1. Causes of Inequalities in Health: Socio-economic Status

3. 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)

4. 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

5. 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

9. The Black Report (1980) Findings Key causes of inequalities in health were: Low income Unemployment Sub standard housing Poor environment Poor education

12. 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:

16. “ Working Together for a Healthier Scotland”

21. Scotland Health Survey 2003