks into social class as a determinant of health, with a close focus on some of the variables that influence the relationship between health and class.

Class vs. Socio-Economic Status

The social class of an individual highlights the behavior of the individual regarding income, education, and social wellness, and it is normally a long-term state. Social-economic status, on the other hand, refers to the individual’s economic status, and it influences their behavior regarding luxury. The social-economic status of an individual is likely to change faster than the social class because it only requires the individuals to liberate themselves economically. Both concepts play a major role in the health outcomes of the individuals and the rest of the society within their social class and social-economic status (Howarth 2007).

Materialistic/Structural Explanation

The structural orientations of the people in different classes have a direct impact on their respective health outcomes. One of the issues that have led to the high inequality in health for the society is the purchasing power associated with the different social classes. The members of the upper class in the society are associated with the ability to purchase health insurance and access specialized services from private health care facilities. It is also apparent that the private sector in the health care system provides the best services because the associated entities have the funds to purchase the best equipment and to enhance the quality of services (Blas & Kurup 2010). It is, therefore, vivid that the people in the upper class are likely to highlight better health outcomes than their counterparts (Wagstaff 2002).

Contrastingly, the people in the middle class are likely to have the ability to purchase health insurance, and some of the individuals in the group can access privatized health care services. However, the majority of the individuals in this bracket of society depend on the public sector for health care services because it is fairly affordable (Marmot & Wilkinson 2005). The lower class members, on the other hand, have a difficult time accessing health care services because most of the people living below the poverty line cannot afford health insurance. The associated individuals also live in neighborhoods that have limited social amenities and facilities like hospitals.

Various studies have developed consistent findings that people, especially children, in the lower class of society have a higher propensity of developing obesity and related illnesses. The cost of a healthy meal in modern society, especially in urban areas is extremely high (Marmot 2005). This implies that only the rich can afford to purchase fresh agricultural products from the grocery stores regularly. The impoverished members of the society have been forced to rely on cheaper processed foods, which are quite unhealthy. While all members of society face a risk of obesity, children in the lower social class have a higher probability of developing obesity and other lifestyle-related illnesses (Relationship between Poverty and Obesity 2016). The impoverished members of the society have a minimal ability to determine what to place on the dining table at the end of the day, which implies that they have a challenge in eating healthy meals.

Cultural/Behavioral Explanations

Cultural attributes influence the behavior of people in different classes, and this affects their respective health outcomes. It is also apparent that social classes have a direct influence on the advantages associated with better health in society. For instance, the rich members of the society live in neighborhoods that are spacious and clean, whereas the poor members of the society live in congested neighborhoods (Berkman 2009). Many disease outbreaks in society commonly affect the people living in congested neighborhoods because the diseases spread easily (Braveman et al. 2005). Additionally, the living conditions in impoverished neighborhoods are associated with high levels of issues concerning sanitation. Impoverished neighborhoods also have lower numbers of health care facilities, which makes it more difficult for health outcomes in these areas to improve. The private sector avoids the impoverished neighborhoods because the people cannot afford their services, whereas the public sector has been associated with the inability to provide sufficient health care facilities, equipment, and health care providers.

Morbidity and mortality are some of the measures of health that have been used by researchers in comparing the health outcomes regarding social classes (Marmot 2004). Studies have revealed that morbidity and mortality rates are higher among people in the lower class (Schell et al. 2007). One of the issues that foster this disparity in statistics is the fact that the people in the lower class face more health-related disadvantages such as lack of access to health care facilities and poor diets among many other issues (Marmot et al. 2008). Additionally, people in the lower class are likely to work in hazardous environments, which increases the risk of health complications. It is also apparent that poverty has a major role to play in health outcomes within developing nations. The developed nations have a larger population within the high and middle-income levels; hence, the majority of the people can afford quality health services (Mackenbach et al. 2008). In developing nations, on the other hand, the highest numbers of people are impoverished; hence, the health outcomes highlight higher morbidity and mortality (Wilkinson & Marmot 2003).

Psychosocial/Social Capital Explanations

The interaction between social factors and individual issues may also result in different health outcomes for different people. Psychological stress has been associated with the development of various illnesses, and long-term exposure to stress is one of the issues that lead to the development of illnesses. The quality of life is a direct determinant of health outcomes when stress is considered (Braveman 2006). In the context of class, stress affects all members of the society, but it is apparent that the impoverished members of the society face constant stress because of the economic challenges faced regularly (Keleher & MacDougall 2011). This implies that the people in the lower class are subjected to a higher propensity of developing stress-related illnesses than their counterparts in the upper and middle classes.

Psychological health issues are among the emerging issues among people in the lower class. This is especially seen when there is the interplay between gender and class as a determinant of health in the community. For instance, women in the lower class have a higher propensity to developing stress-related illnesses than their counterparts in the upper and middle class (Kreiger 2001). Society must identify some of the factors that combine to increase health issues in the community. In most cases, the lack of opportunities to liberate the women financially is the main cause of stress, especially when the associated parties have many children looking up to them (Keleher & MacDougall 2011).

Education is one of the factors associated with the promotion of health in society; hence, access to education is a socio-economic determinant of health. It is apparent that the people in the upper class are likely to be more educated than their counterparts in other social classes; hence, they have a better understanding of the requirements to improve their health (Raphael 2006). Researchers in the health care field have established that health literacy is one of the major determinants of health in society. Studies have also revealed that the people in the upper class are more literate concerning health; hence, they are the major consumers of preventive health care services (Scott et al. 2002). Contrastingly, people in the lower class have a lower health literacy level, which has a negative influence on their consumption of preventive health care services.


The inequality in the distribution of wealth has led to the development of three distinct social statuses whose boundaries involve the economic liberation status of the members of the society. The different social classes have access to different qualities of health care services, which influences the health outcomes across the social class table. The people in the upper class of the society have a higher purchasing power, which results in their ability to access privatized health care services. The middle class has access to the standard quality of health care services, whereas the lower class members struggle to access health in the public sector.

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