Lay perceptions of health inequalities
Epidemiologists have long known that health is socially patterned - but what do lay people think about the social patterning of health? In the West of Scotland Twenty-07 study we asked respondents their views on what influences health (habits, self-care, the environment, family relationships, one’s constitution, money and luck). Personal health behaviours and the environment were seen as very important determinants, whereas luck was regarded as relatively unimportant. Older people and those in lower social classes were more likely to view money and family relationships as being important for health. Those in lower social classes or from poorer neighbourhoods were less likely to say that the poor had worse health, and there was a tendency for each gender to think that risks were higher for their own sex.
Some research has suggested that it is not just absolute levels of socio-economic deprivation that affect people’s health, but also relative deprivation – in other words where we see ourselves in relation to others. In another study we conducted focus group discussions in Scotland and the north of England to explore the ways in which people discuss inequalities in health and their sense of ‘relative deprivation’ and how it might affect health. We also wanted to see if and how people compared themselves to others. We used headlines and photographs from British newspaper coverage of the then New Labour Government’s initiatives to tackle inequalities in health to help stimulate discussion. These discussion groups showed widespread acceptance of the evidence for social inequalities in health and clear consciousness of how people are placed in social hierarchies and how they might be seen by others. The discussions amongst people living in poorer circumstances and more deprived areas showed that they were very aware of the effect of their relative poverty on health. Many of them expressed anger and frustration when talking about their experiences of living in an unequal society.
Davidson R, Mitchell R, Hunt K. Location, location, location: the role of experience of disadvantage in lay perceptions of area inequalities in health. Health & Place 2008;14:167-181pubmed
Davidson R, Kitzinger J, Hunt K. The wealthy get healthy, the poor get poorly? Lay perceptions of health inequalities. Social Science & Medicine 2006;62:2171-2182pubmed
Macintyre S, McKay L, Ellaway A. Lay concepts of the relative importance of different influences on health: are there major socio-demographic variations?. Health Education Research 2006;21:731-9pubmed open access
Macintyre S, McKay L, Ellaway A. Are rich people or poor people more likely to be ill? Lay perceptions, by social class and neighbourhood, of inequalities in health. Social Science & Medicine 2005;60:313-317pubmed open access
Davidson R J C. Representations and lay perceptions of inequalities in health: an analysis of policy documents, press coverage and public understandings [PhD], MRC Social and Public Health Sciences Unit 2003.
Emslie C, Hunt K, Watt G. A chip off the old block? Lay understandings of inheritance amongst men and women in mid-life. Public Understanding of Science 2003;12:47-65
Emslie C, Hunt K, Watt G. Invisible women? The importance of gender in lay beliefs about heart problems. In: Nettleton S, Gustafsson U, editors The sociology of health and illness reader. Cambridge: Polity Press, 2002:146-161.
Emslie C, Hunt K, Watt G. 'I'd rather go with a heart attack than drag on' lay images of heart disease and the problems they present for primary and secondary prevention. Coronary Health Care 2001;5:25-32
Emslie C, Hunt K, Watt G. Invisible women? The importance of gender in lay beliefs about heart problems. Sociology of Health & Illness 2001;23:201-231open access
Hunt K, Emslie C, Watt G. Lay constructions of a 'family history' of heart disease: potential for misunderstandings in the clinical encounter?. The Lancet 2001;357:1168-1171pubmed
Hunt K, Davison C, Emslie C, Ford G. Are perceptions of a family history of heart disease related to health-related attitudes and behaviours?. Health Education Research 2000;15:131-143pubmed open access
Hunt K, Emslie C, Watt G. Barriers rooted in biography: how interpretations of family patterns of heart disease and early life experiences may undermine behavioural change in mid-life. In: Graham H, editor Understanding health inequalities. Buckingham: Open University Press, 2000:113-126.