Material and psychosocial explanations for deprivation and poor health
Deprivation (poverty) can harm health through a material pathway, meaning poor housing, heating and food, or a psychosocial one, meaning stress from low-status, insecure work.
Remember
The material explanation is about the direct effects of poverty on housing, heating and food, while the psychosocial explanation is about stress from low-status, low-control work causing biological changes (changes in the body). They can overlap and reinforce each other.
Deprivation (or poverty) has a link with ill health, and there are many theories as to why. The Black Report, a UK report on inequalities in health, identified a number of explanations for these inequalities.
The material explanation is about the direct effects of poverty. Inadequate heating, overcrowding, damp or cold housing and limited access to nutritious food can bring illness. The harm comes from what people lack, rather than from stress or behaviour.
The psychosocial explanation works through stress. The stress of working in poorly paid, low-status jobs with little control over the work can cause biological changes in the body, and repeated stress of this kind is thought to harm physical and mental health over years. The word psychosocial joins the psychological, meaning thoughts and emotions, with the social, meaning a person's position in society.
The behavioural explanation points to more smoking and drinking alcohol, and less exercise and poorer diet, in deprived areas. The artefact explanation says there is no true link and that the apparent association is a measurement by-product. Social selection reverses the direction of cause: illness lowers income and social position.
The psychosocial and material explanations can overlap and reinforce each other. In insecure, low-paid work, stress is more likely and good housing and food are less affordable. The psychosocial and material pathways can act together. That is why public health responses often target more than one pathway.
Key facts
- Material explanation
- the direct effects of poverty, such as poor access to food or poor access to quality housing.
- Psychosocial explanation
- stress from poorly paid, low-status work with little control over it can cause biological changes in the body that damage health.
- Behavioural explanation
- more smoking and alcohol, less exercise and poorer diet in deprived areas.
- Artefact explanation
- no true link exists, because the apparent association is a by-product of how health and deprivation are measured.
- Social selection
- ill health leads to lower income and social position, which reverses the direction of cause.
- Different solutions
- material causes call for action on income and housing, and psychosocial causes call for tackling stress and insecurity.
Exam traps
- The psychosocial explanation does not describe a lack of basic resources, because it traces harm to stress from low-status or insecure work.
- Ill health reducing a person's income and moving them down the social scale is social selection, not the material explanation, because illness leads to poverty rather than poverty leading to illness.
- A higher prevalence of smoking and alcohol use in deprived populations is the behavioural explanation, not the material one, because it concerns what people do rather than the resources they have.
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