Social class difference in Health and Healthcare

Despite rapid advances in medical and healthcare policies, social class differentials in healthcare provision continue to persist. Social class as a complex reflection of individual professional, educational, and employment characteristics is integrally linked to individual health and wellbeing. This social class belonging also affects and alters the system of healthcare delivery, making it available and accessible only for those, who experience few social difficulties. As a result, lower social classes operate in a vicious circle of vulnerabilities, which negatively influence their health status and, simultaneously, create barriers to accessing quality healthcare options. Understanding and outlining social class differences in health and healthcare is impossible without understanding what means to be healthy and what exactly social disparities in healthcare mean for the broader community. Generally, health incorporates the state of physical and psychological wellbeing.1 Consequentially, healthcare is defined as a complexity of profoundly interrelated factors which are not limited to medical care but also involve other aspects – financing, quality, resource allocation, and others.2 Health determinants can be proximate and distant. the latter affect the quality and efficiency of health care through a long and sophisticated causal chain.3 In this sense, social class disparities are among the most essential healthcare determinants. Social group health differences are considered to be the differences across subgroups of the population, which may be based on biological, social, economic or geographical characteristics.4 Despite numerous policies and policy solutions, social class remains a crucial factor of healthcare disparities in Britain and the rest of the world. The relationship between socioeconomic status (SES) and care provision are extensively documented. It would be fair to say that the effects of SES on care are two-fold: on the one hand, SES always affects individual health and wellbeing. On the other hand, social class disparities in accessing and using even the basic healthcare services continue to persist. The former appear to be extremely stable over time, and even effective interventions on the main social risk factors of health and wellbeing fail to break this SES-health relationship.5 Notwithstanding the rapid advancement in social policies, individual social position (both absolute and relative) remains the most important variable of individual health and wellbeing.6 This social position justifies the validity of cross-social comparisons and groupings in the United Kingdom.7 It also makes the theory of health inequalities in light of socioeconomic class differences extremely legitimate. Individuals of lower socioeconomic position experience serious health difficulties and demonstrate higher rates of mortality/ morbidity.8 SES causes threshold effects on health, through poorer life conditions and malnutrition.9 In almost every single disease category, individuals lower in their SES experience higher rates of mortality and morbidity than their better-off counterparts.10 Not only do people of lower socioeconomic position suffer poorer health, but individuals at higher levels of SES always enjoy better health than those on the SES levels just below them.11 The question of how exactly SES affects individua