# Health Education Development/Funding class equality

Sometimes it is hard to even imaging how disparities in wealth, position or prestige might influence the health of individuals, groups, communities and societies. This week's topic tries to expose participants to the reality that most of the planet lives through each day. It's bad enough when you have a bad day. Image a life-time of bad days that are endured because people are happy to live in a steeply stratified community. Most people who are doing well in life do not even know how the other 90 percent live. Watch the playlist, consider the story and the background. See what sense you can make of it and what needs to be done for our futures.

## Instructions

Each week we hold a lectorial and a tutorial. The lectorial is a lecture involving audience participation. The tutorials are for discussing the and group activities relating to the topic, and for working on the assignments.
Lectorial
* Watch the videos here.
* Review the final assessment material.
* Attend the lectorial.
Tutorial
* Breath a sigh of relief.
* Review Legacy Letter on page 183.
* Attend the final tutorial if you need to say goodbye to your peers or ask any questions.

## What are the key issues to consider for funding submissions engaging class equality?

We like to say that Australia is a class-less society. Is that really true? I am from a rural working-class background. I have had to learn how to function in a wide variety of settings. Yet, if you dressed me up and sent me off to some high class affair, it would not take long for people to notice a faux pas, a false step, or two. Try as I might, it would be very hard to cover up everything and I would probably go mad with the effort. Do you remember the movie Gattaca? It would be something like that; always working to cover up your true genetic, or in our case, class identity. What about the girls and the nursing sister in the photograph to the right? Consider the photograph carefully. For instance, how many girls are being tested at the same time? How old are they? Where are the instructions? What would happen if someone also needed glasses? Would the nursing sister be able to spot this? How reliable are medical tests when they are given in a manner that would have made Henry Ford extremely happy? Here is an assembly line of young uniformed girls in the earlier form of their school. I doubt seriously that they are much above the lower middle classes at best. Now, think about the time. Would there have been much that could be done for the children? Probably not. But, a hearing test might indicate why someone may have difficulties with learning. If that were attended to, then the tests could be useful in terms of education and literacy, or in terms of healthy learning. But, what if they are used to cull out the less useful? All things considered, the lower your class status, the more your worth is determined by your fit in the function assigned to you by those in charge.

## Background

Class does matter. It places us within a set of conscious and unconscious networks of meaning and resources for getting on in the world (Ferrie 2004). There is a power differential. You should look up the Whitehall Studies (Michael Marmot) to see just how different your health outcomes can be given your position in any power structure. I would suggest, in keeping with the fundamental operations of salutogenesis as outlined by the concept's originator, Aaron Antonovsky (1996), that it has to do with the ability to engender, access and use 'generalised resistance resources' (GRRs). I did my PhD considering how Australian Prisoners of the Japanese survived on the 'Burma-Railway' doing just that: engendered, accessed and used GRRs. Let me explain. You might have specialised resources for dealing with something like a fire in your office such as a fire extinguisher and an alarm. Generalised resistance resources (GRRs) help us to deal with and ease unrelieved tension. If it remains unrelieved, you risk stress breakdown. There is no one-to-one correlation between stress and any disease. Stress breakdown may manifest in any number of symptoms. For instance, consider the following real situation. When I worked on what was effectively an assembly-line, you could not leave the line to relieve yourself until the supervisor stopped the belt. That creates more than just a great deal of discomfort. Did you know that if your bladder is full, your blood pressure becomes elevated through time (Fagius & Karhuvaara 1989)? The supervisor could relieve his or her bladder whenever this was required and it would not stop the belt. Therefore, the supervisor did not necessarily run the risk of elevated blood pressure due to work conditions. The people working the belt were subject to potentially wide variations in blood pressure through a shift due to the lack of freedom to leave the belt to relieve themselves. This freedom is a GRR in this case. VanBreda (2001) has developed an important literature review that examined resilience theory and its relation to salutogenesis in a way that would be useful to working with people from backgrounds that often have to deal with overloads due to their circumstances.
References and Resources
    Antonovsky, A. (1996) The salutogenic model as a theory to guide health promotion. Health Promotion International. 11(1):11-18.
    Fagius, J. and Karhuvaara, S. (1989) Sympathetic activity and blood pressure increases with bladder distension in humans. Hypertension. 14(5):511-517.
    Ferrie, J.E. (Ed.) (2004) Work Stress and Health: The Whitehall II study. London: International Centre for Health and Society, Department of Epidemiology and Public Health, University College London.
    VanBreda, A.D. (2001) Resilience theory: A literature review with special chapters on deployment resilience in military families and resilience theory in social work. Pretoria, South Africa: South African Military Health Service, Military Psychological Institute, Social Work Research & Development.

## Learning Outcomes

On completion of this topic, through your own investigations, group preparation, tutorial participation and lectorial explorations, you should be able to:
* Name a wide variety of policies that might influence funding availability for programs which own the importance of respecting aspirations for class equality.
* Outline the key principles that can be derived from such documents and discuss how these might be used to buttress an argument supporting class equity in a variety of settings.
* Develop responses to funding submission criteria that require specific reasons for taking account of class in terms of health literacy and health education in general.
* Demonstrate how these responses can be used to justify health literacy and health education programs that are sensitive to class related issues and concerns in a tertiary setting.