The (re)production of health inequalities through the process of disseminating preventive innovations: the dynamic influence of socioeconomic status

摘要

Fundamental Cause Theory suggests the replacement of mechanisms that produce the persistent relationship between socioeconomic status and health over time. Understanding how this process operates is central to explaining the reproduction of health inequality. We use data from the Onco-barometer survey (2010) to test a set of hypotheses derived from FCT, Diffusion Of Innovations theory and the intersection between these theories to examine how socioeconomic inequality emerges and evolves across the cycle of diffusion of six relevant preventive practices in Spain: faecal occult blood tests, prostate-specific antigen tests, Papanicolaou tests, mammograms, cholesterol readings and blood-pressure checks. Because these preventive measures are characterised by differing rates of spontaneous knowledge and use amongst the Spanish population, we assume that they are at different stages in the diffusion cycle. Results suggest that SES has a dynamic influence according to the diffusion stage of each preventive measure. We argue that the conjunction of these theories offers a dynamic 'imagery' that can help to explain the generation and diminishment of inequalities. Moreover, this integration has the potential to bring 'social change' back into the study of health inequalities, which is essential to understanding equitable (and inequitable) returns produced by preventive innovations.