Determinants of Health Inequality

Question 1

What are health determinants?

Answer 1

Underlying characteristics of societies which influence and ultimately shape health of individuals and communities

Question 2

Give 5 examples of social determinants of oral health

Answer 2

1. Income
2. Social support networks
3. Education
4. Cultural environment
5. Employment / workplace environment

Question 3

Give 3 examples of non-social determinants of oral health

Answer 3

1. Genetics
2. Early child development
3. Age / gender

Question 4

What are health inequalities?

Answer 4

Differences in health status or distribution of health determinants between different population groups

Question 5

Describe 2 health inequalities

Answer 5

1. Morbidity differences between elderly and younger people

2. Mortality rate differences between people of different social classes

Question 6

What 3 things may cause health inequalities?

Answer 6

1. Biological variations
2. Free choice
3. External environment

Question 7

What is health inequity

Answer 7

Differences in health status due to differences in access to health care or ability to take-up care that lead to uneven distribution

Question 8

Describe an example of health inequity

Answer 8

• A person on zero hour contract does not get time off without losing income
• They may get a painful tooth removed in one visit
• Someone salaried may attend several times for root canal work and a crown

Question 9

What 3 types of social determinants of health majorly influence health inequalities?

Answer 9

1. Social
2. Political
3. Economic

Question 10

What are 3 Principles of Action in the WHO Commission of the Social Determinants of Health (2008)?

Answer 10

1. Improve conditions of daily life
2. Tackle the inequitable distribution of power, money and resources
3. Measure and understand problem

Question 11

What is life course analysis?

Answer 11

Consideration of how events in early life or across generations can affect susceptibility to disease in adulthood

Question 12

What is life course epidemiology?

Answer 12

Investigates the long-term effects of physical and social exposures during gestation, childhood, adolescence, young adulthood and later adult life on health and disease risk in later life

Question 13

Name 4 positive factors influencing the life course

Answer 13

1. Healthy diet
2. Good educational attainment
3. Living in good quality housing
4. Being in stable employment

Question 14

Name 4 negative factors influencing the life course

Answer 14

1. Smoking
2. Adverse childhood experiences
3. Crime and violence
4. Poor mental health

Question 15

What are risk factors?

Answer 15

Personal characteristics, behaviours and environments that increase people’s chances of contracting a given disease

Question 16

What are 2 types of risk factors?

Answer 16

1. Modifiable

2. Non-modifiable

Question 17

Describe modifiable risk factors

Answer 17

Usually environmental or behavioural in nature e.g. smoking, diet

Question 18

Describe non-modifiable risk factors

Answer 18

Usually intrinsic to the individual and not easily changes e.g. age

Question 19

What are protective factors?

Answer 19

Factors which decrease the likelihood that a disease will occur

Question 20

What is an example of an oral protective factor?

Answer 20

Healthy salivary flow

Question 21

Give an example of shared risks for obesity

Answer 21

• School, policy and political environment can influence diet
• Workplace, housing and social environment can influence exercise
• Poor exercise and diet can lead to obesity

Question 22

What 2 things are prevention of childhood dental caries dependent on?

Answer 22

1. Control of free sugars intake

2. Twice daily tooth brushing

Question 23

What is the most common oral disease which affects children and young people?

Answer 23

Dental caries

Question 24

Name 4 distal risk factors of caries

Answer 24

1. Socio-environmental conditions
2. Economics
3. Employment
4. Education

Question 25

What are 4 proximal modifiable risk factors of caries?

Answer 25

1. Diet
2. Tobacco
3. Alcohol
4. Stress

Question 26

What are 2 strong recommendations on sugar from WHO?

Answer 26

1. Reduce intake of free sugars throughout life course

2. Reduce intake of free sugars to less than 10% total energy intake

Question 27

What is the function of taxation of drinks with added sugar?

Answer 27

Initiatives due to obesity concerns

Question 28

How does the industry view taxation of drinks with added sugar?

Answer 28

Massive anti-sugar control lobby

Question 29

What is the UK sugar tax active from April 2018?

Answer 29

Soft Drinks Industry Levy (SDIL)

Question 30

What is the SDIL?

Answer 30

Puts a charge of 24p on drinks containing 8g sugar per 100ml and 18p per litre with those with 5-8g of sugar per 100ml

Question 31

Name 2 exemptions from SDIL legislation

Answer 31

1. Pure fruit juices

2. Milk-based drinks

Question 32

Name 2 positive impacts of the SDIL

Answer 32

1. Manufacturers are reformulating drinks

2. Tax raised is contributing to support for sport in schools

Question 33

Describe the relationship between inequalities and inequity in terms of oral health

Answer 33

Inequalities in oral health are confounded by inequity in access to and uptake of dental services

Question 34

Describe 2 points of variation in uptake of dental services in children from disadvantaged communities

Answer 34

1. Fewer carious teeth filled

2. Less likely to have orthodontic care