Do conceptualisations of health differ across social strata? A concept mapping study among lay people

Abstract

ObjectivesThe legitimacy of policies that aim at tackling socioeconomic inequalities in health can be challenged if they do not reflect the conceptualisations of health that are valued in all strata. Therefore, this study analyses how different socioeconomic groups formulate their own answers regarding: what does health mean to you?DesignConcept mapping procedures were performed in three groups that differ in educational level. All procedures followed exactly the same design.SettingArea of the city of Utrecht, the Netherlands.ParticipantsLay persons with a lower, intermediate and higher educational level (±15/group).ResultsThe concept maps for the three groups consisted of nine, eight and seven clusters each, respectively. Four clusters occurred in all groups: absence of disease/disabilities, health-related behaviours, social life, attitude towards life. The content of some of these differed between groups, for example, behaviours were interpreted as having opportunities to behave healthily in the lower education group, and in terms of their impact on health in the higher education group. Other clusters appeared to be specific for particular groups, such as autonomy (intermediate/higher education group). Finally, ranking ranged from a higher ranking of the positively formulated aspects in the higher education group (eg, lust for life) to that of the negatively formulated aspects in the lower education group (eg, having no chronic disease).ConclusionOur results provide indications to suggest that people in lower socioeconomic groups are more likely to show a conceptualisation of health that refers to (1) the absence of health threats (vs positive aspects), (2) a person within his/her circumstances (vs quality of own body/mind), (3) the value of functional (vs hedonistic) notions and (4) an accepting (vs active) attitude towards life.

Constructing social identity through multiple “us and them”: a grounded theory study of how contextual factors are manifested in the lives of residents of a vulnerable district in Brazil

“…Possible explanations for the perceived lack of connection between contextual factors and health might be related to the participants' biomedical and individually determined view of health or their notion that health is not in itself a consequence of context but actually a prerequisite for individuals to do other activities, for instance for working and studying. These health views have been previously described in other settings as well, even though there is important variation regarding countries, socioeconomic conditions, among other factors [73,74]. Thus, further analysis about these participants' views on health are considered relevant for health research and will be further elaborated and reported elsewhere.…”

Concepts of health in different contexts: a scoping review

“…Eleven articles were written from a context specific perspective. We divided these articles with a context specific perspective in four groups: cultural perspectives (4 articles) [ 75 – 78 ], immigrant perspectives (3 articles) [ 73 , 79 , 80 ], educational level perspectives (2 articles) [ 81 , 82 ], and other perspectives (2 articles) [ 83 , 84 ] (see Table 11 ). These contexts are diverse and cannot be seen as one similar group.…”

“We Don’t Assume That Everyone Has the Same Idea About Health, Do We?” Explorative Study of Citizens’ Perceptions of Health and Participation to Improve Their Health in a Low Socioeconomic City District

“…Accordingly, a focus on possibilities, self-confidence, and acceptance were mentioned as supportive of good health. This indicates the importance of paying attention to the subjective dimensions that determine health judgements and the way in which citizens cope with circumstances [ 28 ]. The participants asked for different social activities in the community centers—e.g., a “Looking for sense” course nearby, in their own neighborhood and free of charge.…”

“…A prerequisite for citizen participation is to recognize how citizens perceive health and the issues that are important for them regarding health and wellbeing. Studies that explored low SES citizens' perceptions of health found that how people experience and define health differs depending on the context and the situation [28,29]. In general, citizens with a low SES are less likely to perceive the need for lifestyle advice and participate less often in lifestyle programs compared to citizens with a high SES [30][31][32].…”