21 - Healthcare Disparities Flashcards
Where can health inequalities be found?
Both rich and poor countries
Likely to be due to social, economic, educational and environmental differences
What is the relationship between income and health
It’s a linear relationship
How do ATI people differ in their health to caucasian Australians?
Males, 10.6 yrs shorter and Women 9.5 yrs shorter life
- Higher infant mortality rates
- Higher unemployment rates
- Lower weekly income than other Australians
- More health risk behaviours
- Poorer housing circumstances
- Less access to education and child and maternal health.
Rates of liver, lung and other smoking cancers higher.
Mortality for cervical cancers 6-10x higher
What did Torzillo (1999) say about researching health disparities in australia
There are difficulties due to the political climate.
shouldn’t detract from need to do quality research in this area.
Why is USA the exception to the rule of linear health-income relationship?
USA is below the OECD average for life expectancy
Explanations;
- Some social groups have extremely poor health
- HIV epidemic caused higher proportion of death among young and middle-aged Americans
- USA one leading countries for tobacco cancers
- US has high incidence of homocides
What are the reasons for health inequalities within countries?
- A problem within rich countries
- A failure of health care systems
- A technical problem to be addressed by improving access to services among those with poorer health
- Lifestyle, behavioural or cultural differences between socio-economic or ethnic groups that can be solved through health education and promotion
- Possibly also genetic differences between groups
What are the differences between ethnic minorities who were born overseas and moved to Australia and those born in Australia?
Migrants to Aus have lower rates of CV mortality
Deaths from lung and breast cancer higher in UK and Irish migrants, but skin cancer lower
Asia had higher mortality from infectious disease, diabetes and homocide
Type 2 diabetes in Greek and Italian migrants 3x of Aus
What is the healthy migrant effect?
Most people who migrate to Australia are as healthy,. if not healthier than the Australian born population
Found in Australia
In Australia, what is the most important indicator of health status?
Socioeconomic status
If men of all social classes had the same mortality experiences and higher social class men, overal death rates would be reduced by 60%
What are the two models that attempt to explain the causation between SES and health status?
Social Causation Model
- Low SES ‘causes’ health problems
- Something about occupying a low SES group that negatively influences health of individuals
Social Drift Model
- Health problems ‘cause’ Low SES
- When individuals develop a health problem, the may not maintain a job to maintain their standard of living
What are the health selection and statistical artefact explanations of health status and SES?
Health Selection
- poor health lowers income and limits earning potential
Statistical Artefact
- poorest in society usually sickest
- Society with high levels of income inequality has high numbers of poor and therefore more sick people
Little support for either empirically
How should we explain differences in health status?
Different health behaviour
More health-damaging and less health-promoting
E.g. socially disadvantaged people in aus 2x likely to spoke than richer, and more likely to eat less healthy diet
These don’t provide whole explanation; stress, lack opportunities, possess sufficient knowledge
With Indigenous Australians, how does their environment impact their health status?
Exposed to working in more dangerous settings
Have more accidents
Live in rented accomodation
Stress Strain and Depression
- Childhood (overcrowding, poor diet)
- Adolescence (exposure to smoking, leaving school)
- Adulthood (hazard work, unemployment, negative social interactions)
- Older Age (no pension inadequate heating and food)
Describe the conservation of resources model of health
Mental and physical health are determined by the amount of resources available to the individual
- economic
- social
- structural
- psychological
Poor health fits well into this model, as ATi have higher unemployment, poorer housing conditions, and less likely higher education access.
high level of resources is health-protective
Low levels place individual at risk for health problems
What mediates access to health care services in Australia?
- availability of services, especially in rural and outer urban areas
- cost of health care services, especially services to which patients are referred from primary care
- waiting times especially allied health services
- outpatient medical specialist services
- elective procedures
