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Social Determinants of Health

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Social Determinants of Health <[log in to unmask]>
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Mon, 8 Jan 2007 15:52:50 -0500
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Social Determinants of Health <[log in to unmask]>
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John Courtneidge <[log in to unmask]>
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Dear friends

The responses typify the essence of humanity -someone asks, and many 
respond - hurrah!

My few thoughts:

1) The choice aspect seems an adoption of a false proposal

    - that many of us have choices:.

The question (lack of) social mobility suggests otherwise, and that, 
apart from day-to-day moral choices, the fixity of the social gradient 
dictates life-'styles'.

2) As to the route(s) to longevity - education is no guarantee to having 
one's needs met.

The first mental picture I have is of a concertina held vertically, with 
IQ (/aptitude/whatever) bell-curves attached at each fold.  When the 
income (social) gradient is closed, the bell curve spans a number of 
folds, so that need can be met by the bell curves overlapping a number 
of folds (life-'style' opportunities).

This occurred in the 1950-60s, when more jobs were available than there 
were applicants, and when opportunities for education and opportunities 
appropriate to needs were more abundant (ie working -class kids got to 
go to university etc - to some greater degree - than before, and there 
were jobs open for them once educated).

That ended in 1970 in the UK

    - in 1969, for example, ICI (th largest employer of chemists in the 
UK) took on 220 chemistry graduates (as chemists) - in1970, and onwards, 
this was reduced to 20.

Social (im-)mobility data will doubtless show that  health (generally: 
'needs met') is ordinately dependent on the inequality (income) gradient 
- not 'life-style choice'.

The final mental picture is the sliding-tile children's toy (where you 
have to move the tiles to get them in alphabetical order, or reveal the 
picture): if there are more spaces than tiles, one can move the tiles 
around.

However, if all spaces are filled, then the system (society of tiles) is 
locked - the story is not told, the picture not revealed.

Similarly, even if the toy has one free space, but it is held 
vertically, the only freedom space is at the top - and, even then, 
'those at the top' have no true freedom - see, eg, the episode of 'The 
Virgin Queen' about various Queen Marys and QE I shown on pbs last evening.

What life-style choice is there is you have to wear amour for fear of 
assassination, or to have a food taster for fear of poisoning?

So: how to increase life-possibilities and to reduce income gradient as 
the route to good-health for all?

More on that?

Love

john

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