Climbing the social mobility ladder Where does health fit in?

For an icebreaker in my first year of university, everyone in the room said what kind of secondary school they had been to and their experience of school – a seemingly innocent exercise that ended up being a big eye-opener. It quickly became apparent that I was in the minority having attended a comprehensive school. As this thought dawned on me, one student turned to me and congratulated me for making it to university. I found this strange – why wouldn’t I have got in?

This icebreaker highlighted the deeply entrenched way we view success in our society. University is a prime example of limited social mobility within the UK: for each child from a treadmill family (defined as those among the lowest 40% of income bracket) attending university, seven do not. Young people from affluent families are more than three times as likely to attend a Russell Group university. However, according to research, even going to university does not guarantee upward social mobility – your background still impacts upon your life.

To improve social mobility the entire life course needs to considered, but the early years are particularly important. This point was emphasised at the Social Mobility Commission’s conference I attended in March. There, Dr Gabriella Conti explained that future life chances are even influenced before birth, as prenatal health can impact early development. Delegates learned that a rounded approach is needed to break the link between parental income and future life chances. This means introducing polices that not only improve education and early development, but also target the labour market, housing and geographical mobility. Her research highlighted that health is not only improved by better social mobility, but it is a determinant of that same mobility.

In its State of the nation 2016 report, the Social Mobility Commission also touched upon the idea that health and wellbeing play a role in an individual’s social circumstances and, thus, their mobility. For example, the report concluded that those in social housing are less likely to find employment as they are more likely to have a mental health condition, disability or other health condition. Individuals in these circumstances are more likely to struggle to move social classes without a combination of health and social support.

Diderichsen et al’s model of the ‘mechanisms of socioeconomic inequalities in health’ illustrates how a person’s social position influences their exposure and vulnerability to different health issues. For instance, a person may be exposed to different risk factors depending on their income level, work environment, living conditions and health behaviours. The consequences of illness also vary greatly depending on social position, affecting access to work, treatment and rehabilitation. Health and social mobility are therefore inextricably interlinked.

A lack of upward social mobility will perpetuate health inequalities that are not only unjust for individuals, but also affect life chances between different groups in society. Our recent infographic highlights the 19-year gap in healthy life expectancy between the most and least deprived areas of the UK and shows the extent to which health is primarily shaped by factors including good work, education, housing, resources, physical environment and social connections. By taking action on these social determinants of health we will not only reduce the inequities of the healthy life expectancy gap, but may also promote upward social mobility.

Hannah Jones is Economics intern at The Health Foundation