Class as a Determinant of Health


Class as a determinant of health plays a critical role in indicating the level of inequality within the social settings. In class-divided societies, people are classified according to education level, occupation and even housing conditions (Marmot 2004). The indicators of socio-economic status and rates of mortality, morbidity, and disability strongly support the fact that class is a critical determinant of health in society. The low social status of individuals in the world can be attributed to health deprivation by way of discrimination based on class and social status (Van Krieken et al. 2013). This paper evaluates the cultural and behavioral, material and structural, as well as psychosocial and social capital explanations of class. In the evaluation, social issues that bring about disparities in the health and wellbeing of individuals in the society concerning class and social status will be discussed to bring out the class as a determinant of health.

Cultural/Behavioral Explanations of Class

Cultural attributes and differences bring about parameters where people associate with certain values and beliefs forming social groups. Cultural influences impact class in respect to traditions, beliefs and values which make the main factors that influence status (Marmot 2004). People of similar traditions and beliefs form a cultural class, and the availability of influence is based on the social position of the individual or family being used as parameters to create sub-classes. Such categorization may result in social imbalances and a lack of efficient access to social services within a state or a nation. Moving to a new area with different cultural beliefs involves adopting the values and beliefs to be able to integrate and fit in the new community. Individuals holding onto the old cultural attributes are categorized as ancient forming a class of their own (Review 2010). According to Keleher and MacDougall (2011), various cross-cultural values bring about social status categorization with groups of persons as per their values and beliefs. A good example is in Australia where among the Aboriginals, there is considerable inequity in access to health in respect to other communities (Australian Institute of Health and Welfare 2012).

Risky behaviors that include smoking, alcohol consumption, disinterest in getting health screenings and failure to exercise impact the well-being of a person. Gender as an attribute of humanity shapes the ways in which either group is exposed to health problems. Men are significantly more likely to have fewer physician contacts compared to women regardless of income or social status (Schofield 2002). Men compared to women are likely to engage in health-risk behaviors showing disparities in health-related beliefs and practices in the gender groups. However, the behavioral aspects are used as factors to classify people within a society where you find social drinkers, hikers, party-goers among others interacting with respect to their social status.

Materialist/Structuralist Explanations of Class

The material condition or the structural life of a person has a direct impact on their well-being resulting in inequalities of health. According to Van Krieken (2013), resources possessed by a person determine how easily they can access social services. Populations in a higher socioeconomic status enjoy better life chances, as well as opportunities to lead a healthy lifestyle. For example, individuals in the middle and upper classes have access to health insurance, and thus, can access the healthcare they need (Keleher & MacDougall 2011). The upper class is said to own means of production, and the middle class is equipped with skills and credentials that steer their economic life, while the lower levels are regarded as the working class (Obeng-Odoom 2012). The definition gives a clear state of class with respect to living standards inequalities in the general populace.

The impact of the materialist aspect on class determines the overall wellbeing of an individual in the general populace. To fight the materialistic approach in the acquisition of healthcare, governments are coming up with incentives in the healthcare providers such as free maternity and free or subsidized medication just to mention a few (Holmes, Hughes & Julian 2013). Further, raising the social standards and the educational outcomes in society is necessary to bring down the inequalities (Marmot 2006). Disparities in educational outcomes share a similar gradient with a low level of well-being. Thus, by ensuring equal distribution of resources in the society it enhances strategies for reducing health inequalities.

Psychosocial/Social Capital Explanations of Class

Social and economic issues impact the access to quality health services, as well as contribute to health inequalities observed in a population. Although resources of health as stipulated by the Commission on the Social Determinants of Health (2008) ought to be equitable and universal, some issues have made this factor not be attainable across different nations. Social status is an individual’s or part of society’s social perspective (Holmes, Hughes & Julian 2013). It is stipulated that, unlike class where one can move from one stage to another, in the social status, the individual tends to remain fixated on that particular status for life. According to Obeng-Odoom (2012), social status is identifiable with rigidity. Take the case of aboriginal communities which remain in a unique social situation typically regarded as caste (Holmes, Hughes & Julian 2013). In the class system, it is an individual or a family that bears the status unlike in the social status where the caste or a group carries one.

Psychological aspects like stress, mood and guilt affect the behavioral attributes of persons. A relationship between psychosocial health and physical health is evident in the case where due to high-stress levels; the poor are prone to indulge in health-compromising behaviors to evade depression and anxiety (Review 2010). Members of the lower class within a society rarely have medical covers, and for those lucky to have one, it might not cover major or chronic illnesses (Keleher & MacDougall 2011). This renders such groups be solely dependent upon the government healthcare incentives.


In conclusion, social inequities present significant difficulties in the universal access to quality healthcare for all members of society. Class as a determinant of health presents diverse explanations in respect to establishing the inequalities existing in health. Marmot (2006) argues that inequalities bring about certain differences in health systems. Thus, it is of importance to create fair societies so as to improve the well-being of the larger population. The fundamental powers that give life to these inequalities are the availability of resources, power, and wealth. Equitable distribution of resources among all communities is necessary to enhance access to quality healthcare and wellbeing. Governments should put up surveillance systems to monitor health inequity and social determinants of health among all communities, and subsequently, create strategies to ensure equitable access to health.

Reference List

Australian Institute of Health and Welfare, 2012, Australia’s Health 2012, Australia’s Health Series No. 13. Cat. no. AUS 156. AIWH, Canberra, Web.

Commission on the Social Determinants of Health, 2008, Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health Final Report, WHO, Geneva, Web.

Holmes, D, Hughes, K & Julian, R, 2013, Australian Sociology: A Changing Society, 3rd edn, Pearson, Sydney.

Keleher, H. & MacDougall, C (Eds.), 2011. Understanding Health: A Determinants Approach, 3rd edn, Oxford Press, South Melbourne.

Marmot, M 2004, Status Syndrome: How Your Social Standing Directly Affects Your Health and Life Expectancy, Bloomsbury, London.

Marmot, M, 2006, Health in an equal world, Lancet, vol. 36, pp. 2081-2094.

Obeng-Odoom, F, 2012, ‘Health, Wealth and Poverty in Developing Countries: Beyond the State, Market, and Civil Society’, Health Sociology Review, vol. 21, no. 2, pp. 156-64.

Review, M, 2010. Fair society, healthy lives: Strategic review of health inequalities in England post-2010, Marmot Review, London.

Schofield, T, 2002, ‘What Does “Gender and Health” Mean’? Health Sociology Review, vol. 11, no. 1-2, pp. 29-38.

Van Krieken, R, Habibis, D, Smith, P, Hutchins, B, Martin, G & Maton, K, 2013, Sociology, 5th edn. Pearson, Sydney.

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