Social Inequity as the Root of Disease (Reflective Writing)

‘Only by combating social inequality can we really combat ill health. Social inequity lies at the root of disease and underpins what some have called the negative results of ignorance and health-damaging behaviour.’

There are several factors that contribute to health and interrelate with each factor in defining health state or condition of an individual. McMurray (2007, pp. 7-9) describes ‘gender, parenting styles, family dynamics, family finances, geographical mobility, health services, social resources, education, political economic factors, neighborhood, culture, age, employability, biological factors’ as the variables that  are affecting health. Thus, if these factors are not met or incompletely obtained, an optimal health status and wellness cannot be achieved.

Although there are still arguments on determining which specific factor has the greatest influence affecting one’s health state, several factors which can be grouped in social factors are often considered to hold a key role in obtaining an optimal health. Thus the presence of confounding factors that affecting the social factors such as social disparity or inequality may greatly affect one’s health state. This may be due to the fact that social disparity or inequality amongst the society has lead to the differences in health behaviours and how a society perceived ill health and wellness (Cooper 2001, p. 48).

In a community where social inequality persists and known as the main cause of the factors that cause many health problems, health state can be improved if social inequality is eliminated from the society. Turrell et al (2006) describe that the people who are living in the area where socioeconomic disadvantages is apparent, or living with low income and low level of education and high unemployment, are more likely to practice unhealthy behaviours such as tobacco smoking and alcohol consumption. Thus, the prevalence of specific disease such as hypertension is higher than those who are not socioeconomically disadvantaged. By identifying the disparity and inequality within the society and the health care system, specific health policy can be made and efficient actions can be delivered to facilitate the efforts in creating healthy community. However, in some extent, combating social inequality cannot be assumed as the only approach to combat ill health. As previously stated, there are also other factors that actively interact as the determinants of health.

The trigger statement of the discussion suggests that the type of epidemiology illustrated through the statement is observational epidemiology. To be precise, it can be stated as one of ecological or correlational studies, which are identified to be ‘useful for generating hypothesis’ (Bonita et al 2006, p. 41). The hypothesis in the trigger statement projects that the social inequality is the root cause of the problem (disease). Thus, to overcome the problem or the disease we must resolve the issue of social inequality in the community or society. However, Baum (2008, p. 160) states that confounding factors in ecological studies are often affecting the results which then caused ‘ecological fallacy’ (Bonita et al 2006, p. 43). This means that the obtained data from the observed population may not always be applicable in individual within the population due to the fact that there are many factors that affecting ill health state and wellness of a person other than social inequality such as age and biological factors.

To conclude, social inequality, as one of the variables of ill health must be properly addressed as well as other variables both in individual and population level. Furthermore, more epidemiology studies should be done to obtain more eminent results that can best represent the condition of the population. Therefore, biases can be identified and eliminated and the results can be effectively utilized.


Baum, F 2008, The New Public Health, 3rd edn, Oxford, Sydney.

Bonita, R, Beaglehole, R, Kjellstrom, T 2006, Basic Epidemiology, 2nd edn, World Health Organization, Geneva.

Cooper, R 2001, ‘Social inequality, ethnicity and cardiovascular disease’, International Journal of Epidemiology, Vol. 30, pp. 48-32.

McMurray, A 2007, Community Health and Wellness: A socioecological approach,  3rd edn, Mosby, Sydney.

Turrell G, Stanley L, de Looper M & Oldenburg B 2006, ‘Health inequalities in Australia: Morbidity, health behaviours, risk factors and health service use’, Health Inequalities Monitoring Series, no. 2. AIHW Cat. no. PHE 72, Queensland University of Technology and the Australian Institute of Health and Welfare, Canberra.

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