21 - Healthcare Disparities Flashcards

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1
Q

Where can health inequalities be found?

A

Both rich and poor countries

Likely to be due to social, economic, educational and environmental differences

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2
Q

What is the relationship between income and health

A

It’s a linear relationship

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3
Q

How do ATI people differ in their health to caucasian Australians?

A

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

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4
Q

What did Torzillo (1999) say about researching health disparities in australia

A

There are difficulties due to the political climate.

shouldn’t detract from need to do quality research in this area.

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5
Q

Why is USA the exception to the rule of linear health-income relationship?

A

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
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6
Q

What are the reasons for health inequalities within countries?

A
  • 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
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7
Q

What are the differences between ethnic minorities who were born overseas and moved to Australia and those born in Australia?

A

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

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8
Q

What is the healthy migrant effect?

A

Most people who migrate to Australia are as healthy,. if not healthier than the Australian born population

Found in Australia

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9
Q

In Australia, what is the most important indicator of health status?

A

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%

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10
Q

What are the two models that attempt to explain the causation between SES and health status?

A

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
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11
Q

What are the health selection and statistical artefact explanations of health status and SES?

A

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

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12
Q

How should we explain differences in health status?

A

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

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13
Q

With Indigenous Australians, how does their environment impact their health status?

A

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)
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14
Q

Describe the conservation of resources model of health

A

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

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15
Q

What mediates access to health care services in Australia?

A
  • 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
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16
Q

How do we reduce inequalities?

A

Should involve different levels of intervention

  • Strengthening individuals
  • Strengthening communities
  • Improving access to essential facilities and services
  • Encouraging macro-economic and cultural change
17
Q

What are the recommendations to close the gap in a generation in Australia?

A

Reducing health inequities is an ethical imperative. Social injustice is killing people on a grand scale

Overarching recommendations:

  • Improve daily living conditions
  • Tackle inequitable distribution of power, money, and resources
  • Measure and understand the problem and assess the impact of action