Vulnerable Populations: The Uninsured and Underinsured - Essay Example

Individuals, their families and groups in the higher social classes live longer on average. The life expectancy of children born of higher income families today in Western societies is five years longer than those born to working-class families (Acheson, 1998). Until recent studies directed attention toward the sociological explanation for the inequality that exists in health status, a more direct link was thought to explain the disparity, a line of reasoning that merits serious consideration.

Low status jobs generally pay less. Lower incomes translate to restricted choices which means choosing food, housing and health care based on budgetary constraints, not on which is the healthier choice (Marmot, 1984). This direct association, while valid, is only a surface view of the link between social class and health status. A more clearly defined view of this social phenomenon can be found only by examining the less obvious psychological and sociological aspects of the connection. The psychological component of this triad is the product of various sources many of which are sociological in nature.

Psychological concerns involve the extent to which levels of pessimism, optimism and general feelings of self-esteem affect health. Self-esteem can be linked to health by two dissimilar social processes. First, “low self-esteem is part of a causal sequence that may lead to severe depression and related psychiatric disorders” (Brown, 1990). The second suggests a more indirect explanation that likely is the more harmful of the two. “Persons with low self-esteem lack the confidence and determination to adopt or maintain appropriate health behaviors with regard to smoking, substance abuse, diet, and exercise” (Hurst, 1997).

Social location more often than not is closely related to physical location. Living in certain areas of the country and cities is a determining factor in projecting health