P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO MHBK005-FM MHBK005-Graham July8,2009 20:34 Understanding Health Inequalities Second Edition i P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO MHBK005-FM MHBK005-Graham May25,2009 20:28 ii P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO MHBK005-FM MHBK005-Graham July8,2009 20:34 Understanding Health Inequalities Second Edition Edited by Hilary Graham Open University Press iii P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO MHBK005-FM MHBK005-Graham May25,2009 20:28 OpenUniversityPress McGraw-HillEducation McGraw-HillHouse ShoppenhangersRoad Maidenhead Berkshire England SL62QL email:[email protected] worldwideweb:www.openup.co.uk andTwoPennPlaza,NewYork,NY10121-2289,USA Firstpublished2009 Copyright(cid:2)C HilaryGraham2009 Allrightsreserved.Exceptforthequotationofshortpassagesforthepurposesof criticismandreview,nopartofthispublicationmaybereproduced,storedina retrievalsystem,ortransmitted,inanyformorbyanymeans,electronic, mechanical,photocopying,recordingorotherwise,withoutthepriorwritten permissionofthepublisheroralicencefromtheCopyrightLicensingAgency Limited.Detailsofsuchlicences(forreprographicreproduction)maybeobtained fromtheCopyrightLicensingAgencyLtdofSaffronHouse,6–10KirbyStreet, London,EC1N8TS. AcataloguerecordofthisbookisavailablefromtheBritishLibrary ISBN10:0335234593(pb) ISBN13:978033523459 2(pb) LibraryofCongressCataloging-in-PublicationData CIPdatahasbeenappliedfor Fictitousnamesofcompanies,products,people,charactersand/ordatathat maybeusedherein(incasestudiesorinexamples)arenotintendedto representanyrealindividual,company,productorevent. TypesetbyAptaraInc.,India PrintedintheUKbyBell&BainLtdGlasgow iv P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO MHBK005-FM MHBK005-Graham May25,2009 20:28 Contents Listofcontributors vii Acknowledgements ix Listoftablesandfigures xi Introduction:thechallengeofhealthinequalities 1 HilaryGraham Part 1: Health inequalities: understanding patterns over time and place 1.1 Life-courseinfluencesonchildren’sfutures 25 CatherineLaw 1.2 Life-courseinfluencesonhealthatolderages 48 MelBartleyandD avidBlane 1.3 Geographicalinequalitiesinhealthoverthelast century 66 DannyDorlingandBethanThomas 1.4 Neighbourhoodinfluencesonhealth 84 SallyMacintyreandAnneEllaway Part 2: Health inequalities: understanding intersections 2.1 Religion,ethnicityandhealthinequalities 103 SaffronKarlsenandJamesNazroo v P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO MHBK005-FM MHBK005-Graham May25,2009 20:28 vi CONTENTS 2.2 Negotiatingethnicidentitiesandhealth 125 KarlAtkin 2.3 Genderandsocio-economicinequalitiesinmortality andhealthbehaviours:anoverview 141 KateHuntandG.DavidBatty 2.4 Classculturesandthemeaningofyoung motherhood 162 NaomiRudoeandRachelThomson Part 3: Health inequalities: understanding policy impacts 3.1 Unequalconsequencesofillhealth:researchingthe roleofpublicpolicy 181 MargaretWhitehead,BarbaraHanrattyandBoBurström 3.2 Tacklinghealthinequalities:thescopeforpolicy 199 HilaryGraham Index 219 P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO MHBK005-FM MHBK005-Graham May25,2009 20:28 List of contributors KarlAtkin,SeniorLecturer,DepartmentofHealthSciences,University ofYork. MelBartley,ProfessorofMedicalSociology,Departmentof EpidemiologyandPublicHealth,UniversityCollegeLondon. G.DavidBatty,WellcomeTrustResearchFellow,MRCSocialand PublicHealthSciencesUnit,UniversityofGlasgow. DavidBlane,ProfessorofMedicalSociology,DivisionofEpidemiology, PublicHealthandPrimaryCare,ImperialCollegeLondon. BoBurström,ProfessorinSocialMedicine,DepartmentofPublic HealthSciences,KarolinskaInstitute,Stockholm. DannyDorling,ProfessorofHumanGeography,SocialandSpatial InequalitiesGroup,DepartmentofGeography,Universityof Sheffield. AnneEllaway,SeniorResearchScientist,MRCSocialandPublicHealth SciencesUnit,UniversityofGlasgow. HilaryGraham,Profe ssorofHealthSciences,DepartmentofHealth Sciences,UniversityofYork. BarbaraHanratty,SeniorLecturerinPopulationandCommunity Health,DivisionofPublicHealth,UniversityofLiverpool. KateHunt,ProfessorandHeadofGenderandHealthProgramme, MRCSocialandPublicHealthSciencesUnit,UniversityofGlasgow. SaffronKarlsen,SeniorResearchFellow,DepartmentofEpidemiology andPublicHealth,UniversityCollegeLondon. CatherineLaw,ProfessorofPublicHealthandEpidemiology,Centre forPaediatricEpidemiologyandBiostatistics,UCLInstituteofChild Health,London. SallyMacintyre,ProfessorofSocialandPublicHealthScience, UniversityofGlasgow,andHonoraryDirector,MRCSocialand PublicHealthSciencesUnit. vii P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO MHBK005-FM MHBK005-Graham May25,2009 20:28 viii LISTOFCONTRIBUTORS JamesNazroo,ProfessorofSociology,SchoolofSocialSciences, UniversityofManchester. NaomiRudoe,ResearchStudent,FacultyofEducationandLanguage Studies,TheOpenUniversity. BethanThomas,Researcher,SocialandSpatialInequalitiesGroup, DepartmentofGeography,UniversityofSheffield. RachelThomson,ProfessorofSocialResearch,FacultyofHealthand SocialCare,TheOpenUniversity. MargaretWhitehead,WHDuncanProfessorofPublicHealth, DivisionofPublicHealth,UniversityofLiverpool. P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO MHBK005-FM MHBK005-Graham May25,2009 20:28 Acknowledgements This new edition of Understanding Health Inequalities presents 11 new chapters by authors at the forefront of research on social and health inequalities.Itincludesauthorswhocontributedtothefirsteditionofthe book published in 2000. The book’s authorship has also been extended for the new edition to give emphasis to the intersections between socio- economic inequality and other dimensions of inequality and identity, includingage,gender,ethnicityandreligion. IwouldliketothankSallyStephenson,UniversityofYork,forherhelp withthepreparationofthemanuscript. HilaryGraham ix