16.6 Socioeconomic and Ethnic Health Inequalities

Socioeconomic and Ethnic Inequalities in Health

• Risk factors impacts health, leading to chronic conditions.
• Risk factors can be indicators for potential health issues in certain groups.
• Socioeconomic status and/or ethnicity affects health and wellness.

Multiple Deprivation

• The Index of Multiple Deprivation (IMD) 2019 is the official measure of relative deprivation for small areas in England.
• IMD ranks areas from 1 (most deprived) to 32,844 (least deprived).
• There are 7 domains of deprivation included in the Index:
• Income: 22.5% weighting.
• Employment: 22.5% weighting.
• Education: 13.5% weighting.
• Health: 13.5% weighting.
• Crime: 9.3% weighting.
• Barriers to housing & services: 9.3% weighting.
• Living environment: 9.3% weighting.
• Each domain has a weighting based on a group of indicators.

Task 1: Socioeconomic Status and Health

• Jim (25 yrs, male) lives in a deprived, low SES area in Bolton, England.
• Consider the cumulative effects of a lack of education along with the 6 other factors/domains listed in the IMD that leads to unfavourable health outcomes.
• Income: gym/sport membership or equipment unaffordable.

Task 2: Ethnicity and Health

• Ravi (32 yrs, male) arrived in the UK as a refugee with his young family.
• His family fled from the Sri Lankan Civil War and cannot speak English fluently.
• Key questions about Ravi include:
• What illnesses does Ravi's ethnicity mean he is at greater risk for?
• What might they have experienced before and during the war and how might it affect their health and wellbeing?
• What might transit and migration to UK mean for their physical and mental health?
• What issues may they face in terms of accessing healthcare, education and work? -- Consider their social integration and whether they can settle harmoniously

Intersection of Socioeconomic Status and Ethnicity

• Socioeconomic and ethnic inequality are problematic alone.
• Inequality is disadvantageous when wealth is unevenly distributed across ethnic groups.
• Inequality generates: lack of social cohesion, social immobility, hatred, envy, and potentiates conflict.
• These issues lead to negative consequences for health.
• Inequality in income along ethnic lines exacerbates group identity.
• It limits social cohesion by increasing between-group animosity, impedes institutional development.

Socioeconomic and Political Considerations of Inequality

• Institutionalised discrimination is the mistreatment of an individual or group of individuals by society.
• It is unjust and discriminatory mistreatment by institutions.
• Discrimination occurs through intentional or unintentional bias or selection.
• This bias isn't necessarily a conscious decision to harm.

Recent Manifestations of Inequality

• Inequality in income along ethnic lines is likely to exacerbate the salience of group identity, limit social cohesion and can cause conflict
• Income differences across ethnic groups cause and are consequences of discriminatory policies including the unequal provision of public goods or services
• The denial of the COVID-19 vaccine for ethnic Palestinians while offering mass rollout of vaccines for ethnic Israelis.

Summary

• Socioeconomic status, employment, and occupational context all have associated risk factors that affect health outcomes
• Though reducing ethnic inequalities can lead to social immobility, institutionalised discrimination and can have negative health outcomes
• Socioeconomic status and ethnic inequality intersect, exacerbating disadvantages for certain demographic groups.

Explore the impact of socioeconomic status and ethnicity on health outcomes. The Index of Multiple Deprivation (IMD) 2019, a key measure of relative deprivation in England, considers factors like income, employment and education. Analyze how deprivation affects health.