Health Inequalities Flashcards
What is public health?
HHH
- Art and science of preventing disease
- Health protection - vaccines, flu/shingles, severe weather effects
- Health improvement - exercise programs
- Healthcare public health - CVD checks, health checks
Dahlgren and whitehead
- Inner - can’t change, fixed eg age, sex
- Then individual - exercise, smoking
- Social and community - support
- Living conditions and working conditions - employment, housing, education, food have access too
- Outer ring - climate change etc
What percentage of health is determined by healthcare itself?
20%
Majority is socio-economic status
Others inc environment
Disability free life expectancy difference most deprived vs least deprived areas
More 15 years
What do we aim for in public health?
Ensure equity - those who need more resources etc will be able to access more
What is taking a public health approach mean?
- Start with populations
- Seek to understand and address the causes of the causes - wider determinants eg social, eg lung cancer, why harder to give up smoking?
- Championing prevention
- Intelligent use of data and evidence base
- Organisations working in partnership with eachother and communities - eg social care, patient representatives
How can PH approach be used clinically?
- Understand causes of the causes you see
- Putting patient in contect - hollistic
- Counsel more effectively on lifestyle change
- Avoid accidentally widening inequalities when implementing new guidance, services or procedures
- Use tools like brief interventions and social prescribing
Particular problems facing older members of population
- Multi-morbidity
- Frailty/limited mobility/falls risk
- Sensory impairment
- Dementia/cognitive impairment
- Increased risk from flu/covid-19
- Social isolation and loneliness
- Food and fuel poverty
Causes of causes of loneliness
- Unemployment –> isolation
- Live alone due to children moving away or loss of spouse
- Chronic illness –> difficult to leave house
- Social networks shrink with age as friends die/difficult to socialise with mobility issues
- Cost of living - struggle to get out
Loneliness and living alone and poor social connections is as bad as…cigarettes per day
15
Half a million older people go 5-6 days without seeing anyone
What does loneliness increase the risk of?
- Coronary heart disease
- Stroke
- High BP
- Cognitive decline
- Dementia
Who is more at risk of social isolation?
- Long term limiting health conditions
- Lone person households
- Social housing tenants
Organisation in leicester that help older communities
Leicester Ageing Together
* Lottery funded
* Reduce loneliness and isolation through community projects
Steady steps
* Falls management exercise program - 24 weeks
* Secondary gains eg socialisation and more confident to go out
Framework for teamworking
PROC framework
* Processual - processes, how info is shared, urgency
* Contextual - cultural, respected
* Organisational - support given to organise, fear of litigation
* Relational - power, hierarchy, collaborate
Aims of MDTs
- Share professional perspectives –> deliver best care
- Co-ordinate care (priorities agreed and understood)
- Eradicate mistakes
- Reduce costs and complications
- Care more time efficient
- Involve families and patients - motivate them towards agreed shared goal
