Health Inequalities Flashcards
acceptable inequalities in oral health?
- CONGENITAL (predisposition to diseases)
- consequences of AGE (natural process creates inequalities)
- differences according to GENDER
what is an unacceptable inequality?
consequence of social, economic, political factors -> affect different sections of society
not everyone is affected equally
DH defines oral health as:
oral health is integral to general health
contributes to overall well being
what things are being increasingly proven that oral health has an impact on? (4)
diabetes
CV disease
rheumatoid arthritis
links seen from inflammatory markers seen in PD
determinants of health: (15)
- fixed factors
- lifestyle
- behaviours we engage in
- social positions in society
- socio economic status
- living environments
- working environments
- access to healthy food
- access to employability (unemployment)
- early childhood experiences
- life course influences
- wealth
- cultural factors
- access to dentist
- international security (palestine)
what are fixed behaviours which determine health?
gender
age
ethnicity
hereditary factors
the position you occupy a role in in society, determines what?
a lot of your outcomes in life (mother? father?)
how are our behaviours influenced by wider networks?
outer layers influence towards our personal health outside of our own personal behaviours
what are inequalities?
inequalities:
- diff in health status
- diff in distribution of health determinants between diff population groups
includes UNJUST, UNFAIR + AVOIDABLE
what are health inequalities attributable to? (3)
- biological variations
- free choice
- external environmental (uncontrollable)
what in equity?
diff support to diff people based on their needs= provides equal access
if inequity is addressed, intervention is removing systemic barriers
what is diff between health equality + equity?
equality = all treated the same
equity= diff support given based on individual needs to give equal access (acknowledges disadvantaged groups)
-> systemic barrier removed= everyone benefits (like removing covid)
but we cant, so most vulnerable groups are helped more
health inequalities
in higher income countries:
⬇️infant mortality rates
+ life expectancy
3) less likely to have self- reported poor health
4) more affluent areas= higher healthy life years
are there disparities in health inequalities within england itself?
yes
so if a country is getting richer + more developed, will the shown health patterns for that country exist over time?
yes
not everyone is being boosted in same way in the country
not everyone in country is getting to level of longer/ healthier life
what do more affluent areas have?
higher healthy life years
-> less long term disease impacting QOL
Health inequalities = bidirectional with what?
other inequalities in life
Health inequalities = bidirectional with what?
other inequalities in life
aging leads to other inequalities in life
-> issues with moving/ walking
inequity in maternal mortality?
huge variation in rich/ poor areas
between urban/ rural areas
urban area= more access to hospitals
rural areas- don’t have as many resources/ transport to get them to the urban areas
inequity in child mortality?
poor, rural, to mothers denied basic education children:
+ risk of dying before 5
what is the mortality rate in poorer regions within countries?
under 5
1.5-2.5 x more than in richer regions
why does overall rates in CDS going down not address inequality?
poor people still + likely to die from NCDS because of social determinants
who is smoking more prevalent in?
smoking- more prevalent in low socioeconomic status
who is smoking more prevalent in?
smoking- more prevalent in low socioeconomic status
4 theories to explain inequalities in health:
1) artefact- health inequalities= not real. artificial
2) natural + social
3) materialists (material deprivation)-
4) cultural/ behavioural differences
what is the artefact theory for inequalities in health?
health inequalities= not real. artificial.
effect produced by trying to measure something we cant effectively measure (we don’t know how to classify) - class is not an accurate measure, something else underlying
what is the natural and social selection theory for inequalities in health??
if you’re healthier, you get better job. if poor health status, less unemployment, move down social gradient because of barriers to do with employment
health status affects social position
people with a lot of DMFT felt they were less likely to get a job over a person with a full dentition
what is the materialists (material deprivation) theory for inequalities in health??
emphasises role of external environment
-> the conditions under which people live and work + the pressure on them to consume unhealthy products
do more dangerous work, poorer housing, have fewer resources to access better health
structure of society is implicated
what is the lifestyle (cultural, behaviours) theory for inequalities in health?
- differences in the way individuals choose to live their lives (people indulge in unhealthy behaviours)- doesn’t focus on why they’re doing it in the first place
never seen it- wont grow up to partake in
= victim blaming
which 2 theories are generally accepted?
artefact
natural + social selection
make small contribution to overall experience of inequality
what must be the basis for promoting health?
the interaction of lifestyle + socio economic factors are major influences
psycho social:
lack of social cohesion -> more conflict due to inequality of income
less resources
life course- take into account whole life experiences including before they were born (if you’re born to a fam where no one works, child wont think it is normal to work)
life expectancy variation in gender
north south divide
north -> lower life expectancy for men
women live longer -> lower life expectancy for men
life expectancy variation in gender
north south divide
north -> lower life expectancy for men
women live longer -> lower life expectancy for men
why does the north south divide exist if we are all affected by same policies?
wider social determinants
behaviours in north- smoking more prevalent
long term disease can affect amount of time you spend studying in school
what does the higher % of babies born at term with a low birth weight in the 3 most deprived areas show?
indicative of inequality of health in mothers
could have lasting effect on health of child
why can a reduction in overall NCD rates be deceiving?
the reduction within overall NCD rates can be seen as a reduction in inequality in the country
masks wider inequalities
NCDs affects most deprived areas more with- cancer, disease, stroke
inequality= present but affects most deprived areas, it is polarised by level of SEFs
which causes make up a large proportion of the large burden of premature death in england overall?
heart disease
stroke
cancer
in most deprived areas
where do we see highest number of DMFT
most deprived groups
health inequalities in trends of DMFT?
generally edendate rates going down
+ unskilled people
far less in professional people
limited language skills
occasional employment
living in a deprived community
hard to find NHS dentist
not knowing not having to pay- may not have regular job/ income
less access to healthy food
cheap food= more accessible
cost of toothpaste
social determinants of oral health in a newly immigrant family?
limited language skills
occasional employment
living in a deprived community
hard to find NHS dentist
not knowing not having to pay- may not have regular job/ income
less access to healthy food
cheap food= more accessible
cost of toothpaste
inequalities in oral health?
seen in all areas
perio- smoking +
tooth loss
caries
oral cancer
erosion
trauma- lack of social cohesion, more incidents of getting attack, a more physical manual labour- loose teeth
what are the 4 determinants for oral health?
1) attendance
2) diet
3) OH practices
4) attitudes
role of dental team in tackling health inequalities (6)
- health promotion in other key health professionals (shared goal to reduce obesity)
- become advocates for health
- act as enables to make healthy choices
- empower people to take control of their own lives + health
- engage with communities (recent partnership in bradford-> mosques, brush for Mohammed)
- have thorough understanding of how conditions people live, work, age, born affect their health- and how to tackle
what will focusing solely on meeting demand likely to do?
further increase oral health inequalities without improving OH
detrimental effects of inequality on a country as a whole? (5)
GDP
life expectancy
crime levels
literacy
health
“only as strong as weakest member”
country should look after most vulnerable people otherwise, country cant develop as whole leaving people behind
what does inequality create? (2)
- mental + emotional suffering despite wealth + achievement
- psycho social impact
how are we trying to reduce health inequalities? (3)
- WHO initiative (give out vaccines)
- priority public health conditions
- reducing HI through action on social determinants of health
our role in tackling health inequalities? (6)
- tailor response to Oral and general health needs
- build on community assets
- strengthen family self efficacy to self manage health (include OH)
- emphasis on early years (outreach in nurseries, toothbrushing has recently been incorporated into early years foundation curriculum)
- family focus- make it an integral part of daily routine
- personalised approach to delivery services
