Health improvement Flashcards
What is health improvement?
- Action aimed at improving the health of the population.
- Action to prevent the development of clinical conditions to maintain good health
- Action to mitigate the impact of existing conditions and improve quality of life
- Emphasis on reducing inequalities in health.
What are the determinants of health?
- Individual lifestyle factors
- Social and community networks
- General socioeconomic, cultural and environmental conditions
How do we measure health improvement?
- Life expectancy- Health outcomes affecting life expectancy- QoL, presence of illness, chance of survival through childbirth, living without chronic conditions, quality adjusted life years
- Disability free life expectancy/ healthy years
What are the health inequalities?
- Systematic differences in health status, life expectancy, mortality and morbidity between different groups
- Differential access to health care
- Differential experience of health care
Who are the inequalities between?
- Socio-economic status – e.g. income
- Geography – e.g. region
- Specific characteristics – e.g sex, ethnicity or disability
- Socially excluded groups – e.g. people experiencing homelessness or those seeking asylum
What is the ladder of interventions?
Used to promote positive lifestyle changes
What is population health?
Population health- Population health is an approach that aims to improve physical and mental health outcomes, promote wellbeing and reduce health inequalities across an entire population
What is public health?
Public health- discipline that addresses health at a population level- looks at groups of sick and well people in all different size groups
Public health- try to understand to inform how to act- do surveillance and research- look at exposure- risk factors or interventions and outcomes- disability and disease. With respect to these factors work out magnitude and distribution (geographically and sociologically). This allows us to work out exposure and outcomes and plan to interventions to improve health.
Intervene by prevention and care and treatment. To prevent we promote behaviour change and reduce exposure to risk e.g. radiation, water exposure and social determinants health- human right violations.
Want to make sure safe and effective treatment need health systems in place to provide care. Capability- what capable of doing- government, capacity- how much able to do- finance/ people
Key differences between population health and public health
What are the wider determinants having an impact on diet?
- No contact with family
- Not enough money from benefits
- Supporting children- less money
- Mental and physical health
- Deprivation- food prices, income
- Cooking skills
- University- campus culture and frequency of examination (stress eating)
- Influence of peers
- Dietary intake
- Meal patterns
- Biological determinants- hunger, appetite and taste
- Attitudes beliefs and knowledge about food
1.What opportunities can you identify where you as a doctor may be in a position to support someone experiencing food insecurity?
- Education to explain to the patient the importance of a healthy diet, what they need and provide resources so they are able to get the food
- Give information about food banks and fareshare (redistributes surplus food)
- Asking retailers and restaurants donating extra items
- Prepare meal parcels for people
- Donate
- Provide support and listen to them then refer them to a therapist if problems with mental health
- Treat the problem physically if there is one that is preventing them to make money causing them to not have the food needed
1.What are the wider determinants of obesity?
If we consume more energy than we use up, we tend to put up weight
- Stress
- Lack of sleep
- Trauma
- Lack of education
- Lack of exercise
- No access to places to exercise
- Poverty then cheaper to eat more calory dense foodstuffs
- Portion sizes
- Ethnicity
- In more deprived areas, you could be up to twice as more likely to be obese
- Are they similar or different to those you identified during the report on food insecurity?
- What interventions to combat obesity are identified in the government strategy?
- Advertising ban for junk food on children’s TV (junk food is defined as something which is high in sugar and high in fat and high in salt then determine this by nutrient profiling)
- Ban on buy 1 get 1 free deals on junk food
- A ban on where junk food is placed in supermarkets à e.g., not at the end of aisles where people are more likely to pick it up0
- For larger restaurants and cafes (>250 staff), calories will be put on food and drinks
- Encourage smaller business to provide calories
- Expand NHS weight loss services so that people get more support to lose weight
- 12-week weight loss plan then personalised – gives advice and suggestions
- Online group sessions
- GPs will take more of an action if they see people who are overweight – in order to incentivise this, the practices will receive money
- Sugar tax on sugary drinks (but not on sugary / fattening foods)
Where are the inteventions to combat obesity on the ladder inteventions?
- Guide choice through disincentives
- Eliminate choice
- Guide choice through incentives
1.Can you suggest other approaches that may help to combat obesity?
- Education / advertising
- Apps or websites offering healthier alternatives at a lower cost
- Taxes (similar to the sugar tax for sugary drinks) on all
Where are inequalities in health mostly found?
Most inequalities in health follow a social gradient with poorer health outcomes seen in the most deprived areas or in families with lower incomes or poorer educational attainment and better health outcomes seen in the least deprived areas or families with higher incomes or higher educational attainment.
The more deprived areas, the higher the levels of obesity. The higher the parental educational attainment is a risk factor for what?
Anorexia and bulimia
What do you think are likely impacts on the ability to eat a healthy diet and maintain a healthy weight?
- Having a healthy balanced diet provides you energy to keep active and nutrients for growth and repair and preventing you from diet related illnesses.
- During the pandemic with less people able to work out due to not enough space, lack of motivation, lack of equipment a healthy diet is essential to manage your weight and health
- The pandemic has motivated people to eat more healthily and workout more which are positive effects on the body for example, working and eating healthily can reduce diabetes, prevent certain types of cancers and heart diseases
- Eating healthily allows for stronger bones and teeth which a diet rich in calcium preventing diseases like osteoporosis
- Eating healthily and losing weight can help with mental health, from body confidence or just feeling more healthy by what you are eating
Do you think impacts will be felt equally across the whole population?
- Across the population there will be differences with deprivation being a main factors- less money = less space to workout, less money to buy healthier food as can be more expensive
- People with mental health problems could result in eating disorders or increase the severity of the eating disorders
- Can affect groups of people mentally due to the uncertainties increasing anxiety and depression
Difference between inequalities and inequities?
Inequity refers to unfair, avoidable differences arising from poor governance, corruption or cultural exclusion while inequality simply refers to the uneven distribution of health or health resources as a result of genetic or other factors or the lack of resources
Examples of health inequalities
- Mortality from cancer
- Relationship between smoking and lung cancer
- Health Inequalities by deprivation
- Health inequalities by ethnicity- Black mothers likely to die than white people by 5x
- Health inequality- Mental Health Act- black people more likely to be detained
Definition of health inequality
- “… can be defined as differences in health status or in the distribution of health determinants between different population groups”
- Some health inequalities are unavoidable. For example, a difference in mobility between the young and elderly.
- lth inequalities are the unjust and avoidable differences in people’s health across the population and between specific population groups.
Health inequity defintion
Health inequities are differences in health status or in the distribution of health resources between different population groups, arising from the social conditions in which people are born, grow, live, work and age.
What is the social gradient?
The social gradient in health is a term used to describe the phenomenon whereby people who are less advantaged in terms of socioeconomic position have worse health (and shorter lives) than those who are more advantaged.
Key messages of Marmot review- good start in life, being in control of your life, having good employment, having a healthy standard of living and a state of home and good community.
What is equal healthcare?
Giving everyone the same level of care (e.g. same budget for every patient)
What is equitable healthcare?
Giving everyone the level care of they need to be healthy (e.g. smaller/larger budgets for those with lesser/greater needs)
Care needs to be equitable to reduce health inequalities
Addressing Inequity- equality is sameness, equity is fairness
What wider derminants have an impact on diet?
- Economic determinants
- Social and community networks- clear link to deprivation, fast food cheap and unhealthy but more available
- Cultural determinants
- Educational determinants
Diagram comparing sensitivity and specificity?
What are the three factors that lead to behaviour?
