Socio-economic status and physical health outcomes : the need for change in theoretical formulations : thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University

Abstract

The Black Report (Department of Health and Social Security, 1980) , which was a seminal publication in the field of health inequality, proposed several possible theoretical explanations for the phenomenon of socio-economic health inequality. To date the models proposed in the Black Report have yet to be improved on, or developed greatly. While research in the field of socio-economic health inequality has been substantial, the state of theoretical formulation which attempts to explain such inequality has remained static. The phenomenon of socio- economic health inequality will be established by producing evidence for how socio-economic status impacts on health from many countries, but especially from the United Kingdom, North America, Australasia, and Europe. Potential pathways for socio-economic status to impact on health outcomes will be assessed, and an illustration of potential pathways will be provided with an application. The theoretical approaches of the Black Report, along with a more recent conceptualisation, will be discussed. The potential contribution of psychological factors to socio-economic health inequality will be considered following the establishment of the relationship, proposal of potential pathways, and theoretical formulation discussions to demonstrate how such factors are involved in socio-economic health inequality. From these first four sections it can be deduced that current theoretical formulations to explain socio-economic health inequality are deficient. To contend with this deficiency it is proposed that a more holistic approach, which includes psychological factors, is necessary. Future research should seek to empirically validate links within the confines of a more holistic framework if our understanding of the relation between socio-economic status and physical health outcomes is to improve.