Health - Health Disparities Flashcards
Clear evidence of health differentials across whole populations
both ______ and _______ countries
In general, the richer the country, the ______ its population lives.
People who live in developing countries live significantly
______ lives than those who live in more affluent countries
Health inequalities can be found in rich and poor countries. Within industrialised countries, ______ people live longer and have less
illness than the economically less able – there is a ______ relationship between income (however measured) and
health.
Contributing factors are _______, _________, and ______. Eg: lack of safe water, poor sanitation, inadequate diet and poor
access to health care
within
between
longer
shorter
richer
linear
economic
environmental
social
Homelessness in Australia
- an example of inequality within countries
In Australia, of those that are homeless, ____% are male, ____% are female, 20% and _________ and 30% were _____ _______.
Homelessness is ______ in Australia.
58
42
indigenous
born overseas
increasing
UK Health Discrepancies
- an example of inequality within countries
Improvement in life expectancy has ______ since 2010, and although health inequalities have previously reduced they are now _________. Further, there is a strong ______-______ divide in health.
slowed
increasing
north-south
Indigenous Australians
- an example of inequality within countries
On average, if expectancy is ___ years lower for indigenous Australians. They have ______ mortality, unemployment, and health risk ________.
They have _____ access to education, child/maternal health, and a lower ______.
Generally they have higher rates of lung and liver cancer (as these are ______ related) and _____ rates of breast, prostate, colorectal and skin ______ (they don’t live long enough to get them. These rates are _______.
For cervical cancer, incidence among indigenous Australians are ______ that of other Australians. It is thought this is a result of lower rates of ______ (35% compared to nearly 60%)
There are also discrepancies in ________ _______ infections. Research suggests these rates are ________.
10
higher
behaviours
less
income
smoking
lower
cancer
increasing
twice
screening
sexually transmitted
increasing
Indigenous Australians
- an example of inequality within countries
What causes the discrepancies seen in Indigenous populations?
- Poverty
- Difficult to research these populations
- Political climate - treaty, consolation processes, etc
- Lack of material targeted at Indigenous Australians (with some kind of Indigenous representation)
The USA - an example of inequality within countries
The USA is one of the richest countries in the world, but they are an exception to the rule that people in richer countries live longer. They are way below the OECD average.
This is due to…
- Some social groups have extremely poor health - sometimes characteristic of developing countries
- Lack of harm minimisation techniques in HIV mitigation
- War on drugs - no leniency - zero tolerance - cannot minimise harm
- High rate of homicides
Inequality within countries is often due to:
- Lack of _______ health care - those with poorer health cannot access healthcare
- _______ or cultural ______ in different SES groups and different cultural groups
- _______ differences?
equitable
lifestyle
differences
genetic
Inequality within countries - Ethnic Minorities
There are significant differences in Australians born ______ and those born in Australia. This is known as the “______ _______” effect.
Migrants have ______ rates of cardiovascular mortality
BUT
People from UK/Ireland had _____ rates of _____ and ______ cancer, but lower rates of _____ cancer.
Those from Asia had _____ mortality from ______ diseases, diabetes and _______.
The incidence of _______ in Greek and Italian migrants
to Australia is three times that of the Australian born population
overseas
healthy migrant
lower
higher
lung
breast
skin
higher
infectious
homocide
diabetes
Inequality within countries - Social Class
In Australia there is a clear effect of ____ on health. Interestingly, this is more pronounced in _____.
SES
men
Explaining Inequalities
What is the difference between the social causation model and the social drift model?
Social Causation Model
- Low SES “causes” health problems - there’s something about occupying a low SES background that negatively influences health.
Social Drift Model
- Health problems “cause” low SES - developing health problems means it is difficult to maintain a job, limits earning potential, and makes it difficult to maintain standard of living, so they “drift” towards low SES (also closely related to poor mental health)
–> It’s probably a bit of both!
Explaining Inequalities - Health Selection
A “health selection” explanation suggests that…?
Is there evidence for this…?
People are not sick because they are poor, but rather poor health lowers income and limits earning potential
Not much evidence for this
Explaining Inequalities - Statistical Artefact
The “statistical artefact” explanation suggests that…
Is the evidence for this…?
Poorest in society are usually the sickest, so if there are high levels of inequality has higher nos. of poor people, and hence more people who are sick.
Not much evidence for this
Explaining Inequalities - Let’s just focus on Health Behaviours
It is impossible to decide how much each of these causes of inequality contributes to gradients of health.
It is more important to understand the ________ differences that occur in these populations.
We can separate health behaviours into health-________ and health-________ and see how these relate to SES.
Eg: low SES more likely to smoke, eat unhealthy diet and be sedentary
However, these only account for _____ of the ________ seen. They don’t provide the whole explanation
Marmot et al (1984) examined impact of job level. Despite controlling for smoking, alcohol, obesity, etc, they found _______ status was _________ predictive of health status.
behavioural
damaging
promoting
some
differences
occupational
independently
Explaining Inequalities - Health Behaviours
Why do those of low SES engage in more health risk behaviours?
INTERNAL
- insufficient knowledge?
- stress? depression?
EXTERNAL
- lack of opportunities/less time?
- More likely to work in dangerous situations
- Have more accidents
- More likely to rent
Explaining Inequalities - conservation of resources model
Overall, it was found that lower SES are more likely to encounter stressors over their lifetimes.
This paints a pictures of access to resources. What model was developed to explain inequality in health because of this?
CONSERVATION OF RESOURCES MODEL
Mental and Physical Health determined by the amount of resources available to the individual
Resources include:
SOCIAL family/community support,
STRUCTURAL safe home,
ECONOMIC job, income, PSYCHOLOGICAL perceived control, coping strategies
High resources - health protective
Low resources - health damaging
