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YEAR 4 OLDER PEOPLE INTEGRATED CARE > Health Inequalities > Flashcards

Health Inequalities Flashcards

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1
Q

What is inverse care law with regard to health inequalities?

A

The availability of good medical care tends to vary inversely with the need of the population served.
(increased need for care in more deprived area but less likely for a doctor to be able to help)

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2
Q

Define social determinants of health

A

**The social determinants of health (SDH) are the non-medical factors that influence health outcomes. **

They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems

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3
Q

What are examples of social determinants of health?

A
  • Income and social protection
  • Education
  • Unemployment and job insecurity
  • Working life conditions
  • Food insecurity
  • Housing, basic amenities and the environment
  • Early childhood development
  • Social inclusion and non-discrimination
  • Structural conflict
  • Access to affordable health services of decent quality.
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4
Q

What is meant by proportinate universalism?

A
  • Focusing soley on the most disadvantaged will not reduce health inequalities sufficientlly
  • To reduce the steepness of the social gradient in health, actions must be universal
  • but with a scale and intensity that is proportionate to the level of disadvantage
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5
Q

Describe the prevention paradox

A

Interventions that make a difference at population level might not have much effect on the individual

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6
Q

Define health inequalities

A

Health inequalities are avoidable, unfair and systematic differences in health between different groups of people.

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7
Q

How can health be measured?

A
  • Mortality and life expectancy
  • Self-report i.e. surveys
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8
Q

Describe what we mean by a social patterning of health

A

Deprivation is strongly associated with ill health - the more deprived a person is, the larger the proportion of their life will be spent in ill health, and more likely to die at a younger age

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9
Q

Name the different explainations for inequalities in health?

A
  • Artefact
  • Social selection
  • Behavioural-cultural
  • Materalist
  • Psychosocial
  • Income distribution
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10
Q

Describe artefact explaination for health inequalities?

A

The existence of health inequalities is due to the way statistics are collected - in particular to problems with the measurements of social class

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11
Q

What are main concerns with artefact explaination of H.I?

A
  • Quality of data
  • Method of measurement
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12
Q

Describe social selection explaination for H.I

A

Direction of causation is from health to social position.

I.e health status dictates your social position. (Social position does not dictate your health status)

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13
Q

Describe social selection explaination for H.I

A

Direction of causation is from health to social position.

I.e health status dictates your social position. (Social position does not dictate your health status)

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14
Q

Using the social selection explaination for H.I, describe health inequality for disabled people

A

Social selection explaination: Direction of causation is from health status to social position.

Disabled people are more likely to be disadvantaged.
Sick individuals move down social hierachy whereas healthy individuals move up.

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15
Q

Describe behavioural-cultural explaination for H.I

A

Ill health is due to people’s choices, decisions, knowledge and goals

so..
* people from disadvantaged backgrounds tend to engage in more health-damaging beahviours
* people from advantaged backgrounds tend to engage in more helath-promoting beahviours

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16
Q

Describe the materialist explaination for H.I

A

Inequalities in health arise from differential access to material resources
* lack of choice in exposure to hazards and adverse conditions
* accumulation of factors across life-course

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17
Q

What are examples of social determinants of health explained by materialist explaination?

A

Low income
Unemployment
Work environments
Low control over job
Poor housing conditions

18
Q

What is the most plausible explaination for H.I?

A

Materialist explaination

19
Q

Limitation to materialist explaination?

A

Further research needed as to precise routes through which material deprivation causes ill-health

20
Q

ID main difference between behavioural-cultural and materialist explainations

A
  • B-C explaination assumes people have choice
  • Materialist recognises that differenital access to material resources can seriously limit choice
21
Q

Limitations to B-C explaination?

A
  • Behabiours are outcomes of social processes, not individual choice alone
  • “choices” may be difficult to exercise in adverse conditions
  • “choices” may be rational for those whose lives are constrained by their lack of resources
22
Q

What is psychosocial explaination for H.I?

A
  • Health is influenced more by differences in income than actual income
  • Some stressors are distributed on a social gradient (e.g. job security, social support)
  • Stress impact on health via different pathways (direct = physiological. Indirect = mental health)
23
Q

Describe income distribution explaination for H.I

A

Larger the income gaps within a country, the worse the country performs on these health and social problems

24
Q

What can be done to reduce inequalities?

A

Depends on what caused them.
* strengthening individuals
* strengthening communities
* improving living and working conditions
* promoting healthy macro-policies

25
Q

What is difference between inequality and inequity?

A
  • Inequality = when things are different (not equal)
  • Inequity = inequalities that are unfair and avoidable

Note: you can have inequality without inequity

26
Q

Inequities in access to healthcare:

1.More deprived groups seem to have higher rates of use of what?

2.More deprived groups seem to have under use of what?

A
  1. GP services and Emergency services
  2. Preventative services (screening, asthma, outpatients) and Specialist services (cancer treatment)
27
Q

What factors are associated with H.I?

A
  • Ethnicity
  • Gender
  • Age
  • Disability
  • Homelessness
28
Q

Describe inequalities of gender and health:
* males have…
* females have …

A
  • Males have: higher mortality rate and more suicide and voilent deaths
  • Females have higher life expectancy, higher reported poor mental health, higher rates of disability and limited longstanding illness
29
Q

What is implicit bias?

A

Actions based on prejudice and stereotypes without intending to do so. This is an unconscious act or thought; however, it does show a familiar association.

30
Q

What is explicit bias?

A

Actions based on prejudice and stereotypes intending to do so. In this type people are very aware of their bias.

31
Q

Describe Wilkinson Income distribution theory

A
  • Western economies: what matters is not gross national product but the relative income within the country - i.e. relative income affects health
  • Countries that have greater income inequalities have greater health inequalities
32
Q

What did Marmot: Fair Society review conclude r.e. H.I?

A
  1. Give every child the best start
  2. Enable all children, young people and adults to maximise their capabilities and have control over their lives
  3. Vreate fair employment and good work for all
  4. Ensure a healthy standard of living for all
  5. Create and develop healthy sustainable places and communities
  6. Strengthen the role and impact of health prevention
33
Q

Describe health inequality in homeless population

A
  • more health inequalities
  • poorer health outcomes
34
Q

What are issues faced by homeless popN that prevent them accessing healthcare and social care?

A
  • Can not access services due to criteria needed to register (e.g. address, bank details)
  • Stigma
  • Discrimination
  • a lack of close family and friends for support
  • inflexible or poorly organised services.
35
Q

Causes of homelessness?

A

People become homeless for lots of different reasons.
1. Social causes
* lack of affordable housing
* poverty
* unemployment
* life events which push people into homelessness.

  1. forced into homelessness:
    * leave prison
    * leave care
    * leave army with no home to go to.
    * escaped a violent or abusive relationship.
    * no longer afford the rent.

3.Life events:
* relationship breaking down
* losing a job
* mental or physical health problems
* substance misuse put people under considerable strain

36
Q

Key problems affecting homeless popN?
(from Sas deck)

A
  • drug and alcohol dependence
  • sexual assault
  • skin problems
  • malnutrition
  • parasitic infection
  • dental and periodontal disease
  • joint disease
  • hepatic cirrhosis
  • infectious hepatitis- iIVDU
37
Q

What health problems may cause homlessness?

From sas deck

A
  • mental illness e.g. schizophrenia
  • AIDS
  • alcoholism and drug dependence
  • degenerative illness/ accidents which causes loss of occupation
38
Q

With regard to Covid-19, what health inequalities are people in low income populations more vulnerable to?

A
  • some groups are particularly at risk from the negative direct and indirect consequences of COVID-19
  • limited access to preventative measures e.g. handwashing
  • more likely to be employed in occupations where there are no social distancing measures
  • so… unable to protect themselves from Covid19
  • and lack access to timely healthcare when becoming ill.
39
Q

How does socio-economic status affect incidence of T2DM?

A
  • Socio-economic status (SES) may influence access to and quality of care, social support and availability of community resources.
  • It may also influence diabetes-related knowledge, communication with providers, treatment choices and the ability to adhere to recommended medication, exercise and dietary regimens.
40
Q

Define poverty

A

Cannot afford the basic needs of life—food, clothing, shelter and so on.

41
Q

What are the key characteristics of poor housing?

A
  • Fails to meet the decent homes standard
  • Overcrowded against bedroom standard
  • Fails the Housing Health and Safety Rating System – HHSRS

YEAR 4 OLDER PEOPLE INTEGRATED CARE (21 decks)

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