Introductory Sociology Sample Essays (Example 3)

Example 3: an essay from a CSU student in a second-year sociology subject How is class and stratification linked to health inequality? The correlation between class and health has framed modern studies concerning the complexities surrounding exposure to health problems and the experience of illness. According to the World Health Organisation (1948) health is defined as a state of complete physical, social and mental wellbeing, and not merely the absence of disease or infirmity. Further, health encapsulates the cultural context in which an individual lives. The historical and contemporary motivation for sociological interest in health disparities, is embedded in the indisputable fact that individuals differ in their physical health profiles, regardless of how health is defined (Read & Gorman, 2010, p. 373). By applying Bottero’s theory of stratification (2005), this essay will examine how class, stratification, and levels of autonomy shape health inequalities with only the formation of egalitarian health policies encapsulating universal access to health care decreasing any disparities. Class is an overarching term which embodies status, wealth, culture, background and employment (Craib, 2002, p. 344). An individual’s location in their community’s class hierarchy has a significant impact on their physical health, their ability to receive sufficient medical care and nourishment, and their life expectancy. Further, studies of morbidity and mortality have steadily revealed that class status is the greatest determining factor in an individual's level of access to healthcare (‘Social class and health,’ 2016, May 26., para 1) with individuals of lower class status experiencing a vast array of health problems which are only exacerbated by their limited access to health care. An example of how class relates to health inequality is highlighted in the difficulties experienced by indigenous people in Australia. A study conducted by Markwick, Ansari, Sullivan, Parsons, and McNeil (2014) sought to identify the determinants of health of Aboriginal adults compared with their non-Aboriginal counterparts (Markwick et al., 2014, p. 91). The investigation revealed that according to class status Aboriginal people are severely disadvantaged compared with their non-Aboriginal equivalents, with lower household incomes and lower employment rates. (Markwick et al., 2014, p. 91). Specifically, lower class status has been shown to have a significant adverse impact on health (Kondo et al., 2009, p. 1) with low household income resulting in less disposable income to purchase healthy foods, engage in physical activity, and be able to afford safe and adequate healthcare. Furthermore, the study found that the majority of Aboriginal people acquired a lower level of educational attainment thereby limiting their likelihood of obtaining a job that pays a living wage, and as a consequence, positions them at a higher risk of unemployment and lower levels of health literacy (Markwick et al., 2014, p. 7). The persistence of health inequalities in Australia is multifaceted being further swayed by social stratification; the patterning of inequality and its enduring consequences (Bottero, 2005, p. 3). Social stratification provides the milieu for all interactions inescapably affecting the choices people make by opening up doors of opportunity or shutting them (Bottero, 2005, p. 3). Moreover, social stratification is concerned with how some people have more freedom and choice than others. This freedom is predominately saturated in money and power and gives those who possess them greater control over external forces (Bottero, 2005, p. 3). Arguably, this social liberty is sustained through ‘inter-generational transmission’ (Bottero, 2005, p. 3). This structural notion explains how inequality in one generation affects inequality in the next as the resources available to one generation affect their education and eventual occupations. Consequently, generating their social position which can cascade into their children’s life chances. Therefore, social stratification allows inequalities that persist and endure over time to be analysed (Bottero, 2005, p. 4). These distinct components that encapsulate social stratification can also be used to identify underlying health inequalities (Mackenbach, 2012, p. 762). For example, a study conducted by Marmot, Rose, Shipley, and Hamilton (1978) sought to identify and explain any social class gradient in coronary heart disease mortality in a group of employed men by analysing data from the Whitehall study of British civil servants. The study revealed an inverse association between employment grade and mortality from a variety of illnesses. Men in the lowest grade had a three-fold higher mortality rate than men in the highest grade (Marmot et al., 1978, p. 244). A possible explanation of the inverse association between employment grade and mortality is grade variances in job control and job support (Marmot, Kogevinas & Elston, 1987, p. 131). This study supports Bottero’s social stratification theory, specifically, individual freedom and greater individual control over external forces (Bottero, 2005, p. 3) by highlighting how low levels of autonomy and personal control can be a vital arbitrator between low class position and poor health. Health inequalities have been and continue to be influenced by class and social stratification. This essay highlights how both concepts are linked to this social phenomenon by examining the difficulties experienced by indigenous people in Australia and the effect of social class gradients in homogenous groups. Arguably, while the health industry trades in on the culture of agency, the solution to universal access to health with an egalitarian approach to exposure and experience is not only personal but also political. Therefore, only when health policies are created to encapsulate universal access by limiting the effect class and stratification has on health will a classless approach to health care be achieved. References Bottero, W. (2005). Stratification: Social division and inequality. Abingdon, United Kingdom: Routledge. Craib, I. (2002). What is social class? Group Analysis, 35(3), 342 – 350. Kondo, N., Sembajwe, G., Kawachi, I., Van Dam, R. M., Subramanian, S. V., & Yamagata, Z. (2009). Income inequality, mortality, and self rated health: Meta-analysis of multilevel studies. British Medical Journal, 341, 1-9. Mackenbach, J. P. (2012). The persistence of health inequalities in modern welfare states: The explanation of a paradox. Social Science & Medicine, 75, 761-769. Markwick, J., Ansari, Z., Sullivan, M., Parsons, L., & McNeil, J. (2014). Inequalities in the social determinants of health of Aboriginal and Torres Strait People: A cross-sectional population-based study in the Australian state of Victoria. International Journal for Equity in Health, 13, 91-103. Marmot, M. G., Kogevinas, M., & Elston, M. A. (1987). Social/Economic status and disease. Annual review of public health, 8, 111–135. Marmot, M. G., Rose, G., Shipley, M., & Hamilton, P. J. (1978). Employment grade and coronary heart disease in British civil servants. Journal of Epidemiology and Community Health, 32, 244-249. Read, J. G., & Gorman, B. K. (2010). Gender and health inequality. Annual Review of Sociology, 36, 371 -386. Social class and health. (2016, May 26). In Boundless Sociology. Retrieved from https://www.boundless.com/sociology/textbooks/boundless-sociology- textbook/health-and-illness-19/the-experience-of-illness-132/social-class-and-health734-8214/. WHO definition of health (1948). In World Health Organisation. Retrieved from http://www.who.int/about/definition/ Example 4: an essay from a CSU student in a second-year sociology subject Essay Two: How is class and stratification linked to health inequality? Bottero (2005) tells us that the discrimination, disadvantage and exclusion that people experience is imprinted onto health inequalities, as “an embodied index of hierarchy and inequality” (p. 187). Direct links between socioeconomic status and health outcomes have been proven to exist (Babones, 2010, p. 130). Health outcomes not only differ between the rich and the poor, they differ between all levels of social classes in a gradient of health (Bottero, 2005, p. 189). The social class hierarchy affects health through psychosocial effects, which impact on a person’s health inequalities (Bottero, 2005, p. 190). Life expectancy is correspondingly affected by class, with as much as ten years difference between the top and bottom of the hierarchy (Bottero, 2005, p. 188). The gradient of health will be used to explain how class position can lead to health inequalities directly, whilst at the same time considering the class based psychosocial reactions and their impact on heath status. Gradual increases in class status correlate with gradual increases in favourable health status (Valle, 2009, p. 2). Individuals with greater access to resources have better health outcomes, as they can afford better health care, are better equipped to access and understand health information and are less likely to make poor health choices (Babones, 2010, p. 131). Exposure to harmful health situations such as poor diet, environment and work risks, and sanitary living conditions, are linked to low class status (Valle, 2009, p. 2). As access to resources is a measurement of social standing, health inequalities will naturally occur, as those with access to more resources intrinsically have greater access to health opportunities (Babones, 2010, p. 132). Self-reported health measurements also differ along the class hierarchy (Valle, 2009, p. 6). Valle (2009) found that individuals in higher classes were not only less likely to report poor health, but were also less likely to report experiencing health problems within the test period (pp. 4-5). The social distance experienced by the lower classes creates negative health experiences due to a sense of low levels of agency (Valle, 2009, p. 7). Higher levels of social capital can be utilised to effectively manage stress, through better economic and emotional assistance, which reduces the likelihood of detrimental health behaviour (Uphoff, Pickett, Cabieses, Small & Wright, 2013, p. 2). Psychosocial reactions to poor social position, such as high levels of stress, low perceptions of self worth and lack of control over life circumstances, lead to negative health consequences (Bottero, 2005, p. 190). These consequences can result from indirect risks, such as poor health choices like smoking or drinking, or direct risks, such as physiological changes induced by stresses, which increases the chance of disease (Bottero, 2005, p. 190). Cardiovascular disease (CVD) is a useful means of gauging health inequalities, as it is prevalent in many countries, and its cause can be either hereditary or social (Tiikkaja, Olsson, Malki, Modin & Sparén, 2012, p. 1883). Studies have shown that significant differences in CVD rates exist between social classes, with parental class having long term impacts on the children’s risk of developing CVD (Tiikkaja et al., 2012, p. 1883). While upward social mobility decreases the risk of CVD, psychosocial reactions to downward mobility can cause stress or negative health choices that may impact on the risk of developing CVD (Tiikkaja et al., 2012, p. 1884). Job satisfaction and working conditions also play a role in determining the risk of CVD, with those in higher status occupational groups and the self-employed reporting higher job satisfaction and lower CVD rates, whereas low job satisfaction from poor working conditions, lack of control and inflexibility lead to higher levels of CVD (Tiikkaja et al., 2012, p. 1888). The classed nature of the gradient of health can be observed through the impact of diseases on life expectancy, for as socioeconomic status decrease, mortality rates increase (Saydah, Imperatore & Beckles, 2013, p. 49). Amid adults diagnosed with diabetes, Saydah et al. showed that as socioeconomic status decreased, mortality increased (2013, p. 53). The socioeconomic differences in mortality rates can be explained by the higher likelihood of poor health choices as class levels decrease (Stringhini et al., 2010, p. 1159). Studying patterns of poor health choices and mortality rates amongst British civil servants, Stringhini et al. found a distinct gradient of health (2010, p. 1161). This health gradient was directly linked with a mortality gradient, which revealed that lower occupational levels also had higher mortality rates (Stringhini et al., 2010, p. 1164). Interestingly, it has been shown that stratification in health equality can also work in reverse, with adult children’s class status impacting on their parent’s health outcomes (Torssander, 2014, p. 148). Torssander (2014) found that mortality rates amongst parents were not only affected by their own education level and occupational status, but were negatively associated with their children’s level of education and current income (p. 151). Parents of professional children had lower mortality rates than parents of non-professional children (Torssander, 2014, pp. 151-152). As an individual’s health outcomes are directly related to their class status, unequal class positions will inevitably lead to unequal health status. Not only does class directly affect health outcomes through fewer resources to manage illness, but stressor associated with class position can lead to psychosocial symptoms which alter a person’s outlook on life and can lead to poor health choices. Ultimately, the effect of class on a person’s health is clearly a determinant of longevity, with mortality rates inversely related to class position. References Babones, S. (2010). Income, education, and class gradients in health in global perspective. Health Sociology Review, 19(1), pp. 130-143. doi: 10.5172/hesr.2010.19.1.130 Bottero, W. (2005). Stratification: Social division and inequality. London: Routledge Saydah, S. H., Imperatore, G. & Beckles, G. L. (2013). Socioeconomic Status and Mortality: Contribution of health care access and psychological distress among U.S. adults with diagnosed diabetes. Diabetes Care, 36, pp. 49-56. doi: 10.2337/dc11-1864 Stringhini, S., Sabia, S., Shipley, M., Brunner, E., Nabi, H., Kivimaki, M. & Singh-Manoux, A. (2010). Association of Socioeconomic Position With Health Behaviors and Mortality. JAMA, 303(12), pp. 1159-1166. doi: 10.1001/jama.2010.297 Tiikkaja, S., Olsson, M., Malki, N., Modin, B. & Sparén, P. (2012). Familial risk of premature cardiovascular mortality and the impact of intergenerational occupational class mobility. Social Science & Medicine, 75(10), pp. 1883-1890. doi: 10.1016/j.socscimed.2012.06.031 Torssander, J. (2014). Adult children’s socioeconomic positions and their parent’s mortality: A comparison of education, occupational class, and income. Social Science & Medicine, 122, pp. 148-156. Retrieved from http://www.sciencedirect.com Uphoff, E. P., Pickett, K. E., Cabieses, B., Small, N. & Wright, J. (2013). A systematic review of the relationships between social capital and socioeconomic inequalities in health: A contribution to understanding the psychosocial pathway of health inequalities. International Journal for Equity in Health, 12(54), pp. 1-12. doi: 10.1186/1475-927612-54 Valle, A. M. (2009). Social class, marginality and self-assessed health: a cross-sectional analysis of the health gradient in Mexico. International Journal for Equity in Health, 8(3), pp. 1-12. doi: 10.1186/1475-9276-8-3