comparisson of causes of death rates in belgium and spain by social class
TRANSCRIPT
Class differences in mortality Comparison between Spain and Belgium
1999/2009
Manuel León Méndez
SOCIOLOGY MASTER PROGRAM- SEMINAR IN SOCIAL DEMOGRAPHY – ERASMUS EXCHANGE PROGRAM GHENT UNIVERSITEIT – LECT.: BART VAN DEPUTTE
I
Death is an equall doome To good and bad, the common In of rest.
Edmund Spenser
Men fear death, as children fear to go in the dark; and as that natural fear in children is increased with tales, so is the other.
Francis Bacon
II
Table of contents:
DEVELOPING THE RESEARCH QUESTION 1
TYPOLOGY OF WELFARE STATES 4
LITERATURE OVERVIEW 6
NUTRITION 8
OCCUPATION 9
EDUCATIONAL LEVEL 11
AVAILABILITY OF MEDICAL SERVICES AND THE MODEL OF LIVING 11
URBANISATION AND GEOGRAPHICAL POSITION 12
INCOME LEVEL 14
STATUS 15
MARITAL CONDITION 15
RETHINKING SOCIAL CLASS 15
SOME POSSIBLE EXPLANATIONS 17
HYPOTHESES 17
MAIN HYPOTHESES 17
SECONDARY HYPOTHESES 18
FACTUAL INFORMATION 19
DISCUSSION AND CONCLUSION 27
BIBLIOGRAPHY A
WEBGRAPHY B
1
Developing the research question
The Death is the elder well-known partner of humanity. Biologically speaking,
dying only takes a few seconds or minutes. It begins with the failure of one
organ and so on this situation spreads all along the rest of the organs as if they
were light bulbs, just switching off forever. When the time of dying arrives, is the
same to everyone, no matter gender, religion nor social class. But the way in we
die is so different if we look again thought the previous typology.
My willingness to study the death and the dying has several reasons from the
will to gain intellectual resources to became more self-reflective about the
feeling we develop about the death and the dying and all of the feelings,
reactions or opinions associated with them, passing through the desire to know
about death, types of deaths, and the management and control of the pain
associated to it, and ending up with the understanding of the changes produced
in life expectancy and mortality rates.
In the present research I am going to try to find an accurate theoretical
explanation to the different ways of dying if we approach to them from the social
class cleavage.
More specifically I am going to do an attempt to figure out which differences and
similarities exists in the death between social classes, but besides I am going to
do a comparison of the most meaningful facts between two different countries
and consequently cultures, such as Spain and Belgium.
The choosing of these two countries have a very easy explanation, as Emile
Durkheim postulates in his renowned essay, “The rules of the sociological
method”, the investigator are able to interpose its values, beliefs and will at the
moment of start a research.
As I am an exchange student from Spain, and I was very well received by one
of the oldest universities in Belgium, I decide to do the comparison of the ways
of dying in these countries, of such different culture and social behaviour, in
order to understand a little bit more the cultural trends of these so different
societies in the last action that a man do, die.
2
In order to justify the willingness of that comparison between these countries I
am going to do a briefly overview remaking the most meaningful facts of them
both to enhance the differences and similitudes between them.
Spain
Form of government Parliamentary monarchy
Total population
• Total
• Density
Rank 27º
47.150.800 (2010)
93,17 hab./km²
GDP (nominal)
•Total(2009)
•GDP per capita
Rank 12º
$1.438.356 millions
$29.595
HDI (2010) 0,863 (20º) – Very High
Member of: European Union, NATO, UN, OECD, OSCE, UL,
CIN, OEI, ABINIA, AED, EBRD, COE, G20
3
Kingdom of Belgium
Form of Government Federal parliamentary monarchy
Total Population
• Total
• Density
Rank 72º
10.827.000
354.6 hab./km²
GNP (nominal)
• Total (2007)
• GNP per capita
Rank 19º
$ 530.613 million
$ 49,430 (2008)
HDI (2010) 0,8671 (18º)–Very High
Member of: European Union, NATO, UN, OECD, OSCE, Benelux, COE
We can notice than these two countries have very similarities despite its great
differences in matter of population and distribution of the GDP (Gross Domestic
Product) per capita. Despite Belgium is a smaller country than Spain and
consequently produces less benefit in whole numbers, Belgium has better
distribution of that benefits being in the 19th position an 29th position in nominal
GDP respectively according to the list provided by the Wold Bank in 2010. That
factor influences consequently the position of both countries in the ranking of
the Human Development Index (HDI) provided by the United Nations (UN).
Then, as it is possible to see after the reading of the basic socioeconomic data,
Belgium and Spain are so close in the HDI holding the 18th and 20th ranks
respectively. As the HDI is calculated by three indicators such as Health,
represented by the life span at birth, Wealth: measured by GDP per capita PPP
4
(Purchasing Power Parity) in international dollars and Education measured by
the adult literacy rate and combined gross enrolment in primary, secondary and
higher education, as well as year of compulsory education, I think these are
quite good indicators to realise the levels of the countries in revision in the
economic, social and cultural level related to the educational level field.
Although, in order to define in a precise way about those indicators I am going
to use the welfare state typology postulated by Gøsta Esping-Andersen where
we can see that Belgium remains in the Continental group characterized by one
of the highest levels of social protection and its main feature is the universal
provision based on the principle of citizenship, i.e. that is a wider access with
fewer conditions, social benefits and higher proportion of expenditures in
pensions. It is based on the principle of "assistance" (help) and insurance
system, with a partial subsidy system that is not conditioned on employability.
In the other hand Spain is situated in the Mediterranean group characterized by
its later development (seventies and eighties decades) and with lower social
costs and heavily based on a lower pension and social assistance costs.
TYPOLOGY OF WELFARE STATES
LIBERAL/RESIDUAL OR ANGLO SAXON LIBERAL COUNTRIES (LCS)
In the welfare states of these countries (UK, USA, Canada, Australia and Ireland), state provision of
welfare is minimal; social transfers are modest and often attract strict entitlement criteria; and recipients
are usually means tested and stigmatised. In this model, the dominance of the market is encouraged both
passively, by guaranteeing only a minimum, and actively, by subsidising private welfare schemes. Also
minimises the decommodification effects of the welfare state and a stark division exists between those,
largely the poor, who rely on state aid those who are able to afford private provision. In these countries the
parties of liberal persuasion (LPs) have governed for the longest periods of time.
CONSERVATIVE/CORPORATIVE/BISMARCKIAN OR CHRISTIAN DEMOCRATIC COUNTRIES (CDCS)
These kind of welfare state comprehends countries as Germany, France, Austria, Belgium, Italy and
Netherlands and are distinguished by its ‘status differentiating’ welfare programs in which benefits are
often earnings related, administrated through the employer and geared towards maintaining existing social
patterns. The role of the family is also emphasised and the redistributive impact is minimal. However, the
role of the market is marginalised. These countries, historically have been ruled by Christian Democratic
and Judeo-Christian traditional parties (CDPs)
5
SOCIAL DEMOCRATIC/SCANDINAVIAN COUNTRIES (SDCS)
This kind of countries are characterised by universalism, comparatively generous social transfers, a
commitment to full employment and income protection and strongly interventionist state. The state is used
to promote social equality through a redistributive social security system. Unlike the other welfare state
regimes, this regime promotes an equality of the highest standards, not an equality of minimal needs and it
provides highly decommodifying programs. These countries have been governed by social democratic
parties or labour parties (SDPs) for the longest periods of time and include Sweden, Norway, Denmark,
Finland and Austria.
SOUTHERN/LATIN OR EX-AUTHORITARIAN OR EX-DICTATORIAL COUNTRIES ( EDCS)
These states comprehend countries as (Italy, Greece, Portugal and Spain and comprise a distinctive
southern welfare state regime. This kind of welfare state is described as ‘rudimentary’ because they are
characterised by their fragmented system of welfare provision, which consists of diverse income
maintenance schemes that range from the meagre and generous welfare service, particularly, the
healthcare system, that provide only limited and partial coverage. Reliance on the family and voluntary
sector also a prominent feature. These countries the authoritarian or dictatorial ‘parties’ have governed for
the longest periods of time.
SOURCE: OWN MAKING MIXING INFORMATION OF RAMBA AND NAVARRO et al. PAPERS
A priori is difficult to determine out a strong cultural-socio-economic differences,
due to the closest position of both countries in the raking of de HDI, which
shows a very huge similarity in the aspects considered to make that index. In
other way the big difference is noticed in the kind of welfare state that exists in
each country and its political tradition, and that could be the path to follow in the
research in order to find the differences in mortality rates between social
classes.
Due to the explained above and taking advantage of the actual tessitura of
world economic crisis, I wonder to know if there are differences or similarities in
mortality rates between social classes between Belgium and Spain during the
period comprehended 1999 and 2009.
6
Literature overview
First of all I am going to try to find out what is said about the topic, looking into
scientific literature. In order to start focusing in our question and having a clearly
image of what I am referring to. To do so is necessary to choose one of the
many concepts of social class.
The social class is a status of membership to a specific social structure, but this
status can be given by several factors. These factors can be cultural or
educational, given by bloodline, kinship or castes, or given by the law made by
men under certain prerequisites, or, and it is the well-known cleavage explained
by Karl Marx in the modern occidental societies, the factors that can determine
the membership to a social class can be given by the relationship of the
individual with the ownership of the means of production, the production of
goods or the consumption of these.
But despite that is our main cleavage, the factors which influence the disparities
that surround the act of dying are very disparate, in fact as Benjamin says:
“different elements in the environment influences the process of adaptation (to
death): i.e. the mode of employment, working conditions, intelligence and
educational levels, level of living, including this, nutrition, clothing, housing,
medical care access and other kinds of wellbeing access and also is influenced
by the cultural background as the religion, social customs, art forms and
different modes of emotional expression“(Benjamin, 1965:5).
One way to approach to our issue, as I said is the historically way that tries to
separate the effects of mortality of social changes by successive generations or
cohorts as something related to the genetics and the environmental thus as an
issue of our Zeitgeist, understood as the cultural spirit and values of our times.
The human being, historically has had very heterogeneous ways of confront the
death, but this is no reason because all that traditions had to soak in the
common conscience. Thus, we can say, just climbing on the shoulder of giants,
the act of dying is an amalgam of that traditions plus a succession of factors
specifically of our contemporary Zeitgeist.
7
The study of the mortality related to the social class is a long recognized issue
through the history, in fact there are several studies and comparisons between
the total population death and high class population death rate during the pre-
industrial age, and those did not find any significant mortality differences
between social classes.
But lately with the spread and use of the demographic discipline by the
Nation/States in order to take account of the army and the population, these
gathered a lot of information about born an deaths and thus i.e. in 1835 A.
Quetelet synthetized that kind of data for the first time in his study of “Sur
l’homme et le developpement de ses faculties ou Essai de physique sociale”
establishing with it the first bigger differences between social classes.
In the second half of the XIX century and the first half of the XX, the social
differences increased in a dramatically way, due to the industrial revolution, and
bringing into play a variety of new variables to consider. For that reason has
become so difficult to isolate only one factor that affects in a significant way to
the death and the many of them usually overlap themselves removing clarity of
perception. As is explained to exemplify this in the research of Benjamin, the
presence of a small group of low status and high mortality might have more
effect on mortality than for the social index of a specific area, leading to a
departure from the normal inverse relationship between social status and
mortality. And this can lead to sociological artefacts (Stockwell in Benjamin 1965:8).
But despite on that confusion, one thing appears to be constant by doing an
historical review of the issue, and is that the hygiene and the health changes
interfere in the mortality rates, and the inequality of access to that cares
depending of the social class based in economic aspects may be a reason for
the difference in the act of dying. But in the recent ages where the technologies
of hygiene have reached the mass is needed to look for more indicators which
can lead us to a more causal answer of our initial question.
8
Another possible approaching way may be to look at the act of dying as a lack
of health, as they are two sides of the same coin they have always appeared to
be closely related, despite the historic discontinuity that marks a huge change in
the boundaries of the quality of life in the modern societies, splitting the
mortality rates of the per capita growth and relating it to the social inequalities,
that is a better indicator that also embraces the per capita growth (Extracted from
Wilkinson 1984:61).
So in that ways of thinking the next step will be an attempt to find the more
important of these factors and try to explain briefly how they work and how can
be used in future researches.
In order to do that I’m going to enumerate the most used indicators used by
sociological theory and after that pick the ones which fits better with the
approach to the issue I want to do, namely differentials in social class mortality
rates taking in account the welfare state of each country.
NUTRITION
I am going to start paying attention to the nutrition habits as an environmental
factor that has changed amongst the times in several ways, in the quantity of
calories consumed, the quality of the food and the access to them as a basic
good.
The existence of a relationship between nutrition and mortality is widely
accepted but for epidemiological analyses better than for demographic ones
that don’t take so much in account about that relationship. Anyway that
relationship is difficult to establish because the effect of the nutrition over the
mortality can be both positive and negative.
Omram hypothesised in 1977 that the high nutritive foods were part responsible
of the diminution of mortality and of the epidemiological transition occurred
between the Age of Pestilence and Famine and the Age of Degenerative and
Man-Made Diseases following the timeline specified by Abdel R. Omran.
The few researches done looking after the direct relation between nutrition and
mortality rates had hypothesised that the nutrients of food rather than the
changes in the diet are a determinant of the distribution and variation in the age
9
patterns of mortality among populations, and economic factors, as income, has
only an indirect relationship.
The research made by Cage and O’Connor (1994) states that if the caloric
consumption is not the only factor that affect to the mortality rates, the study of
the different nutrients present in regular food as fats, carbohydrates and protein
may lead us to a better knowledge of how the good or the bad nutrition can
affect to the mortality.
In a deep research guided by quantitative methodology, these three aspects
must be crossed with the mortality rates during any specific lapse of time in
order to find any correlation between them. A hypothesis can be that the
reduction of the “major illness and diseases” can be reduced by these nutrition
habits guided by more a bigger caloric ingest in the diet. Namely to a better
nutrition a better health and due to that a lower chance of death.
OCCUPATION
In order to establish a relation between the mortality rates and the occupation is
needed to know the number of deaths for each previously stipulated cause of
death by age and sex in each type of occupation. And as it is recommended in
the essay on Benjamin, standardise the occupations by ages because there are
significant differences of when the jobs are reached. But anyway we can find
incongruences in the input data because the actual grade of occupation taking
from the contracts often do not coincide with the occupation grade given at the
moment of register the death. A good initiative in order to start getting some
perspective could be look at the occupations with highest and lowest mortality
rates, and compare them to a previously specified social class rank where has
to fit all the occupations.
There is a very simplistic but clearly cleavage made by the British Decennial
Supplement of the Registrar General, made from occupation positions, which
can help us to put the individuals in not so many groups in order to generalize
our explanations:
10
I. Upper and middle class-professional occupations.
II. Intermediate class-managerial and technical, intermediate occupations.
III. Skilled occupations count since 1971 with two sub-classes.
IIIN. Skilled non manual workers.
IIIM. Skilled manual workers.
IV. Partly skilled occupations, as agricultural workers
V. Unskilled occupations.
(Benjamin 1965:59 and Gadeyne 2006:39)
As example of that, the research made by Erikson and Torssander (2008), after
the standardization of the and the ages by occupation as Benjamin suggest,
notes that he hazard of dying in wide largest in unskilled working class than in
white collar workers, despite this approach is quite vague and the researchers
encourage to do a more accurate typology, they charge the highest level of
mortality in manual workers because the highest hazard of exposure to
dangerous situations, the exposition to harmful work environments and bad
health consumption habits as smoking, drinking or the use of drugs.
Source: Kunst, A. E., Groenhof, F. & Mackenbach, J. P. (1998), Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies, British Medical Journal, 316, 1636-1641
11
EDUCATIONAL LEVEL
This indicator can help to define in a better way the main relationship between
occupation, income and mortality, used in a lot of sociological studies. The
study of Benjamin assure than those in professional and managerial
employment have lighter mortality than unskilled workers, also are better
educated in health and other matters due that education plays an important part
in deciding whether people cloths or feeds themselves adequately, what they do
about fresh air, exercise or relaxation or in the other hand whether they avoid
the massive alcoholic consumption, or tobacco or other harmful habits. (Benjamin
1976:50)
In some studies is assert that the cultural and educational level is a clue
indicator to understand the relation between the socioeconomic class and the
health-related behaviour.
AVAILABILITY OF MEDICAL SERVICES AND THE MODEL OF LIVING
Is well checked that the higher economic development the higher health care
has a country and this leads to a decreasing of the mortality rates caused by the
“lesser diseases” like smallpox, diabetes, tuberculosis or diphtheria.
We can find a variety of managing the public health care system depending if
exists or not a welfare state and if already exists is also possible to match
differences depending on the type of these.
“…in conditions of universal accessibility of these medical services
understanding by any economic barriers, social and economic differentials in
mortality are highly reduced” (Benjamin, 1976:53)
The way of living, also influence in the mortality rates, in the study of Benjamin
is said that the health care and a careful way of living leaded to a decrease of
the elder men mortality rates and in a reduction of the mortality of the woman of
all ages. Also was noticed that the lung cancer and heart disease was reduced
too due to the good living
As concludes Charlotte Van Tuyckom,, lecturer of the, Department of Sociology
at Ghent University, another factor to observe is the relationship between social
inequality and health which happens to be very consistent.
12
One of the more used indicators to observe the social inequality is the Gini
index made from the Lorenz curve and based in the economic distribution of
one specific society, where 0 is full equitable distribution or equality of income
and 100 is the highest inequality possible.
Gini Index by years in Belgium and Spain
Belgium Spain 1992 26.92 Missing data 2000 33.0 35.0 2005 28.0 32.0 SOURCE: COMPILED FROM GAPMNIDER, UNITED NATIONS DEVELOPMENT PROGRAM WEBPAGE AND NATION MASTER WEBPAGE.
URBANISATION AND GEOGRAPHICAL POSITION
The migration from the town to the cities might be another good indicator of
social class, due as it is known the lowest classes of the towns the mostly of the
times they migrate is to try improve its socio-economical level. Thus, and taking
this in account, it could be very informative to check the mortality rates from
those migrants from the town to the city, spread by borrows since they can be
easily classified by social class.
Another possible approach is the geographical placement of the individual,
which can determine itself the social class and can give information about the
mortality rates due to the inequality of that distribution, where the lower social
classes may live in non-secure or harmful environments that affect negatively to
his health status and can shorten the lifespan
And both approaches can be crossed at the same time with the GDA per capita
of each country, or to handle better the amount of information, each country can
be divided in its main administrative regions, doing the comparison easier due
to the more comparable data on one single region at the time. (Shaw et al.
2000).
The evidence shows that health levels decrease dramatically in socio-economic
disadvantaged areas and consequently the mortality rates rise up. In fact the
World Health Organization (WHO) states that social distribution in health status,
and indeed mortality rates, is underlain by the unequal distribution of
fundamental resources and opportunities for a healthy life, such wealth
education, employment, access to health care and the environment in which
people live (WHO Commission on Social Determinants of Health 2008).
13
Source : Shawn M. et al. 2000
The main concept the researchers of that field are working on is the
‘environmental justice’, which studies de disparities in access to beneficial
health environments and the protection of that deprivation by considering the
socioeconomic status of an area. Unfortunately there is a lack of research in
that field.
Concluding is has been postulated but not so much proved that a better access
to healthy environments (pollution-free, with open green spaces etc.) influences
in a positive way to the health of the population and indeed in its mortality rates.
The researchers also noticed that the access to the better places is strongly
correlated with the socio economic level. I.e. research in Hamilton, Canada
found thatr socio economic status modified the relationship between air
pollution exposure and mortality (Jerrett et al 2004 in Pierce et al 2010).
14
INCOME LEVEL
The level of money that a regular individual earns, operationalized as income
per capita, is another variable to considerate and to relate with the others to
realise what is social class an thus find the causality between social class and
mortality rate, due that from the income are extracted the taxes paid to the
state, that could be one of the best indicators at the time to relate the
information with the type of welfare state of the country observed.
At the time of operationalize that variable the gap can be chosen freely by the
researcher but it’s highly recommended to make a likert scale of five or of seven
steps, due to its statistical utility and making each of the steps equidistant,
starting from the lowest amount of income and finishing with the highest.
Evolution of life expectancy depending on the Income level per capita in Belgium and Spain between 1991 and 2009.
15
STATUS
The concept of status is wide used in social sciences and specifically if it is
wanted to find any kind of correlation or causality with the mortality rate, but, is
also a concept who can allow a lot of facets in it. Thus I’m going to define what I
am going to use as the status indicator.
Social status can be both acquired and determined by the main cultural values
of a specific society. In ours the status can be understood as a combination
position, gained by the marriage with equals o higher individuals in terms of
power. The power itself understood as the possibility of oblige to do something
to another person against its will and the specific occupation in the labour
market, that also gives to the owner certain amount of power.
MARITAL CONDITION
Torssander and Erikson (2009) describes the Status variable as the measure
based on the occupational structure of marriage or cohabiting, considering the
general advantage or disadvantage that these provides reflecting the combined
rates of both material an social inequality. The construction of that variable is
based on the presumption that individual tends to relate and marry its equals in
socio-economic level an education level.
RETHINKING SOCIAL CLASS
But despite all the indicators listed above the mainstreams of the written
sociology related to the understanding of mortality and social class, argue that
none of them itself are fully relevant in the results. For that cause I am going to
redefine the social class concept and try to fit it into the different social politics
of each specific welfare state our object study countries.
16
For an easy understanding of what I want to explain I will display a schematic
graphic of the idea.
The Education indicator may be constructed as is explained below, as so can
be the Income indicator, but in the case of the Status indicator I suggest it can
be a typology created from the correlation between the achievement of the
socio-cultural values of the specific society plus the power held by the
individual, that is closely related to their occupation and finally the social
position determined by formation of a family nucleus with one partner of the
same education and income as the individual or not.
The graphic above wants to illustrate that in the way how are articulated the
education, the income and the Social status, determines a specific a specific
configuration of social class and a specific kind of social politics which in turn
shapes a specific kind of welfare state, determining largely but not entirely the
mortality rates by social class. Coincidentally all the papers used in this
research hold that none of the indicator had a fully explanation capability and
often they overlap themselves. That table can be read in a bidirectional way.
WELLFARE
STATE
Education
Income
Status
Social politics
Social Class
Source: Selfmade
MORTALITY
RATES
17
SOME POSSIBLE EXPLANATIONS
So, following the premises explained before we can start thinking about the
relationship between social class and mortality as a possible bidirectional
causality between Mortality rates and Social Class or, and this is a causation of
less weight because of its deterministic component, the genetic factor has could
had an important role in the cause both mortality and social class having
between those last a bidirectional relation of causality.
HYPOTHESES
Taking in account all the explained above is possible to look for an answer from
that proposed hypothesis, after, doing the right correlations and statistical
analysis, starting from a good data base who contains all the variables we
determine.
MAIN HYPOTHESES
1. All the variables are directly interdependent, named the higher will be the
health level the higher will be the educational level and thus, the higher
will be the educational level and the higher will be the income, etc. both
in Belgium and Spain.
2. Higher socioeconomic status brings a lower mortality.
18
3. Mortality rates, in the entire hypotheses listed above are highest in
Southern well fare state countries than in Conservative countries namely
higher in Spain than in Belgium.
4. Persons of higher socioeconomic status (social class) possess a wide
range of broadly serviceable resources including money, Knowledge,
prestige, power and beneficial social connections, which can be used as
an advantage both in Belgium and Spain to preserve and enhance their
health.
5. Younger people, due to a highest educational level which brings the to a
better health habits, has les mortality rates.
SECONDARY HYPOTHESES
1. The kind of welfare state does not make a real difference in mortality
rates by social class.
2. The reduction of the “major illness and diseases” can be reduced by
these nutrition habits guided by more a best ingest of calories in the food.
3. The change in mortality rates associated with the social class only is
noticed in individuals of 45 years onwards.
4. Mortality rates and social class differences it will be noticed between
allochthonous and autochthonous.
5. Mortality rates are higher in blue-collar workers than in white collar
workers.
19
Factual information
To give support to the exposed above I’m going to attach some statistical tables
of the main Statistical Institutes of each country studied, and do a brief
comment of the data.
Source: Self-made with data of the Instituto Nacional de Estadistica (INE)
As is possible to see in the first chart the mortality rates were going down over
the years in both countries (despite the lack of information for Belgium in the
Spanish database for the years beyond the 1999) is presumably that the trend
of the Belgium people is to decrease the mortality rates. In the chart is also
noticed the high hazard of mortality by ischemic disease bigger in Belgium than
in Spain, is at least 3 times bigger than the non-natural mortality causes, as car
accident or suicide which have a minimal representation in both countries, in the
other hand the death by mental illness produced by drug or alcohol
consumption remains as the mean cause of mortality within these tree specific
causes of dead. it can be seen the polarized behaviour of the people of those
countries, in the death by mental illness by drugs, which in Belgium is wide
bigger that in Spain and in the other hand the death produced by mental illness
by alcohol consumption is much bigger in Spain that in Belgium, this behaviour
could be explained by cultural traditions.
20
Source: Self-made with data of Statistics Belgium
Due to the lack of information in the Spanish database I have addressed to the
Belgian Institute of Statistics and only appear to be fragmented information
about the causes of death, both specific and general. In the graphing of the data
it can be noted that from 1998 to 2006 in intervals of one to three years
maximum the trend is to stabilize the mortality rates with a slightly deceleration
of the rhythm except for the tumors which experiments a minor increasing of
cases. As I had asset before the general trend of the Belgian mortality is a
decreasing one. It remains to check why this general decreasing is produced
by.
Checking only the All
cause standarized death
rates taking as reference
the spanish population in
2009, it is possible to check
the similar behavior of both
countries but with a higher
level of Belgium. Source: self-made with Eurostat data
21
Source: Eurostat
As I said before, a good way to compare the deaths is not by whole country but
by administrative delimitation, in the preceding map the mortality rates of both
countries can be appreciated in whole numbers divide in quintiles and coded by
colours to have a more visual perception of death rates in 2011.
In the following charts is possible to compare the number of deaths of the
countries divided by regions in two different years, 2000 and 2009 in the same
way as in the other graphics it can be noticed that behaviour is very stable, just
with minor changes upward or downward
22
Source: Eurostat
The following representations are related to the main indicators used in the
construction of the variable, “Social Class”, as is explained before, it could be
built by combining Educational level, Income per capita, and Status, the later
based upon the Marriage between equals. I have to say that in the databases
requested, no crossing with other variables were allowed, and is a job that has
to be done by the researchers, to be able to include some kind of typification of
Social Status.
23
The next chart shows the educational level of both the Belgians and the
Spanish students in percentages from the lowest level, Pre-Primary education
to the highest one, Tertiary education. Is needed to say that the data is not
standardised and the percentages show are related to the whole population of
each country, as is well known Spanish population is larger than Belgian, so the
graphic shows this disparity. It can be noticed that the spanish 3 to 6 levels are
quite simile while in Belgium the difference between them is more substantial,
being smaller the percentage of 5th and 6th level of education. These data can
be correlated with the mortality rates, a typificated to be able of build the early
said indicator “Social Class”.
Soure: Self-made with data of the Eurostat.
24
Other of the indicators needed to make the “Social Class” dataset is Income.
Just to have a brief idea of how is distributed the money in our countries, I
present a coloured map indicating the gross earnings in the secondary and
tertiary sector of production, as is clearly visible, Belgium has highest benefits
than Spain, but they are so close because only have one gap of difference.
25
As can be appreciated in the next map, also the minimum inter-professional
wage is higher in Belgium than in Spain. This can be because of the different
kind of welfare state present in each country, maybe taxes revenue data, and
social policies information will be needed to round up the role of that welfare
state plays in the relationship with the social class.
Source: Eurostat
Finally to complete the new proposed Social Class concept the marital status is
observed in the next pictures in a four category typification for both countries,
the graph shows the different behaviour two societies, ruled by a different
religious/moral precepts. While the majority of the population of both countries
marry for the first time without having been in another institutional legitimated
26
relationship or maybe they came from a former civil state In Spain few divorce
occurred in comparison with Belgium, the case of the widowed is minimal an
could not be relevant for the research. Again correlation with Income and
Education level will be needed to find a proper Social Class categorization.
Source:Self-made with Eurostat data
27
Discussion and conclusion
The primal conclusion if any, without doing any analysis at all, and following the
always present conclusive pattern in almost every paper used to document
mine, is that there is not a unique variable which determines in a strong way the
mortality rate in general. So find a single variable for any of the two countries
under observation could be a titanic job.
Following the read, if one of the considered factors must have a special
treatment for it’s a, priori, inextricably relation with the others, is the Educational
Level. It is fundamental to focus and thresh it, because a higher Educational
level leads to another sight of view about the world, which could lead itself to
the individual to take care about its health, to achieve a better job which gives
more money to get certain social status which at the same time could lead to
the owner the chance to get married with a person of the same status. And if
the main hypotheses are corroborated a higher social class leads to a better
health that prevent from death prematurely.
Income is the other main indicator to study about, because it permits access to
material objects that can prevent a deterioration of the health, as well as permits
to move along to healthy environments. As the money is not always achieved
by a high educational level, it is necessary to take a closer look on it.
I suggest the Nutrition indicator as one that can be used as an external factor to
the social class and the mortality rate, cue to its deepness as concept and its
many operationalization possibilities.
In other hand, due to the lack of continuity of the data recollected, it could be
reasonable to reduce the period studied or look for more detailed data for the
proposed period.
Finally, and looking at the raw mortality cyphers, the different welfare state of
each country do not seems to be apparently influent, as it is possible to see, the
standardized ratios are very similar. Correlations following the proposed model
will be needed.
A
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Webgraphy
http://www.gapminder.org/
http://es.wikipedia.org/wiki/Estado_de_Bienestar#El_modelo_continental
http://es.wikipedia.org/wiki/Espa%C3%B1a
http://es.wikipedia.org/wiki/Belgica
C
http://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nominal)_per_ca
pita
http://www.beta.undp.org/undp/en/home.html
http://www.nationmaster.com/graph/eco_gin_ind-economy-gini-index
http://www.nationmaster.com/graph/eco_gin_ind-economy-gini-index
http://en.wikipedia.org/wiki/Epidemiological_transition