The following studies into health inequalities have found a causal link between social class and the incidence of ill health. The Acheson Report (1998) Reports The Black Report (1980) The Health Divide (1987) Working Together for a Healthier Scotland (1998)
Social Class To understand the link between social class and ill health, we need to be clear what is meant by social class. A person’s social class is based on a mixture of factors: Occupation Income level Housing Education
Registrar General’s Classification of Social Class Unskilled. Cleaner, labourer. Semi-skilled manual. Assembly line worker, builder, lorry driver. Skilled manual: Clerical and minor supervisory. Electrician, mechanic, plumber. Non-manual: Clerical and minor supervisory. Clerk, police officer, shop assistant Lower managerial, administrative, professional. Farmer, librarian, sales manager, teacher. Higher managerial, administrative, professional. Accountant, bank manager, dentist, doctor, solicitor. Categories V IV IIIb IIIa II I Class
Report contained 37 recommendations which focused on two main areas:
Government should adopt a policy: aimed at reducing poverty in the UK of spending more money on health education and the prevention of Illness.
The Black Report (1980) Reaction by Government
When the Report was published there was a change of government. Conservatives were now in government and they criticised the Report.
Report did not explain inequalities in health. Spending more on health services would make no difference to health standards. Contrary to what the Report said, poor people did use health services.
The Black Report (1980) Took the individualist approach – people should eat, drink and smoke less Argued that individual behaviour within social classes shaped health Regarded the Report as old-fashioned, socialist explanations of ill-health They wanted to reduce public expenditure Government disagreed Problem was:
Just when the Report was being commissioned, the government announced that the HEC was to be scrapped.
HEC was campaigning on alcohol, tobacco and diet issues which upset some of the government’s financial supporters – tobacco manufacturers gave a lot to party funds.
One week before findings were due to be made public, a press conference was cancelled with no explanation. Clearly pressure had been put on the Chairman of the HEC to cancel because of the controversial nature of the report’s findings.