Determinants of Health Inequality Flashcards
What are health determinants?
Underlying characteristics of societies which influence and ultimately shape health of individuals and communities
Give 5 examples of social determinants of oral health
- Income
- Social support networks
- Education
- Cultural environment
- Employment / workplace environment
Give 3 examples of non-social determinants of oral health
- Genetics
- Early child development
- Age / gender
What are health inequalities?
Differences in health status or distribution of health determinants between different population groups
Describe 2 health inequalities
- Morbidity differences between elderly and younger people
2. Mortality rate differences between people of different social classes
What 3 things may cause health inequalities?
- Biological variations
- Free choice
- External environment
What is health inequity
Differences in health status due to differences in access to health care or ability to take-up care that lead to uneven distribution
Describe an example of health inequity
- 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
What 3 types of social determinants of health majorly influence health inequalities?
- Social
- Political
- Economic
What are 3 Principles of Action in the WHO Commission of the Social Determinants of Health (2008)?
- Improve conditions of daily life
- Tackle the inequitable distribution of power, money and resources
- Measure and understand problem
What is life course analysis?
Consideration of how events in early life or across generations can affect susceptibility to disease in adulthood
What is life course epidemiology?
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
Name 4 positive factors influencing the life course
- Healthy diet
- Good educational attainment
- Living in good quality housing
- Being in stable employment
Name 4 negative factors influencing the life course
- Smoking
- Adverse childhood experiences
- Crime and violence
- Poor mental health
What are risk factors?
Personal characteristics, behaviours and environments that increase people’s chances of contracting a given disease
What are 2 types of risk factors?
- Modifiable
2. Non-modifiable
Describe modifiable risk factors
Usually environmental or behavioural in nature e.g. smoking, diet
Describe non-modifiable risk factors
Usually intrinsic to the individual and not easily changes e.g. age
What are protective factors?
Factors which decrease the likelihood that a disease will occur
What is an example of an oral protective factor?
Healthy salivary flow
Give an example of shared risks for obesity
- School, policy and political environment can influence diet
- Workplace, housing and social environment can influence exercise
- Poor exercise and diet can lead to obesity
What 2 things are prevention of childhood dental caries dependent on?
- Control of free sugars intake
2. Twice daily tooth brushing
What is the most common oral disease which affects children and young people?
Dental caries
Name 4 distal risk factors of caries
- Socio-environmental conditions
- Economics
- Employment
- Education
What are 4 proximal modifiable risk factors of caries?
- Diet
- Tobacco
- Alcohol
- Stress
What are 2 strong recommendations on sugar from WHO?
- Reduce intake of free sugars throughout life course
2. Reduce intake of free sugars to less than 10% total energy intake
What is the function of taxation of drinks with added sugar?
Initiatives due to obesity concerns
How does the industry view taxation of drinks with added sugar?
Massive anti-sugar control lobby
What is the UK sugar tax active from April 2018?
Soft Drinks Industry Levy (SDIL)
What is the SDIL?
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
Name 2 exemptions from SDIL legislation
- Pure fruit juices
2. Milk-based drinks
Name 2 positive impacts of the SDIL
- Manufacturers are reformulating drinks
2. Tax raised is contributing to support for sport in schools
Describe the relationship between inequalities and inequity in terms of oral health
Inequalities in oral health are confounded by inequity in access to and uptake of dental services
Describe 2 points of variation in uptake of dental services in children from disadvantaged communities
- Fewer carious teeth filled
2. Less likely to have orthodontic care
