5.0. CLASS-DISEASE RELATIONSHIPS

5.1. Describe the Relationship between Societal Class and Illness

Social Class is a socio-psychological term that tries to define an individual’s or a group of people socio-economic status. Individual/ group are expected to fall into the one of the following categories:

1. Affluence/ higher/ rich class

2. Average/ middle class

3. Poor/ lower class

Economic and social policies generate and distribute political power, income, goods and services. Social class will affect someone’s access to quality and affordable education and health care, sufficient nutritious food, good work and leisure conditions, among other things. 

More often, it is the rich or the poor that are recognized because the middle class are also grouped under the rich as most of them are seen to have escaped the vicious cycle of poverty and deprivation.

Disease of Affluence/ Western Disease (formerly known as Diseases of Rich People)

These refer to a term sometimes given to selected diseases and other health conditions which are commonly thought to be a result of increasing wealth in a society. These diseases of affluence have vastly increased in prevalence since the end of World War II especially in developed countries (USA, Russia, United Kingdom, Germany, France, China etc….). 

Western Diseases include mostly chronic non-communicable diseases (NCDs) and other physical health conditions for which personal lifestyles and societal conditions associated with economic development are believed to be an important risk factor . Furthermore, many of those conditions are interrelated, for example obesity is thought to be a partial cause of many other illnesses.

However, diseases of affluence started to become more prevalent in developing countries as diseases of poverty decline, longevity increases, and lifestyles change.

Risk Factors associated with Occurrence of Disease of Affluence

• Less strenuous physical exercise, often through increased use of motor vehicles

• Irregular exercise as a result of office jobs involving no physical labour.

• Easy accessibility in society to large amounts of low-cost food (relative to the much-lower caloric food availability in a subsistence economy) 

  • More food generally, with much less physical exertion expended to obtain a moderate amount of food

  • Higher consumption of vegetable oils and high sugar-containing foods

  • Higher consumption of meat and dairy products

  • Higher consumption of refined flours and products made of such, like white bread or white noodles

  • More foods which are processed, cooked, and commercially provided (rather than seasonal, fresh foods prepared locally at time of eating)

• Prolonged periods of little activity

• Greater use of alcohol and tobacco

• Longer life-spans 

  • Reduced exposure to infectious agents throughout life (this can result in a more idle and inexperienced immune system as compared to an individual who experienced relatively frequent exposure to certain pathogens in their time of life)

• Increased cleanliness. The hygiene hypothesis postulates that children of affluent families are now exposed to fewer antigens than has been normal in the past, giving rise to increased prevalence of allergy and autoimmune diseases.

Examples of Diseases of Affluence

Type 2 diabetes mellitus

Obesity

Cerebrovascular disease (Hypertension, stroke)

Coronary heart disease 

Peripheral vascular disease

Cancers (breast, uterus, prostate, colon, rectum, trachea, bronchus and lungs)

Gout 

Some types of allergy including asthma 

Alcoholism, depression , Alzheimer disease and other dementia

Chronic obstructive pulmonary disease

Lower respiratory infections

Kidney diseases

Disease of Poverty

This is a term sometimes used to describe diseases, disabilities and health conditions that are more prevalent among the poor than among the wealthier people. In many cases, the poverty is considered as the leading factor or determinant for such diseases, and in some cases the diseases themselves are identified as barriers to economic development that would end poverty.  

Diseases of poverty are often co-morbid and ubiquitous with malnutrition. These have tended to be largely infectious diseases and or communicable diseases, or the result of poor living conditions.

Risk Factors to Diseases of Poverty 

Ignorance

Food insecurity

Malnutrition

Overcrowding

Pollution

Disproportionate occupation

Stress/ overwork

Contaminated water supply

Lack of basic amenities

Inadequate health care delivery

Examples of Diseases of Poverty

Malaria

Poliomyelitis

Protein Energy Malnutrition (Kwashiorkor-Marasmus)

Tuberculosis

Worm infestations

Diarrheoal diseases

HIV/AIDS

Ebola

Mental disorders

Pneumonia

Cancer of lungs

Measles

N.B: Increasingly, research is finding that diseases thought to be diseases of affluence also appear in large part in the poor. These diseases include obesity and cardiovascular disease and, coupled with infectious diseases, these further increase global health inequalities. 

STUDENTS ACTIVITIES

QUIZ:

1. Compare and contrast between diseases of affluence and those of poverty

2. Describe the relationship between societal class and illness 

3. Covid-19 is a disease of poverty or affluence, discuss?