Health Inequalities Flashcards
What is disability free life expectancy?
How many years someone lives in good health, able to do daily activities etc
Over 15 year difference between most and least deprived deciles
What is The Medical Model of disease
- Scientific approach taken to find out the reasons behind a patient’s disease
- Sole focus is on biological principals behind disease
- Focus on minimizing or eliminating impairment
Doctors, PAs, and ACPs work within the medical model to diagnose and reccomend treatments for those who need medical help.
Symptoms cause -> Diagnosis -> Treatment -> Cure
What is the Social model of disease??
- Practitioners seek to take a wider look at the social and cultural issues that impact on people’s lives
- Looks beyond disease process to consider a range of factors that impact on how a person experiences health and wellbeing
- Barriers that impact everyday living are made up of factors contributing to environment, home, community, economics, how patients can support themselves and earn money and in the social and cultural impacts of society
Social workers, youth and community practitionars work within this model.
Person with different needs -> Disabled by barriers in society -> Remove barriers -> Person is enabled
What is income distribution theory?
- Western economies- what matters is not gross national product but the relative income within the country (not the average income)
- UK rich country but has a steep gradient of inequity of wealth within it
- Morbidity, mortality and adverse events/outcomes are more prevalent in groups with lower relative income within their country
What is the artefact theory of health inequality?
The artefact view proposes that the association between markers of social status and health outcomes is a statistical artefact relating to the way in which social status has been classified over time
this is the theory that states that no true association exists between poverty and poor health, but that this link is a by-product of methods used to measure both health and deprivation.
What is the social selection theory of health inequality?
The theory is essentially that of reverse causation: that poor health causes a social selection (a ‘social slide’) which leads to the observed association between ill health and low social status
If a patient is chronically ill, they cannot work, and this will increase the chances of them entering poverty or having a lower socio-economic status.
What is the behavioural/cultural theory of health inequality?
Cultural and behavioural theories suggest that differences in the prevalence of behaviours such as smoking, alcohol consumption, illicit drug-taking, diet and physical activity between groups, or differences in the dominant cultures between groups, are fundamental causes of health inequalities.
patients in deprived areas are more likely to engage in behaviours damaging to health (negative health behaviours), like smoking and drinking and partake in fewer positive health behaviours such as good diet and regular exercise.
What is the structural/materialist theory or health inequality?
The theory is that differences in the socioeconomic circumstances of social groups (including differences in income, wealth, power, environment and access), at all stages of the life-course, cause differences in health outcomes
Social class brings differences in
the materials circumstances of life
What is the inverse care law?
The availability of health care services is inversely proportionate to the need for it.
those patients who have the greatest health
need, e.g. in inner cities, appear to receive the
poorest-quality health care and so ‘good
medical care’ tends to be inversely related to
the needs of the population.
Components of addressing health inequalities?
Allow extra time for consultations (inverse care law)
Best use of serial encounters to create strong patient narratives (patient stories- increasing their knowledge and confidence as they live with their
conditions and access services)
General practices as the natural hubs of local health systems - developing and nutriting all of the relationships that involves (linking information)
Better connections across the front line (shared learning)
Better support for the frontline (infrastructure)
Leadership at different levels (entry level)
Challenges in tackling health inequalities?
- ageing population,
- increasing numbers of people with complex conditions,
- initiatives to move care from hospitals to the community,
- rising public expectations,
- decreased funding for health and social care,
- fragmentation of health services inc GP
- Difficulties of recruitment to inner cities
Health inequalities vs health inequities
Inequity: unjust differences in health between persons of different social groups - normative concept
Inequality: observable health differences between subgroups within a population, can be monitored and measured
Implicit vs explicit biases
Implicit bias (also called unconscious bias) refers to attitudes and beliefs that occur outside your conscious awareness and control.
Explicit bias are biases that you are aware of on a conscious level. It is important to understand that implicit biases can become explicit biases.
What is meant by health and what definitions can be used to interpret the term?
The World Health Organisation (WHO) defines health as ‘a complete state of physical, mental and social well-being and not merely the absence of disease or infirmity’.
This means that to be ‘healthy’, one should be well physically, mentally and socially.
There are three ways to interpret this definition of health. They are important to understand how a patient (especially those with chronic illness) view themselves and their health.
Positive – a state of well-being and fitness.
Functional – the ability to perform the tasks needed.
Negative – the absence of illness.
What is meant by chronic illness?
Chronic illness is defined as a long-term condition that has a significant impact on sufferers and has many co-morbidities.
Biomedical and biopsychosocial models of health: considered factors, views on what causes illness, patient responsibility, treatment style, responsibility for treatment, role of psychology
What is the COM-B model?
The COM-B model discusses the factors that contribute to a behaviour.
This patient must have the capability to perform the action.
They must also have the opportunity to do so.
These both contribute to the patient having the motivation for performing the action. The patient must also understand why they need to perform the action, and the consequences if they choose not to.
