Socioeconomic Gradient in Health and Global Inequality (10A) - Psych & Soc

What term describes preventable differences in health outcomes between groups?

Health disparities. These differences are avoidable and unjust, not biologically determined.
What is meant by the inverse care law?

Those with greatest need often have the least access to care. Paradox where quality healthcare concentrates in wealthy areas.
What is absolute poverty?

Inability to meet basic needs (food, shelter, safety). Lacks resources for survival regardless of others' circumstances.
Which theory explains illness risk via perceived low rank and chronic stress from inequality?

Status syndrome (relative social position affects health). Lower rank triggers stress regardless of absolute resources.
What is the "fundamental cause" theory of health inequality?

SES shapes health via flexible resources across many diseases. SES provides adaptable advantages that protect against various illnesses.
What is the fundamental cause theory explanation for SES-health differences?

SES provides flexible resources that protect health across changing diseases. Money, knowledge, and connections help navigate any health threat.
What is meant by the socioeconomic gradient in health?

Health improves stepwise as socioeconomic status increases. Each SES level shows better health than the one below it.
What is the socioeconomic gradient in health?

Health improves stepwise with each increase in socioeconomic status. Not just rich vs poor - each SES level has better health than the one below.
Which direction does morbidity typically change as socioeconomic status decreases?

Morbidity increases as socioeconomic status decreases. Lower SES is associated with higher rates of illness and disease.
What is the socioeconomic gradient in health?

Health improves as socioeconomic status increases (stepwise pattern). Each step up in income/education correlates with better health outcomes.
What is infant mortality rate (IMR)?

Deaths under age 1 per $1{,}000$ live births in a given year. Key indicator of healthcare quality and maternal-child health.
What is structural violence in the context of global health inequality?

Social structures systematically harm groups by limiting needs. Poverty and inequality are built into social systems, not natural.
What is structural violence in the context of global health inequality?

Institutionalized social structures that systematically harm disadvantaged groups. Policies and systems that create preventable suffering for marginalized populations.
Which option best describes why relative deprivation can harm health even above poverty?

Psychosocial stress from unfavorable social comparisons and low status. Relative deprivation generates psychosocial stress via perceived social inferiority, which can trigger physiological responses harming health independent of absolute poverty.
Which concept describes how social disadvantage becomes biologically embedded over time?

Embodiment. Social experiences literally get "under the skin" to affect biology.
What is the "fundamental cause theory" explanation for persistent SES health disparities?

SES provides flexible resources that protect health across diseases over time. Money, knowledge, and power help avoid risks regardless of specific threats.
What is meant by social determinants of health?

Social and economic conditions shaping health risks and outcomes. Non-medical factors like income, education, and housing affect health.
Which measure best summarizes average population health across countries: life expectancy or infant mortality?

Life expectancy. Captures overall mortality across all age groups.
What is food insecurity?

Limited or uncertain access to adequate, safe, nutritious food. Food insecurity stems from economic or logistical barriers, contributing to malnutrition and chronic diseases particularly in low-SES populations.
Identify the concept: unequal distribution of resources and opportunities that shapes health.

Structural inequality. Systematic patterns in society that create unequal health opportunities.
What term describes preventable differences in health outcomes between groups?

Health disparities (health inequities when unfair and avoidable). Inequities are disparities that are unjust and preventable.
What does it mean that the SES–health association is graded rather than threshold-based?

Each step up in SES corresponds to better health, not only extreme poverty. Gradient means continuous improvement, not just above/below poverty line.
What is absolute poverty?

Insufficient resources to meet basic needs (food, shelter, sanitation). Below minimum threshold for human survival and dignity.
What is the difference between equality and equity in health?

Equality is same resources; equity is resources matched to need. Equity recognizes different starting points require different support.
Which option best defines "health literacy" as a pathway linking SES to health outcomes?

Capacity to obtain, understand, and use health information and services. Low literacy impairs navigation of healthcare and self-management.
Which pathway links low SES to higher allostatic load most directly?

Chronic stress from material insecurity and low control. Financial strain and powerlessness trigger stress responses.
What is relative deprivation as it relates to health?

Worse health due to perceived disadvantage versus others, not absolute poverty. Social comparison and inequality matter beyond material deprivation.
What is health disparity (health inequality) as used in public health?

A systematic difference in health outcomes between population groups. Measurable differences without implying fairness or causation.
What is the "income inequality hypothesis" regarding population health?

Greater inequality predicts worse average health outcomes in a society. Unequal societies have worse health even controlling for GDP.
Which concept links chronic stress from low social rank to worse health outcomes?

Allostatic load. Cumulative physiological wear from chronic stress response activation.
What does the Maternal Mortality Ratio (MMR) measure?

Maternal deaths per $100000$ live births. Reflects healthcare access and quality for pregnant women.
Which measure best captures income inequality within a country: Gini coefficient or GDP?

Gini coefficient. GDP measures total wealth; Gini measures distribution inequality.
What does the term social determinants of health refer to?

Nonmedical conditions shaping health (education, housing, work, etc.). Environment and social factors matter more than medical care alone.
What is meant by the term health inequity?

An avoidable, unjust health difference rooted in social disadvantage. Emphasizes the unfair and preventable nature of certain disparities.
What is the epidemiologic transition?

Shift from infectious to chronic disease as countries industrialize. Development brings longer life but more heart disease and cancer.
Identify the concept: poorer nations bear more disease burden despite fewer resources.

Global health inequality. Low-income countries face 90% of disease with 10% of resources.
Identify the concept: chronic stress from low social rank dysregulates physiology and harms health.

Allostatic load. Cumulative wear from chronic stress response activation.
What is the fundamental cause theory of health disparities?

SES shapes access to flexible resources that protect health across diseases. Money, knowledge, and power protect health regardless of specific risks.
What is the epidemiologic transition model in one sentence?

Shift from infectious to chronic disease as societies industrialize and develop. Describes changing disease patterns with economic development.
Which measure of SES is most directly tied to access to material resources?

Income (or wealth). Money directly enables purchasing healthcare, food, and housing.
Which pathway links low SES to worse health through chronic stress exposure?

Allostatic load (cumulative physiological wear from chronic stress). Low SES exposes individuals to prolonged stressors, leading to allostatic load that dysregulates physiological systems and elevates disease risk.
Which term refers to the unequal distribution of power and resources across groups?

Social stratification. Social stratification creates hierarchical divisions in society, resulting in unequal allocation of resources and opportunities that perpetuate health disparities.
What is the epidemiologic transition?

Shift from infectious to chronic diseases as development increases. The epidemiologic transition reflects societal development where public health advancements reduce infectious diseases, while lifestyle factors increase non-communicable ones.
Which option best explains why education often predicts better health outcomes?

Education increases health literacy, income potential, and access to resources. Education provides knowledge, skills, and socioeconomic advantages.
What is the inverse care law?

Those with greatest need often have least access to care. Healthcare quality decreases as community need increases.
What is health inequity (as distinct from inequality)?

An avoidable, unjust health difference rooted in social disadvantage. Emphasizes unfairness and preventability, not just difference.
What is the difference between absolute poverty and relative poverty?

Absolute: lack basics; relative: below societal standard of living. Absolute is survival needs; relative is comparison to others.
Which measure compares income distribution within a population on a $0$ to $1$ scale?

Gini coefficient. The Gini coefficient quantifies income distribution inequality using a Lorenz curve, with values ranging from 0 (equality) to 1 (complete inequality).
Identify the term for unequal exchange that benefits core nations at others' expense.

Exploitation (in world-systems/dependency frameworks). Core nations extract more value than they provide in trade.
What is access to care (health care access) in disparity research?

Ability to obtain needed services (availability, affordability, acceptability). Access to care encompasses structural and cultural factors ensuring equitable utilization of health services, addressing barriers in disparate populations.
Which option best describes the SES–health relationship: threshold effect or graded effect?

Graded effect (continuous stepwise differences across SES levels). Health improves continuously with each SES increase, not just above a threshold.
Which determinant is most directly linked to health literacy and navigation of care systems?

Education. Higher education improves understanding of health information.
What is the "inverse care law" in the context of health inequality?

Those with greatest need often have the least access to quality care. Market forces concentrate services where ability to pay is highest.
What is relative poverty (in health inequality contexts)?

Deprivation compared with others in the same society. Poor relative to societal standards, even if basic needs are met.
Which statement best distinguishes absolute poverty from relative poverty?

Absolute: unmet basic needs; relative: below societal standard. Absolute uses fixed threshold; relative compares to others.
What is the life course perspective on SES and health?

Early exposures accumulate and shape later health outcomes. Childhood SES affects adult health through accumulated advantages.
What is residential segregation in the context of health disparities?

Physical separation by race/SES that concentrates risks and limits resources. Creates neighborhoods with unequal environmental hazards and services.
What is a food desert?

Area with limited access to affordable, healthy foods (especially produce). Food deserts exacerbate nutritional disparities by limiting proximity to fresh foods, often in underserved urban or rural areas with transportation challenges.
What is the Gini coefficient and what do values near $1$ indicate?

Income inequality index; values near $1$ indicate high inequality. Ranges from $0$ (perfect equality) to $1$ (maximum inequality).
Which world-systems category typically has high wages and high-value production?

Core countries. They control global trade and extract value from periphery.
What is the definition of social determinants of health?

Social and environmental conditions shaping health risks and care. Non-medical factors like housing and education affect health outcomes.
What is allostatic load?

Cumulative physiological wear from chronic stress responses. Body systems deteriorate from repeated stress activation.
What is the psychosocial explanation for the SES–health gradient?

Chronic stress from low status and low control worsens health. Stress hormones from social hierarchy damage body systems.
What is the epidemiologic transition model (high-level definition)?

Shift from infectious to chronic disease as development increases. Countries progress from high infectious to high chronic disease burden.
What is relative poverty (compared with absolute poverty)?

Poverty defined relative to a society's typical standard of living. Based on median income or social norms, not absolute survival needs.
What is meant by access to care as a mediator of the SES–health relationship?

SES affects ability to obtain timely, high-quality health services. Lower SES limits insurance, transportation, and provider availability.
What is the neighborhood effect as a contributor to health disparities?

Area conditions (crime, pollution, food access) influence residents' health. Neighborhood effects operate through contextual factors like environmental hazards and resource availability that shape health independently of individual characteristics.
What is meant by flexible resources in fundamental cause theory?

Money, knowledge, power, prestige, and beneficial social ties. These resources can be deployed to protect health in multiple ways.
What is the difference between health inequality and health inequity?

Inequality is any difference; inequity is unfair and avoidable. Inequities are inequalities that could be prevented through policy.
What are social determinants of health?

Social and economic conditions shaping health risks and outcomes. These determinants include factors like education, employment, and social support that influence health risks and access to care beyond individual biology.
What is the fundamental cause theory of health disparities?

SES confers flexible resources that protect health across diseases and eras. Fundamental cause theory explains persistent health disparities by positing that socioeconomic status provides adaptable resources to mitigate evolving health threats.
What is food insecurity?

Limited or uncertain access to adequate, nutritious food. Affects nutrition quality and meal consistency.
Identify the mechanism: unequal exposure to hazards (pollution, violence) by neighborhood and SES.

Environmental injustice. Low-SES areas face more toxins and fewer protective resources.
What is meant by the "social causation" hypothesis for SES and health?

Low SES causes worse health via exposures, stressors, and limited resources. Material deprivation and psychosocial stress directly harm health.
Identify the term for unequal health outcomes between countries: global health inequality or herd immunity.

Global health inequality. Herd immunity refers to population disease resistance, not disparities.
What does the Disability-Adjusted Life Year (DALY) measure?

Years of healthy life lost from disability plus premature death. Combines mortality and morbidity into one health burden metric.
What is structural violence in global health?

Systemic social structures that harm health by limiting opportunities. Social systems create conditions that indirectly cause suffering.
Which concept explains how chronic stress can produce long-term physiological wear?

Allostatic load. Cumulative biological cost of repeated stress response activation.
Which indicator best captures average population health for comparing countries globally?

Life expectancy at birth. Summarizes mortality patterns across all ages in one number.
What is maternal mortality ratio (MMR)?

Maternal deaths per $100{,}000$ live births during pregnancy or shortly after. Reflects healthcare access and quality during pregnancy/childbirth.
What is the difference between health inequality and health inequity?

Inequality = difference; inequity = unfair, avoidable difference. Inequity adds moral judgment that the difference is unjust.
What is relative poverty?

Deprivation compared with societal standards or peers. Having less than what's considered normal in one's society.
Which measure compares income shares and is summarized by a coefficient from $0$ to $1$ ?

Gini coefficient. $0$ = perfect equality, $1$ = one person has all income.
Identify the correct interpretation of a Gini coefficient of $1$ .

Maximal income inequality (one person has all income). A Gini coefficient of 1 indicates extreme inequality where all income is concentrated in one individual, leaving others with none.
What is the neighborhood effects mechanism for SES-related health disparities?

Local environments shape exposures, resources, and behaviors. Zip code predicts health through environmental and social factors.
What is absolute poverty (in health inequality contexts)?

Insufficient resources to meet basic needs (food, shelter, safety). Lacks minimum resources for survival, regardless of others' wealth.
What is the definition of health equity?

Fair opportunity for all to attain full health potential. Removes barriers so everyone can achieve their best possible health.
What does a higher Gini coefficient indicate about a society?

Greater income inequality (more unequal income distribution). Values closer to 1 indicate more concentrated wealth.
What does it mean if a health outcome shows a social gradient rather than a threshold effect?

Risk changes continuously across SES levels, not only at poverty. A gradient effect shows health risks vary progressively across the entire socioeconomic spectrum, unlike a threshold where changes occur only below a specific poverty level.
Identify the term for the combined burden of infectious and chronic disease in poorer nations.

The double burden of disease. Developing countries face both old and new disease challenges simultaneously.
What is meant by the inverse care law?

Those needing care most often have the least access to it. Healthcare availability decreases as population need increases.
What is environmental injustice?

Disproportionate exposure of marginalized groups to environmental hazards. Poor communities face more pollution and toxic exposures.
What is the difference between incidence and prevalence?

Incidence: new cases; prevalence: existing cases at a time. Incidence measures rate of onset; prevalence measures total burden.
What does SES most directly represent in health disparities research?

Social standing based on income, education, and occupation. SES combines these three dimensions to measure social position.
What is allostatic load?

Cumulative physiological wear from chronic stress responses. Body's stress systems wear out from constant activation.
Identify the term for unequal exposure to hazards based on race or class.

Environmental injustice. Marginalized groups face disproportionate pollution and toxic exposure.
Which concept states that health disparities persist across the entire SES spectrum?

Socioeconomic gradient (not only poverty vs nonpoverty). Health differences exist at every SES level, not just poor vs rich.
What is the socioeconomic gradient in health?

Health improves stepwise as socioeconomic status (SES) increases. Linear pattern shows each increase in income/education yields better outcomes.
Which direction is the typical association between income and life expectancy within a country?

Higher income is associated with longer life expectancy. Higher income typically enables better access to healthcare, nutrition, and safer environments, which collectively contribute to increased longevity within populations.
What is the inverse care law?

Those needing care most often have the least access to it. Paradox where greatest need meets poorest service availability.
What is the epidemiologic transition model's key claim about development and mortality?

Mortality shifts from infectious to chronic diseases with development. Economic growth reduces infections while increasing lifestyle diseases.
Which health pattern best describes the socioeconomic gradient: threshold or continuous?

Continuous (stepwise) relationship across the entire SES range. The gradient exists at all SES levels, not just below a poverty threshold.
What is the materialist explanation for the SES–health gradient?

Resource deficits (housing, food, care, safety) drive poor health. Physical deprivation directly causes illness and injury.
What is meant by the term health disparity?

A systematic difference in health outcomes between population groups. Focuses on measurable differences without implying unfairness.
What is structural violence in the context of global health?

Social structures that systematically harm health by limiting opportunities. Structural violence manifests through institutional barriers that restrict access to health-promoting resources, systematically disadvantaging certain populations.
What is meant by the socioeconomic gradient in health?

Health improves stepwise as socioeconomic status increases. Each increase in SES level corresponds to better health outcomes.
What is the socioeconomic gradient in health?

Health improves stepwise as socioeconomic status increases. Each SES level shows better health than the one below it.
Which concept explains worse health in lower-SES groups via reduced control, resources, and coping options?

Fundamental cause theory. SES provides flexible resources to avoid/minimize health risks.
Which relationship best describes SES and morbidity/mortality in a gradient model?

Inverse relationship: lower SES is linked to higher morbidity and mortality. Gradient shows progressively worse health with each decrease in social position.
What is the definition of life expectancy?

Average number of years a person is expected to live given current mortality rates. Statistical measure based on age-specific death rates.
Identify the concept: worse health caused by neighborhood exposure to pollutants and hazards.

Environmental injustice. Low-income areas face disproportionate toxic exposures.
Which concept explains how early-life disadvantage can shape adult disease risk?

Life course perspective (cumulative disadvantage across development). The life course perspective highlights how early disadvantages compound over time through biological, behavioral, and social pathways to influence later-life health.
What does the Infant Mortality Rate (IMR) measure?

Deaths under age 1 per $1000$ live births. Key indicator of population health and healthcare quality.
What is the demographic transition model in broad terms?

Shift from high birth/death rates to low birth/death rates with development. The demographic transition model illustrates how economic progress lowers mortality and fertility rates, stabilizing population growth in developed societies.
Which measure is especially sensitive to sanitation, maternal health, and primary care access?

Infant mortality rate. Reflects healthcare quality and social conditions for mothers/babies.
What does the Gini coefficient measure in global inequality?

Income inequality within a population. Ranges from 0 (perfect equality) to 1 (maximum inequality).
What is the behavioral explanation for the SES–health gradient?

SES influences health behaviors (diet, smoking, exercise, adherence). Lower SES correlates with riskier health choices.
What does DALY stand for, and what does it measure?

Disability-adjusted life year; years of healthy life lost to disease and death. Combines mortality and morbidity into one metric.
What is a social determinant of health?

A social condition shaping health risks and outcomes (e.g., income, education). Non-medical factors like housing and employment that influence health.
What is residential segregation in the context of population health?

Spatial separation by race/SES that concentrates resources and risks. Creates unequal neighborhood conditions affecting health.
What is food insecurity?

Limited or uncertain access to adequate, nutritious food. Affects nutrition quality and increases stress about meals.
What is the difference between health inequality and health inequity?

Inequality is any difference; inequity is unjust and avoidable difference. Health inequity emphasizes disparities that are preventable and stem from systemic injustices, distinguishing it from mere observable differences in health outcomes.
What is the epidemiologic transition model?

Shift from infectious to chronic diseases as development increases. Wealthy nations face more heart disease, cancer vs infections.
Identify the correct interpretation of a Gini coefficient of $0$ .

Perfect income equality. A Gini coefficient of 0 signifies that every individual in the population receives an identical share of total income, representing absolute equality.
Which option is a leading downstream determinant of poor health in low SES: education or genotype?

Education. Genotype is biological; education limits opportunities and health literacy.
Which measure is most commonly used to compare income inequality across countries?

Gini coefficient. Ranges from 0 (perfect equality) to 1 (perfect inequality).
Which term describes unequal health outcomes between countries or regions worldwide?

Global health inequality. Global health inequality arises from disparities in resources, infrastructure, and policies between nations, leading to varying disease burdens and life expectancies.
Which term describes disease patterns shaped by social conditions like poverty and crowding?

Social patterning of disease. Social factors create unequal disease risk and distribution.
Which level of prevention aims to detect disease early via screening?

Secondary prevention. Catches disease before symptoms appear, improving treatment outcomes.
What is the epidemiologic transition model describing?

Shift from infectious to chronic disease as development increases. Nations progress from high infectious to high chronic disease burden.
What is a social determinant of health?

A social condition shaping health (e.g., education, housing, income). Non-medical factors in daily life that influence health outcomes.
What is meant by the "social drift" hypothesis for SES and health?

Poor health leads to downward social mobility and lower SES. Illness causes job loss and reduced earning capacity.
What does QALY stand for, and what does it measure?

Quality-adjusted life year; years of life weighted by health-related quality. Used in cost-effectiveness analysis to compare interventions.
Which type of racism involves policies and institutions producing unequal outcomes?

Institutional (structural) racism. Systems and practices that disadvantage racial groups systematically.
Which term describes unequal access to online resources that affect health and education?

Digital divide. Limits access to telehealth, health information, and educational opportunities.
What is the fundamental cause theory explanation for persistent SES health gaps?

SES provides flexible resources that protect health across diseases. Resources can be used to avoid risks and access treatments.
Which metric captures income inequality within a country (not national wealth)?

Gini coefficient. Ranges 0-1; higher values mean more unequal income distribution.

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