C4: variations in health status between population groups Flashcards
Biological factors contributing to heath status variations
factors relating to the body that impact h+wb
- body weight
- blood pressure
- blood cholesterol
- glucose regulation
- birth weight
- genetics (including gender)
Sociocultural factors contributing to heath status variations
social + cultural conditions which people are born, grow live, work and age
- socioeconomic status (education, occupation, income)
- unemployment
- social connections & social exclusion
- cultural norms
- food security
- early life experiences
- access to healthcare
socioeconomic status (SES)
refers to education, occupation, income
- the social standing of an individual compared to others in society
Health literacy
the capacity of individuals to obtain, process and understand basic health info + services to make appropriate health decisions
social exclusion
the segregation that people experience if they aren’t adequately participating in the society they live in – feeling disconnected, little opportunities to use resources available to them in society (eg. education, healthcare)
- can cause or be caused by mental illness
social isolation
individuals who aren’t in regular contact with others
food insecurity
individual’s inability to obtain healthy, affordable food
food security
individual’s ability to obtain nutritious, adequete, culturally appropriate, safe food through local, non-emergency sources
Environmental factors contributing to heath status variations
- housing
- work environment
- urban design + infastructure
- climate + climate change
Aspects of housing that contribute to health status (know some not all)
- ventilation –> increased risk of respiratory conditions
- design + safety –> increased risk of injury, falls (stairs, balcony etc)
- overcrowding -
-> strain on facilities –> increased risk of infectious disease
–> less space to work/study –> reduced education/work opportunities
–> no space to relax –> increased mental health issue rates - sleeping conditions –> noise means poor quality sleep –> increased mental health issue rates
- security –> increased risk of intruders –> promotes fear in residents –> increased stress levels
- pollutants –> increased risk of respiratory conditions
- resources conducive to eating a nutritionally sound diet –> reduces risk of obesity + related conditions
- access to water + sanitation facilities –> reduces risk of infectious diseases
Sanitation
process of eliminating contact between human and hazardous wastes (eg. human feces, sewage water)
Factors of urban design + Infrastructure
- geographical location of resources (like hospitals, schools, workplace)
- infrastructure including roads + transport systems, electricity, communications systems, water + sanitation
Infrastructure
the physical organisation structure needed for society to operate (eg buildings, roads)
Elements of infrastructure (+ impact on health status)
- adequately maintained road systems –> decreases risk of road accidents –> reduced morbidity and mortality from road accidents
- public transport systems –> increase access to resources like food, employment, healthcare, social interaction –> promote health status
- information + communication technologies
–> assists in maintaining social connections –> promotes mental + social health –> decreased risk of mental illness
–> increases ability of people in rural areas to gain employment/education –> increases socioeconomic status
–> increases ability to access health info (eg symptom checkers) –> increases health literacy - electricity –> for heating, cooling, food storage, communication –> promotes h+wb
- water –> for drinking, cleaning, cooking, hygiene –> reduces risk of infectious diseases –> promotes h+wb
- adequate sanitation –> like sewage systems –> eliminates wastes from environment –> reduced risk of infectious diseases
- access to adequate public spaces (eg parks) + recreational facilities –> promotes physical activity + social interaction –> reduced risk of mental health problems & obesity
Variations in Indigenous Australians: Biological factors – body weight
- have higher BMI rates across all age groups –> increased risk of CVD, type 2 diabetes, osteoarthritis
- indigenous adults obesity rate is 1.5 x higher than non indigenous population –> increases risk of syndrome X
Variations in Indigenous Australians: Biological factors – blood pressure
Aboriginals are 1.3 x more likely to report hypertension –> risk factor for stroke + heart disease
Syndrome X
when a person is genetically disposed to exhibit a range of factors (abdominal obesity, high cholesterol, insulin resistance) that increase the risk of CVD + type 2 diabetes, hypertension, which can lead to premature death
- NOT a biological factor but a result of biological factors
Variations in Indigenous Australians: Biological factors – glucose regulation
experience higher rates of impaired glucose regulation –> higher diabetes + kidney disease rate
Variations in Indigenous Australians: Biological factors – birth weight
Indigenous Australian mothers:
- 2 x more likely to give birth to baby with low birth weight
- more likely to give to birth to premature babies
–> higher under 5 mortality rate
–> maternal tobacco use, nutrition, access to healthcare contribute to this difference
Variations in Indigenous Australians: Sociocultural factors – socioeconomic status
more likely to experience lower socioeconomic status
- have lower average incomes, poorer education achievements, lower homeownership rates
- low education outcomes –> lower health literacy rates –> increases risk of smoking, dietary risks, sedentary lifestyle –> higher rates of obesity, type 2 diabetes, CVD, lung cancer
Variations in Indigenous Australians: Sociocultural factors – unemployment
4 x more likely to be unemployed
- indigenous Australian unemployment rate between 20-28%
increases rates of smoking, alcohol use, reduced overall feelings of wellbeing, CVD, mental health problems, lung cancer
Variations in Indigenous Australians: Sociocultural factors – social exclusion
social exclusion, especially discrimination + racism lead to poorer indigenous health status
- increases risk of mental health disorders, tobacco/drug/alcohol use
- 32% of indigenous adults reported avoiding seeking healthcare bc of cultural factors – language barriers, lack of trust in health provider, experiences of discrimination –> increased length + severity of condition –> higher levels of morbidity + mortality
- high levels of racism –> high levels of psychological distress –> participation in risky behaviours –> increased risk of tobacco + alcohol use –> self-harm, CVD, respiratory diseases, cancers, type 2 diabetes, obesity, suicide
- high levels of psychological distress were increased in indigenous adults who were removed or had relatives removed from their family
Variations in Indigenous Australians: Sociocultural factors –food insecurity
- more likely to report food insecurity
contributing factors – lower income, overcrowded housing, higher cost of fresh foods in rural areas, lack of transport, lack of nutritional knowledge –> food insecurity –> increased rates of obesity –> type 2 diabetes, CVD, kidney disease
Variations in Indigenous Australians: Sociocultural factors –early life experiences
eearly life experiences including maternal tobacco/alcohol/drug use
- 44% of indigenous women smoked while pregnant compared to 10% of non-indigenous
- 50% of indigenous babies display effects of maternal alcohol use
- indigenous babies 3.5 x more likely to display signs of drug exposure while in uterus
- these differences –> high rates of low birth weight, infant infections, foetal alcohol spectrum disorder, under 5 mortality rate, CVD, type 2 diabetes
Variations in Indigenous Australians: Sociocultural factors – cultural norms
cultural norms contribute to lower rate of indigenous access to western medicine + healthcare because they perceive western medicine as culturally inappropriate + associate hospitals with death –> undiagnosed + untreated conditions –> increased morbidity + mortality rates, reduced life expectancy
Variations in Indigenous Australians: Environmental factors - housing
- lack of indigenous housing –> homelessness, poor h+wb, lower employment + education participation –> social exclusion and associated health status impacts
–> increased risk of injury, infectious disease, mental health problems
- 33% live in housing with structural problems
- 10% live in housing without at least 1 working facility (eg toilet, kitchen)
- 17.9% live in overcrowded housing compared to 4.9% for non-indigenous –> strain on food + hygiene facilities –> unhygienic living conditions –.> increased risk of injury, infectious disease, mental
Variations in Indigenous Australians: Environmental factors - water/sanitation
many indigenous Australians experience inconsistent water supply + inadequate sewage systems –> lack of clean water + sanitation –> increased risk of infectious diseases like diarrhoea, dysentery, cholera –> increased morbidity + mortality rates
- 40% experience sewage leak
- indigenous people living in rural areas are less likely to access fluoridated water supply –> higher dental decay rate –> morbidity
Variations in Indigenous health status data/summary
- 10 years less lower life expectancy than non-indigenous Australians
- higher mortality rates in each age group
- 2 x more likely to have severe disabiltiy
- 2 x higher infant mortality rate
- 1/2 as likely to self-assess as excellent or very good
- 2.3 x higher BoD than non-indigenous population
- 2 x injury-related mortality rate
- higher rate of chronic conditions – cancer, respiratory disease, CVD
- 3 x more high psychological distress experienced
- 3.5 x diabetes/high glucose rate
- 4 x chronic kidney disease rate
- higher STI rate
- higher dnetal decay rate
Variations in males and females: biological factors – body weight
High BMI is more prevalent in males than females –> males have higher rates of hypertension, CVD, type 2 diabetes
- 32.5% of males are obese compared to 30.2% of females
Variations in males and females: biological factors – blood pressure
- males are more likely to experience hypertension until they’re in the 65-74 age –> after that age group, women are more likely to experience hypertension
- leads to higher rates of CVD + kidney disease among males
Variations in males and females: biological factors – glucose regulation
males have higher rates of impaired glucose regulation
- males have higher DALY contributed to by impaired glucose regulation –> higher rate of type 2 diabetes + kidney disease in males
Variations in males and females: biological factors – genetics
- males tend to store fat around the abdomen –> increased male risk of CVD
- males have more testosterone in the body –> increased risk-taking behaviour –> higher risk of male injuries
- women have higher levels of oestrogen than men –> menapause leads to loss of bone mass –> increased risk of osteoporosis for women 60+
- greater risk of arthritis for women
Variations in males and females: sociocultural factors – unemployment
unemployment has a greater impact on male health status
- according to gender norms, men feel a sense of duty to provide physical resources for the family –> inability to provide bc of unemployment leads to feeling inadequate + stressed –> poor mental h+wb & greater morbidity + mortality from obesity, CVD and suicide
Variations in males and females: sociocultural factors – Socioeconomic status (SES)
males employed full time earn higher average incomes – males generally have higher SES –> less mental + behavioral problems & less psychological distress for men but more for women
Variations in males and females: sociocultural factors – cultural norms
gender stereotypes contribute to health health status variations between men and women
males:
- men are less likely to be carers of children –> women who provide full-time care may experience social isolation –>. poor mental h+wb & higher rate of psychological distress
- physically laborious work is considered masculine (eg construction) –> increased risk of male injury in workplace
- contact sports (eg footy) are considered masculine –> increased risk of injury among males
- males are less likely to access healthcare bc they feel they need to be self-reliant/perseverant + suppress emotions –> higher male morbidity + mortality rates
- men may pressure other males to conform to traditional gender stereotypes –> promote risky behaviour like using violence to solve conflict, alcohol overconsumption –> increased male incidence of injury
females:
- media’s representation of beauty standards leads to increased incidence + prevalence of eating disorders among females
Variations in males and females: environmental factors – work environment
work environment is the main environmental factor contributing to differences in health status between males and females
- males are more likely to work in unsafe environments like using heavy machinery, exposure to hazardous substances
–> increased risk of injury –> increased male morbidity + mortality
- males are more likely to work in an environment w air pollution –> respiratory conditions (eg asthma) –> increased male morbidity + mortality
- males are more likely to work outside –> increased UV ray exposure –> higher male skin cancer rates
- males are more likely to work in transport –> risk of road accidents –> morbidity + mortality from injury
Variations between males and females health status data/summary
Males:
- male life expectancy 4 years less than females
- higher rates of BoD
- increased likelihood of death in each lifespan stage
- males have higher rate of injury
- males have higher suicide, road accident, violence related death
- higher rates of CVD
- higher rates of cancers – especially skin cancer from UV rays
- higher diabetes & kidney disease rate
- higher COPD rates
Females:
- higher rates of osteoporosis + arthiritis
- higher rates of mental + behavioural problems
- more likely to experience high levels of psychological distress
- more likely to experience core activity limitation
Variations in high and low SES: biological factors – body weight
low SES groups have higher rates of higher body mass –> increased obesity rate –> increased death rates from CVD, type 2 diabetes –> lower life expectancy
Variations in high and low SES: biological factors – blood pressure
low SES groups have higher hypertension rates –> higher rate of CVD –> higher rate of DALY + premature death
Variations in high and low SES: biological factors – glucose regulation
low SES groups have higher impaired glucose regulation rates –> higher burden of type 2 diabetes + kidney disease
Variations in high and low SES: biological factors – birth weight
women with low SES are more likely to give birth to low birthweight babies –> higher under 5 mortality rate, infection rate + disability among low SES groups
Variations in high and low SES: sociocultural factors – education and income
low SES groups have lower levels of education + lower incomes
- influences higher rate of behaviours like unhealthy eating, smoking, pack of physical activity, lower likelihood of healthcare access –> lower life expectancy, higher morbidity + mortality rates
- lower average income + education in low SES groups –> lower health literacy –> lower rates of healthcare use –> conditions go undiagnosed + untreated –> higher rates of morbidity + mortality for low SES groups
low SES groups feel like they lack a lack of control over their life –> sense of helplessness –> risky behaviours like smoking –> higher rates of premature mortality + lower life expectancy
Variations in high and low SES: sociocultural factors – unemployment
low SES groups are more likely to be unemployed
- creates cycle between unemployment + poor health status
- creates cycle between unemployment and risk-taking behaviours
Variations in high and low SES: sociocultural factors – social exclusion
- low SES can lead to social exclusion as they are less likely to gain education, employment, access to community resources –> poor physical + mental h+wb
Variations in high and low SES: sociocultural factors – food security
- healthy food options are more expensive in low SES areas + low SES groups have less financial resources to afford nutritious food – > food insecurity –> fruit + vegetable underconsumption
–> less satiety from a lack of fibre–> overeating –> obesity –> associated conditions like CVD, type 2 diabetes
–> lack of fibre –> colorectal cancer
–> lack of antioxidants from fruit –> free radicals aren’t removed –> damaged cells –> cancers - low SES groups have lower levels of health literacy –> more less knowledge about healthy eating –> dietary risks (see above)
Variations in high and low SES: sociocultural factors – early life experiences
- women in low SES groups are 6 x more likely to smoke during pregnancy –> higher rates of respiratory conditions like asthma, low birthweight in babies –.> high infant + under 5 mortality rates
- women in low SES groups are more likely to begin antenatal care later + have higher BMI in pregnancy –> increased risk of premature + low birthweight babies –> higher under 5 mortality rate
Variations in high and low SES: sociocultural factors – access to healthcare
- low SES groups are less likely to access preventative/early detection health services –> undiagnosed health conditions –> fewer treatment options when diagnosis is made –> higher mortality rates (especially for breast + cervical cancer)
- low SES groups are less likely to have private health insurance
–> psychological distress
–> longer waiting times for surgery –> higher morbidity + mortality
Variations in high and low SES: sociocultural factors – neighbourhood safety
- low SES groups are more likely to feel unsafe home alone + walking in their local area at night –> increased anxiety/stress
–> higher rates of mental health issues
Variations in high and low SES: environmental factors – geographical location
- low SES areas tend to have more fast food outlets –> high in fat, salt, sugar –> increased likelihood of people in low SES areas eating these foods –> high obesity rates + associated conditions
- low SES groups have lower health literacy levels –> less educated about healthy eating –> more likely to be influenced by fast food marketing
- low SES areas have less sport + recreational facilities –> lower rates of physical activity –> increased obesity risk + associated conditions
Variations in high and low SES: environmental factors – housing
l ow SES groups are less likely to be able to afford high quality housing leading to:
- overcrowding
–> strain on sanitation facilities –> increased rate of infectious disease
–> higher rates of psychological distress + mental health disorders
- inadequate cooking facilities –> reliance on fast food –> increased rate of obesity and associated conditions
- unsafe physical environment
–> inadequate ventilation –> increased risk of respiratory conditions like asthma
–> fire hazards like heating appliances –> increased risk of injury - closer proximity to industrial sites –> air + noise pollution –> increased respitory conditions + stress
- low SES groups have higher smoking rate –> children + non smokers more likely to be exposed to environmental tobacco smoke –> increased risk of SDS, respiratory diseases like asthma, cancer, CVD
Variations in high and low SES: environmental factors – work environment
- low SES groups are more likely to work in dangerous work environments (factory, manufacturing) –> increased exposure to hazardous substances + working w heavy machinery –> increased rate of injury, respiratory conditions, cancers
Variations in those living within and outside major cities: biological factors – body weight
outside major cities –> higher levels of BMI –> increased risk of CVD, type 2 diabetes, cancers
Variations in those living within and outside major cities: biological factors – blood cholesterol
outside major cities –> experience higher blood cholesterol –> higher rates of CVD
Variations in those living within and outside major cities: biological factors – glucose regulation
outside major cities –> more likely to experience impaired glucose regulation –> increased risk of type 2 diabetes + kidney disease
Variations in those living within and outside major cities: biological factors – birth weight
outside major cities –> higher rates of low birth weight babies
Variations in those living within and outside major cities: biological factors – blood pressure
outside major cities –> higher rates of hypertension –> increased risk of CVD –> contributes to BoD
Variations in those living within and outside major cities: sociocultural factors – SES
outside major cities –> limited opportunities for education + employment –> higher rates of risky behaviours like smoking, low levels of physical activity –> higher rates of preventable diseases like cancer, CVD + lower life expectancy
outside major cities –> lower income –> more likely to rely on social security payments –> impacts access to adequate food supply + healthcare
Variations in those living within and outside major cities: sociocultural factors – unemployment
outside major cities –> higher rates of unemployment – lower health status
Variations in those living within and outside major cities: sociocultural factors – food security
outside major cities –> transporting food to remote areas is costly –> high cost + lack of steady access to fresh food –> food insecurity –> consumption of discretionary food that’s higher in fat, salt, sugar –> higher rates of obesity, type 2 diabetes, CVD
Variations in those living within and outside major cities: sociocultural factors – early life experiences
outside major cities –> mothers in very remote areas more likely to smoke during pregnancy –> higher rates of low birthweight babies, babies w respiratory conditions like asthma –> higher infant + under 5 mortality rate
Variations in those living within and outside major cities: sociocultural factors – social isolation
outside major cities –> geographic distance causes social isolation –> feelings of loneliness –> higher rates of mental health disorders + suicide
Variations in those living within and outside major cities: environmental factors – infrastructure
outside major cities –> roads are generally in poorer condition, wildlife is more likely to cross path of vehicles, roads are poorly lit –> higher rate of injury –> higher morbidity + mortality
Variations in those living within and outside major cities: environmental factors – geographic location
outside major cities
- further proximity to healthcare –> people choose not to access healthcare –> undiagnosed + untreated conditions –> higher morbidity + mortality
- specialist health services or hospitalisation –> family need to take time off work to transport ill person to health services –>
increased costs + stress levels - geographical location influences types of food available –> difficult to access fresh food –> reliance on discretionary foods that’s high in fat salt, sugar –> increased risk of obesity. CVD, type 2 diabetes
- geographic location –> less access to fluoridated water –> increased rates of dental decay
- geographical barriers to recreational facilities, transport, employment opportunities –> low SES, unemployment –> higher morbidity + mortality, lower life expectancy
- geographical isolation –> social isolation
Variations in those living within and outside major cities: environmental factors – climate + climate change
outside rural areas
more prone to unstable weather (drought, fire, flood eg) –> unstable income –> low SES + increased stress levels
- increased frequency of natural disasters (bushfire eg)
–> increased risk of injury
–> reduced access to support services to deal with climate change –> increased rates of mental health conditions + self harm
unpredictable rainfall –> reduced availability of water for agriculture + livestock
Variations in those living within and outside major cities: environmental factors – work environments
many jobs in rural areas are based outdoors
–> higher risk of injuries
–> increased UV ray exposure –> increased incidence of skin cancer
