Control

Control as a ‘determinant’ of health 

The concept of health inequalities focuses on systematic and avoidable differences in health experiences and (healthy) life expectancy between different groups and geographical areas.  In the English context, this health divide is apparent between different regions of the country but inequalities in health are also evident between different socio-economic groups (e.g. gender, age, ethnicity) within every region in England. On average, people living in more affluent areas will experience better health and longer life compared to people living in areas with greater socioeconomic disadvantages.

It is well documented that this health ‘divide’ arises largely from disparity in the distribution of power, wealth and resources across society.  A social model of health also recognises that being able to live a long and healthy life is largely influenced by people’s living and working conditions.  This includes, for example, employment, education, housing, community networks and services. These factors are often referred to as social determinants of health. 

The Marmot Commission on Social Determinants of Health concluded that ‘social inequalities in health arise because of inequalities in the conditions of daily life and the fundamental drivers that give rise to them: inequities in power, money and resources.‘

In this context, the amount of control that people have over decisions affecting their lives is increasingly recognised to be a factor underpinning health inequalities.  In particular, the combination of dealing with stressful life circumstances, combined with a lack of power to influence how these demands are dealt with, may be particularly health-damaging. 

How communities are taking control for better health

In this recorded lecture at the Dukes Theatre, Lancaster from March 2017,  Jennie Popay talks about the scale of inequalities in the UK  and the evidence for control and empowerment 

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