Inequalities in health: the interaction of circumstances and health related behaviour

Abstract

This paper derives its main hypothesis from results of the Health and Lifestyle Survey as reported in Blaxter's monograph Health and Lifestyles. In this book it is argued that in a favourable social environment a healthy lifestyle matters but in a unfavourable social environment a healthy lifestyle does not make much difference. This hypothesis is tested with data from health surveys from the Netherlands and Denmark. The Dutch data showed a highly significant relationship of unfavourable material and social circumstances with both poor health and an unhealthy lifestyle. In turn, an unhealthy lifestyle was also related to poor health. The Danish study showed similar, although generally weaker, associations. When the British findings would apply to Denmark and the Netherlands, we should find an interaction between material and social circumstances and health related behaviour in their association with health and illness. Neither the Dutch nor the Danish data showed an interaction of the type that the British study assumes. The paper concludes with a discussion of the reasons why the findings from the UK could not be replicated.

‘Our healthier nation’?

“…Blaxter [11], using data from the same survey, found that healthy behaviour has a strong influence on health in 'favourable' circumstances (such as higher social class) but little influence in 'unfavourable' circumstances. Kooiker and Christiansen [12] found little evidence of this effect in Dutch and Danish health surveys. Further empirical estimation of the difference in health response to changes in income, social class, education etc.…”

Assessment of the health status and risk factors of Kham Tibetan pastoralists in the alpine grasslands of the Tibetan plateau

“…Since health status is often affected by people's lifestyle (Blaxter, 1990;Gesler, 1992;Galaty & Johnson, 1990;Hertzel & McMichael, 1989;Kooiker & Christiansen, 1995) as well as social and natural environments (Foggin et al, 2001;May, Cancer of the womb was also a self-reported disease and will include other benign tumours and abdominal conditions. 1994; McCray, 2004;Perz, 1997), questions were also asked about these categories of risk factor.…”

Low-income Canadians’ experiences with health-related services: Implications for health care reform

“…Another key premise of a determinants of health perspective is that health care provided by physicians and other health care professionals is only one of many factors that influence health. Health is also influenced by a broad range of community-based services, supports and programs, and by relationships between and among people's personal health practices and coping skills, living and working conditions, and socio-economic, political, and physical environmental contexts [15,17,[46][47][48][49][50][52][53][54][55]. Accordingly, a determinants of health perspective casts our attention beyond the narrow range of health care services that low-income Canadians use when they are ill to a broad range of services, supports, and programs that they use to maintain and promote their health-what we refer to as health-related services.…”