4.2.3.2 Unequal social distribution of health chances Quiz: AQA Sociology, Unit 2

The 20 questions

1. Which 1980 report found that health inequalities by social class had persisted despite the creation of the NHS?

   • The Acheson Report, published in 1998 on health inequalities in England
   • The Beveridge Report, published in 1942 as a plan for a welfare state
   • The Marmot Review, published in 2010 on health inequalities in England
   • The Black Report

2. What is meant by the 'inverse care law', as described by Julian Tudor Hart?

   • Those who most need health care often receive the least of it, while those with least need often receive the most
   • Patients in the most affluent areas always receive more hospital treatment because they report symptoms earlier
   • Health services are funded in inverse proportion to the number of people who use them in each local area
   • Health care is always delivered in direct proportion to the level of patient need, with no social bias in access

3. What is the 'gender health paradox'?

   • Men tend to live longer than women but report more chronic illness and disability across all age groups
   • Women tend to live longer than men but report more illness, disability and years lived in poor health
   • Women and men have identical life expectancy but men report much higher rates of minor illness every year
   • Women visit doctors less often than men but have higher rates of death from every major cause of illness

4. Which measure is most commonly used by sociologists and health researchers to classify people by social class?

   • The number of cars owned by a household, which is used as a direct indicator of wealth and status
   • The postcode of the child's birth, which is used to measure the age of the housing stock in an area
   • The religious affiliation of the household head, which is used to group people by cultural background
   • An occupation-based classification such as the National Statistics Socio-economic Classification (NS-SEC)

5. Which explanation of health inequality attributes differences mainly to low income, poor housing and unsafe neighbourhoods?

   • The material or structural explanation
   • The labelling explanation, which attributes differences mainly to the way deviant identities are imposed
   • The cultural or behavioural explanation, which attributes differences mainly to individual lifestyle choices
   • The biological determinist explanation, which attributes differences mainly to inherited genetic variation

6. Which explanation of class health inequality emphasises lifestyle choices such as smoking, diet and alcohol use?

   • The inverse care law, which emphasises the unequal distribution of available medical services
   • Medicalisation, which emphasises the extension of medical definitions into everyday social life
   • The cultural or behavioural explanation
   • The material or structural explanation, which emphasises income, housing and employment conditions

7. In the United Kingdom, which broad region is typically found to have lower life expectancy and higher rates of ill health than the south?

   • The South West of England, including the holiday resorts of Devon and Cornwall along the coast
   • East Anglia, including the rural counties of Norfolk and Suffolk with their large agricultural economies
   • The South East of England, including the commuter belt around London and its affluent suburbs
   • Northern England, including parts of the North East and North West

8. A study finds that people in the lowest income group are twice as likely to have diabetes as those in the highest. Which is a material explanation for this finding?

   • Poorer people are less likely to see a GP for routine checks because they dislike talking to doctors
   • Poorer people habitually choose less healthy food out of personal preference rather than because of cost
   • Low income limits access to affordable healthy food and to a safe place to be physically active
   • Poorer people are more likely to have inherited a genetic variant that causes diabetes regardless of diet

9. Why do sociologists study ethnicity alongside social class when examining health chances?

   • Ethnic groups have identical health chances in every social class, so ethnicity is useful only for population counts
   • Health differences by ethnicity arise only from the language spoken at home, with no link to social conditions
   • Ethnicity is a biological category that fully determines health, so class has little independent effect on outcomes
   • Ethnic groups can differ in health within the same social class because of discrimination, housing and employment patterns

10. Which evidence best illustrates the gender health paradox?

    • Women have a longer life expectancy than men but report more years of life lived with chronic illness or disability
    • Men visit their doctors more often than women do, which shows that men are more concerned about their health overall
    • Men report higher rates of common mental disorders than women in every national survey, which shows that men are more vulnerable
    • Women have higher death rates from heart disease than men at every age, which shows that women are more at risk

11. A deprived area has fewer GPs per patient than an affluent area, although its residents have greater health need. Which concept best explains this pattern?

    • The inverse care law
    • Medicalisation, which describes the extension of medical control over everyday social experiences
    • Labelling theory, which describes how the reactions of others shape a person's identity and behaviour
    • The sick role, which describes the rights and obligations of people who are temporarily unwell

12. The average life expectancy in one area is 72 years and in another it is 81 years. What is the difference in years?

    • 7 years
    • 13 years
    • 9 years
    • 11 years

13. The Black Report's material explanation would most likely recommend which policy response to class health inequality?

    • Increasing reliance on private health insurance so that individuals pay directly for the care they need
    • Raising incomes of poorer families and improving housing and working conditions for lower social classes
    • Expanding health education campaigns that aim mainly to change individual lifestyle choices and personal habits
    • Introducing higher prescription charges so that patients take more personal responsibility for their treatment

14. Which factor is most often linked to the North-South health divide within the UK?

    • A higher concentration of deindustrialised areas with lower employment levels and lower average incomes
    • A lower rate of hospital building in northern regions, which has left the north without any general hospitals
    • A greater proportion of ethnic minority residents in the north, which by itself reduces average life expectancy
    • A higher birth rate in southern regions, which has increased the number of older people living in the north

15. Which factor might help explain why some ethnic minority women are less likely to take up screening services?

    • Language barriers and a lack of information about services that is presented in a culturally appropriate way
    • A preference for private screening in almost every case, which leaves public services with little demand
    • Higher household incomes, which make screening services less necessary because wealthier women are less at risk
    • Stronger genetic protection against cancer, which makes screening services unnecessary for most ethnic groups

16. A study finds that poorer areas have higher rates of respiratory illness even after smoking rates are controlled for. Which conclusion is best supported?

    • Poorer residents must be less likely to seek medical help, which is the only possible explanation for the difference
    • The study shows that smoking has no effect on respiratory illness, so smoking can be safely ignored in all analyses
    • Respiratory illness is caused entirely by genetic differences between rich and poor areas, which is confirmed by the data
    • Other environmental or housing factors, such as damp housing or air pollution, may be contributing to the difference

17. Which factor can make access to health care unequal between areas even when the same national service applies?

    • The same service being delivered in identical ways everywhere, so access differences can only come from patient preference
    • The national service being funded only in the largest cities, so rural residents are excluded from all treatment
    • Patients being charged the same amount in every area, which forces some people to pay more than others
    • Fewer local services and longer waits for treatment in some areas, due to uneven staffing and facilities

18. Evaluate the claim that cultural or behavioural factors alone explain class health inequality.

    • The claim is irrelevant because health inequality is shaped only by the number of hospitals and the local services available in each region
    • The claim is refuted because health inequality is caused only by genetic differences that operate independently of class
    • The claim ignores that lifestyle choices are shaped by material constraints such as income and housing, so structure still matters
    • The claim is fully supported, since lifestyle choices are entirely independent of income, housing and the local environment

19. Why is the gender health paradox difficult to explain using purely biological arguments?

    • Gender differences in health vary across societies and periods and are linked to social roles, risk-taking and patterns of reporting
    • Women are always biologically weaker than men in all respects, so biology should predict worse outcomes for women everywhere
    • Men have no biological advantages or disadvantages in health, so biology should predict identical outcomes for both sexes
    • Biological differences between men and women are the same in all societies, so they cannot explain any variation over time

20. Which limitation applies when occupation is used to measure social class in health studies?

    • Occupation is recorded only for men, so the measure cannot be used to compare any health outcomes at all
    • Occupation always measures wealth exactly, so it leaves out no groups and has no limitations for any research
    • Occupation may not capture wealth, and the class of women, students and retired people can be misclassified
    • Occupation is measured only by income, so it can never be affected by changes in job type or working status

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