Introduction

Social classes are certain “layers” or groups of people that stand out in society in relation to ownership of the means of production and social division of labor. Division of society called as social stratification is one of the basic concepts of sociology, indicating signs of a system and criteria of society separation in layers; the social structure of society; and the branch of sociology.

Social classes is the division of society into social strata by combining different social positions with approximately similar social status, reflecting the prevailing there an idea of ​​social inequality. The division of society into strata is based on social inequality distances among them, which is the basic property of stratification. Social strata are arranged vertically and in a strict sequence of indicators of well-being, power, education, leisure, and consumption.

The social stratification establishes certain social distances between people (social positions) and forms a hierarchy of social strata. Thus, there is uneven access of society to some socially significant scarce resources through the establishment of limitations at the borders that separate social classes (Smith 3). One of the aspects that different social classes have uneven access or unequal quality is health. Therefore, health inequity in terms of socio-economic status means the differences in quality of life, the levels of health, health services, and their degrees of quality for people of different social classes. Existence of social inequality is a big problem that determines the level of access an individual to the healthcare; that is why, it should be investigated and tried to be solved.

Socio-Economic Status of an Individual that Have an Influence on Health

Socio-economic differences cause significant inequities in health. The basis of this assumption is the ideas about communication mechanisms of health with inequalities in socio-economic status. In some cases, these arrangements are obvious, while others are complex and do not lie on the surface. In any case, the development of social classes and social stratification is the result of a more or less conscious activity (policy) of the ruling elites. It is concerned to impose on society and legitimize it in their own social representations of the unequal access of society to social benefits and resources. The simplest stratification model is dichotomous, which is division of society into the elite and the mass. In some of the earliest archaic social systems, structuring of society into clans was conducted concurrently with the social inequalities between and within them. So there are those who are dedicated to specific social practices (priests, elders, chiefs) and the uninitiated or the profane (all other members of society, ordinary members of the community, compatriots). Inside, their society can continue to be stratified (Hofrichter 15). The modern idea of ​​the prevalence of social stratification models is quite complex since there are multilayered, multidimensional (implemented on multiple axes) and variable (make it possible to a plurality of stratification models to exist) types (Hofrichter 20).

Thus, the level of income determines the differences in living standards or quantity and quality of goods and services consumed (Barr 78). The caloric content, variety, the balance of power, safety and hygienic properties of used clothing and shoes, as well as convenience and comfort of microhabitats depend on the social status. There are differences in living conditions form unequal adaptability to the ability to handle physical and emotional stress. The inequality of living standards determines the disproportion of opportunities in the use of effective measures and methods in the fight against emerging health deviations. The general hypothesis that serves as the link between indicators of health and socio-economic status depends on the principle “the better economic situation, the better health.” That is how the influence of socio-economic inequality relates to health.

However, recently discovered other channels have a significant impact on health inequalities. In particular, chronic stress associated with dissatisfaction occupied by socio-economic status can lead to changes in neuroendocrine and psychological functioning of the body and increase the risk of diseases (Shein 87). It has been already widely recognized that the prolonged state of fear, insecurity, low self-esteem, social isolation, as well as the inability to make decisions and to monitor the situation at work and at home have a serious impact on health. As a result, these conditions cause depression, increase susceptibility to infectious diseases, diabetes, high cholesterol levels, and cardiovascular diseases. Low socioeconomic status affects, therefore, the right to health through the material deprivation and subjective perception of people because of their “unequal” position in society, the related evaluation, and relationship experiences. In the study of the influence of socio-economic inequalities upon the health of the population, there must be the analysis of objective and subjective socio-economic status.

The Difference between the Provision of Medical Care to Poor and Rich

There always has been a gap between the rich and the poor in medical care provision. First of all, low-income individuals cannot afford expensive health insurance (Barr 43). In addition, if a person had health complications or special conditions, life insurance would be limited and much more expensive. Secondly, if an individual does not have insurance due to the low income, he or she cannot cover expenses at the hospital. Then, in developed countries, the costs of health services are very high and still rising, so only the middle class and the rich can get appropriate medical care. In such countries, there may be such a phenomenon as free medical care. However, it is often corrupted, and thus people need to pay for better services and medicines. It can be possible that in poor rural areas, there is no hospital at all, which results in the lack of heath care providers.

Materialistic Component as a Part of Health Impact

Housing and Financial Challenges

The investments in housing and the help of governments may influence the health level of people, significantly increasing it. Thus, good living conditions and proper housing depends on government, investors, engineers, construction experts, architects, local government, housing agencies, and local authorities (Balkin 8). They provide scientific, legal, and financial protection and assurance of housing.

Health risks that depend on housing include those connected with air pollution, noise, building materials and their toxicity, and general living conditions. For example, there may be respiratory and cardiovascular diseases from air pollution in house. Temperature extremes may cause illnesses and deaths. There are communicable diseases that spread easily with air or water because of poor living conditions. Furthermore, poor construction may cause injuries. WHO estimates that nearly two million people in developing countries die from indoor air pollution caused by the burning of biomass and coal in leaky and inefficient household stoves (“Poverty” 1). Poor living conditions and bad ventilation increases risks of tuberculosis and other airborne infectious diseases of asthma and allergy as poor ventilation accumulates pollutants and allergic agents.

Working Conditions

Employment and working conditions have a great influence on equality in the field of health. Good working conditions can create social security and status, as well as opportunities for personal development and protection from physical and psychosocial attacks. They also allow improving social relations and self-esteem of employees and having a positive impact on health. Healthy working people is an important prerequisite of family income, productivity, and economic development (Shein 56). Therefore, the restoration and maintenance of ability to work are important functions of health services.

The health risks in the workplace, such as increased temperatures, noise, dust, hazardous chemicals, unsafe machinery, and psychological stress, cause occupational diseases that can aggravate other health problems. The conditions of employment, the type of work, and place in the hierarchy of work also have an impact on health. People working under stress or in a situation of instability tend to smoke more, do less exercise, and develop unhealthy eating habits.

The most important factor that influences the deterioration of health is nervous work. Thus, the psychological problem creates the tensed atmosphere in the company, an uncomfortable workplace, and much unnecessary noise at work due to many people in the same room. Many workers suffer from inconvenient work schedule, having constantly irregular working hours, without holidays, night shifts, the lack of healthy food, many projects, and insufficiency of staff. Most office workers are troubled by chronic fatigue, back pain, and similar health issues. Also workers have problems with shattered nerves, blurred vision, headache, colds/flu, digestive problems, and the development of excess weight due to poor eating habits and sedentary work. Some also have problems with feet and kidneys. Chronic respiratory disease, musculoskeletal disorders, hearing loss associated with noise, and skin problems are the most common occupational diseases. However, only one-third of countries address these issues.

Office workers often do not count on the understanding of the authorities when it refers to the improvement of working conditions. Workers that have the jobs that require physical efforts are typically from the low-income class, and they get diseases connected with working conditions much often and in higher extent. Non-communicable diseases (NCD), associated with the work, as well as cardiovascular diseases and depression caused by occupational stress, lead to an increase in long-term rates of disability and absence from work. Professional NCDs include occupational cancer, chronic bronchitis, and asthma caused by air pollution in the workplace and radiation.

Pollution Exposure

The negative impact on the environment is caused by the industrial enterprises, transport, nuclear weapons tests, and the excessive use of fertilizers and pesticides. People from the low-income social strata often live in regions of higher pollution, and poor countries have a higher number of enterprises that cause harm to the environment.

There was established a direct link between the increase in the number of people suffering from allergies, asthma, and cancer and environmental degradation in the region. It is well proved that such waste products as chrome, nickel, beryllium, asbestos, and many pesticides are carcinogenic and cause cancer. Most of the negative environmental consequences of human activity appear to change the atmosphere, its physical and chemical compositions. Emissions from industrial plants, energy, and transport systems in the air, water, and subsoil have reached such proportions that in some areas of the world pollution levels significantly exceed the permissible sanitary norms. This leads, especially among the urban population, to an increase in the number of people who develop chronic bronchitis, asthma, allergy, ischemia, and cancer. Man-made impacts on the atmosphere have caused such global changes as the “greenhouse effect,” the destruction of the ozone layer, and acid rain. Consequently, pollution to the greatest extent drains adaptive capabilities of the human body.

A bright example of how social status influences health through pollution, is the Flint Water accident case. In 2014, Flint moved from the Detroit water system to using water from the Flint River. Hereafter, an increased level of lead was detected in the water. The officials neglected to treat water with additives to prevent corrosion of metal pipes. The reasons were saving money, poverty of citizens, and environmental racism. In general, in some countries, people of other races often belong to poor class (Schulz and Mullings 22).

Culture

In social classes, there are different types of culture. Most often, the culture of eating is mentioned. In almost all social classes, both high and low-income, obesity occurs epidemically, although with large variations between and within them. In low-income classes and countries, obesity is more prevalent among middle-aged women, people of higher socio-economic status, and people living in cities (Budrys 165). In richer countries, obesity is not only common among middle-aged women, but is becoming more widespread among younger adults and children. In addition, it increasingly affects people of lower socio-economic status, especially women. As for the differences between urban and rural areas, they are gradually reduced or even reversed.

Food and food products have become a commodity, manufactured and sold in the market, which evolved from a once predominantly “local market” into the growing global market because of its development (Budrys 56). Changes in the global food industry have been reflected in a change of diet, for example, in increased consumption of energy-dense foods rich in fats, particularly in products containing saturated fat and low in carbohydrates unrefined. These trends exacerbated by downward trends in the physical energy of the population, are caused by a sedentary lifestyle. In particular, the presence of vehicles, use of appliances that reduce the complexity of working from home, job losses, as well as manual physical labor and leisure, which is preferably a pastime and not associated with physical activity have contributed to the problem.

Because of these changes in diet and lifestyle, chronic non-communicable diseases – including obesity, diabetes, cardiovascular disease (CVD), hypertension and stroke, and some types of cancer more and more become causes of diseases (Lee, Estes, and Rodriguez 47). Besides illnesses, these factors cause disability and premature mortality in people from developing countries and countries that have recently achieved the status of developed, representing thus an additional burden on national health sector budgets that are already loaded with expenses.

For most people in the world, especially in developing countries, livestock products remain favorite food for their nutritional value and taste. Excessive consumption of animal products in some countries and classes of society, however, can lead to excessive consumption of fats. The increase in the amount of fat in the diet worldwide enhances the number of proteins that is in the same diet.

Besides nutrition, culture includes aspects of morality and spiritual influence. For example, those who live in families, are married, and establish communication ties easily tend to have better health (Newman 254). Thus, family relationships improve both mental and physical health.

Connection between Poverty and Health

The connections between life quality and health are numerous and obvious. The most significant impact on health is made by poverty. That is because poverty and low-income directly influence housing conditions, nutrition, place of living, access to medical care and services, and quality of medical care. Poverty makes people live in unfavorable conditions and save money on bare essentials. Poor people get malnutrition, bad water or energy management, no insurance or lack of health services in the place of living, which depends on the country and region people live in. On the contrary, poor health negatively affects ability to work, creating a vicious circle. Prolonged illness may impoverish people as it is very expensive to buy medications and use hospital services, but a person is unable to work and earn money.

Being highlighted in the society, social classes are valued according to the criterion of social prestige, which expresses the social attractiveness of certain positions. Poverty lowers the person’s position in society and makes healthcare of high quality to be an inaccessible resource. The most important dynamic characteristic of society is social mobility that is the individual’s or group’s change of a place occupied in the social structure (social position), the move from one social class (class or group) to another (vertical mobility) or within the same social class (horizontal mobility). Along with the social filters, establishing barriers, and inhibiting social movement (qualifications, quotas, certification, defining the status, grades, benefits, privileges, preferences for the “elite” and restrictions for others), in society there are “social elevators” that significantly accelerate this process. For example, there are the crisis in society like revolutions, wars, and conquests; in a normal society, these are family, marriage, education, and property. The degree of freedom of social movements from one social stratum to another largely determines the way in which a society is “closed” or “open.”

Social Patterns of Diseases and Health

The Main Infectious Diseases in the World

In the world, there are recorded thousands, hundreds of thousands or even millions of cases of infectious diseases that affect children and adults not only in underdeveloped or developing countries but also in countries with high living standards. There are two major problems in the context of the emergence of infectious diseases in the coming decades. They are outbursts of diseases, which can develop into a pandemic and the continuing increase of pathogens resistance to antimicrobial and other specific drugs (causative agents of tuberculosis, typhoid fever, and malaria). Still, about 20 000 people die from the flu in the United States each year (Washer 14). Malaria each year infects more than 500 million people, and about three million cases end lethal (Washer 15). The first position in the number of infected people is held by tuberculosis that had around six million cases. At the same time, it should be noted that such a terrible disease like polio is disappearing because of vaccination. On the global scale, there were only 285 cases reported in the world (Washer 30). According to the World Health Organization(WHO) statistics, infectious diseases are the cause of 26 percent of all deaths in the world in 2008 (Eyal et al. 31).

The Main Deadly Non-Communicable Diseases in the World

Non-communicable diseases are diseases the occurrence of which is not associated with an infectious agent. Often a predisposition to it lies in the genes, or they develop under the influence of environmentally harmful substances. They have a long duration and usually progress slowly. The four main types of non-communicable diseases are cardiovascular diseases (such as heart attack and stroke), cancer, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes.

NCDs are common in all age groups and all regions. These diseases are often associated with older age groups, but the evidence suggests that the 16 million people, who die from NCDs, are the part of the age group up to 70 years (Eyal et al. 31). More than 80 percent of these premature deaths occur in low- and middle-income countries. Children, adults, and the elderly are vulnerable to the risk factors that contribute to the development of non-communicable diseases. Among the causes, there are unhealthy diet, lack of physical activity, exposure to tobacco smoke and the harmful use of alcohol. Smoking is one of the most important risk factors leading to the development of diseases such as cardiovascular, respiratory, and some forms of cancer.