The wealthy get healthy, the poor get poorly? Lay perceptions of health inequalities

Research repeatedly identifies an association between health and socio-economic status—richer people are healthier than poorer people. Richard Wilkinson has posited that socio-psychological mechanisms may be part of the explanation for the fact that socio-economic inequalities run right across the social spectrum in wealthy societies. He argues that polarised income distributions within countries have a negative impact on stress, self-esteem and social relations which, in turn, impact on physical well-being. How people experience and perceive inequalities is central to his thesis. However, relatively little empirical work has explored such lay perceptions. We attempt to address this gap by exploring how people see inequality, how they theorise its impact on health, and the extent to which they make personal and social comparisons, by drawing on 14 focus group discussions in Scotland and the north of England. Contrary to other research which suggests that people from more deprived backgrounds are more reluctant to acknowledge the effects of socio-economic deprivation, our findings demonstrate that, in some contexts at least, people from less favourable circumstances converse in a way to suggest that inequalities deeply affect their health and well-being. We discuss these findings in the light of the methodological challenges presented for pursuing such research.