Health inequalities

Question 1

How is sociology defined?

Answer 1

Study of development, structure, and functioning of human society

Question 2

What does sociology applied to healthcare study?

Answer 2

People’s interactions with those engaged in medical occupations
How people make sense of illness
Interactions between healthcare professionals

Question 3

What are 5 characteristics of medicine sociologically?

Answer 3

Systematic theory
Authority recognised by clientele
Broader community sanction
Code of ethics
Professional culture sustained by formal professional sanctions

Question 4

What are features of patients in the sick role?

Answer 4

Exempted from daily responsibilities
Patient is not responsible for being ill and is regarded as unable to get better without help of a professional
Patient must seek help from healthcare professional
Patient is under social obligation to get betteer ASAP to take up social responsibilities again

Question 5

What is the healthcare professional role in the sick role?

Answer 5

Must be objective and not judge patient morally
Must not act out of self interest or greed but put patient’s interests first
Must obey professional code of practice
Must have and maintain necessary knowledge and skills to treat patients
Professional has the right to examine the patients intimately, prescribe treatment, and has wide autonomy in medical practice

Question 6

What are the levels of social class?

Answer 6

1.1 - large employer and higher managerial and administrative occupations
1.2 - higher professional occupations
2 - lower managerial administrative and professional occupations
3 - intermediate occupations
4 - Small employers and own account workers
5 - Lower supervisory and technical occupations
6 - semi-routine occupations
7 - routine occupations
8 - Never worked and long-term unemployed

Question 7

What are factors in labour market situation?

Answer 7

Source of income
Economic security
Prospects of economic advancement

Question 8

What are factors in work situation?

Answer 8

Location in systems of authority and control at work

Autonomy at work

Question 9

What are social/socio-economic influences on our health?

Answer 9

Gender
Ethnicity
Physical environment/housing
Education
Employment
Income/social status/ financial security
Health system
Social environment

Question 10

How does gender affect health?

Answer 10

Men have higher mortality at every age
Women have higher morbidity
Women consult more frequently in general practice

Question 11

How does ethnicity affect health?

Answer 11

South asians in scotland have higher rates of heart attacks than general population
Prevalence of type 2 diabetes higher in south asian populations
Lower admissions among white polish and chinese groups
Greater prevalence of sickle cell disease in african origin groups
Data suggests minority ethnic groups have better general health than majority of white population

Question 12

How does ethnicity affect alcohol consumption?

Answer 12

Most minority ethnic groups have higher rates of abstinence and lower levels of drinking compared to people from white backgrounds
Abstinence is high amongst South Asians, particularly those from Pakistani, Bangladeshi and Muslim backgrounds. But Pakistani and Muslim men who do drink do so more heavily than other non-white minority ethnic and religious groups
People from mixed ethnic backgrounds are less likely to abstain and more likely to drink heavily compared to other non-white minority ethnic groups
People from Indian, Chinese, Irish and Pakistani backgrounds on higher incomes tend to drink above recommended limits

Question 13

What ethnic groups are at risk of alcohol related harm?

Answer 13

Irish, scottish, indian men, irish, scottish women, higher rates of alcohol related deaths than national average in england and wales
Sikh men have higher rates of liver cirrhosis
Minority ethnic groups have similar levels of alcohol dependence compared to general population despite drinking less

Question 14

What are patient level barriers to use of health service?

Answer 14

Language concerns
Understanding the system
Beliefs

Question 15

What are provider level barriers to use of health service?

Answer 15

Understanding of differences due to ethnicity
Provider skills
Provider attitudes

Question 16

What are system level barriers to use of health services?

Answer 16

Organisation of appointments and referrals

Question 17

What is culturally competent care?

Answer 17

Combination of attitudes, skills, and knowledge that allows an understanding and therefore better care of patients with a different background to our own

Question 18

How can we deal with disparities in health?

Answer 18

Identify potential barriers to use of health services
Culturally competent care
Recognising when we are being culturally incompetent

Question 19

How does housing affect health?

Answer 19

1 in 4 adolescents living in cold homes is at risk of multiple mental health problems compared to 1 in 20 in warm homes
Children in cold homes more than twice as likely to suffer resp problems
Deaths almost 3 times higher in coldest quarter than in warmest

Question 20

How does educatio affect health?

Answer 20

Those with higher levels of education tend to be healthier than those of similar income who are less well educated

Question 21

Why are well educated people more healthy than less educated people?

Answer 21

Better understanding of health
More effective engagement with services such as screening programmes
Better engagement with health advice
Better able to navigate health services

Question 22

How does employment affect health?

Answer 22

Provides income and financial security
Provides social contacts
Provides status in society
Provides purpose in life
Unemployment is associated with increased morbidity and premature mortality

Question 23

Why may national screening services widen health inequality?

Answer 23

Uptake will be lowest in those who derive the greatest benefit while those who need it less will use it

Question 24

What are effects of public transport on health?

Answer 24

Adverse effects from expansion of car use due to pollution
Active travel has health benefits - walking and cycling
Combining public transport and active travel helps people achieve recommended daily activity levels

Question 25

How does media affect health?

Answer 25

Shapes and stereotypes our views

Shapes our expectations

Question 26

How is health inequality defined?

Answer 26

Differences in health status or in distribution of health determinants between different population groups

Question 27

What are examples of health inequalities?

Answer 27

Rate of low birthweight
Rate of breastfeeding
Dental health
Rate of obesity
Rate of teenage pregnancy

Question 28

What are factors that make an area deprived?

Answer 28

Education
Homelessness/poor quality homes
Unemployment
Family breakdown
Anti social behaviour
Hopelessness
Multi-morbidity
Ambition/aspiration/opportunity

Question 29

What are factors that make homeless people vulnerable?

Answer 29

Average age of death is 47 for men or 43 for women
Death by unnatural causes 4 times higher, suicide 35 times higher
More likely to be assaulted
Alcohol and drug problems
Infectious diseases such as TB, HIV, and hep C
Poorer oral health
Access to health care much lower

Question 30

What are barriers to people with learning disability accessing health care?

Answer 30

Lack of accessible transport link
Not being identified as having learning disability
Staff have little understanding of learning disability
Failure to recognise person is unwell
Failure to make correct diagnosis
Anxiety or lack of confidence for the person
Lack of joint working from different care providers
Not enough involvement allowed from carers
Inadequate after care

Question 31

What are challenges for refugees arriving in a new country?

Answer 31

Family integrity and social adjustments trump medical issues
Competing demands of distinct services such as social welfare, education, housing, etc
Language barriers
Some with complex and urgent medical conditions unable to establish care and specialty referrals in a timely manner
Underdeveloped health care systems in origin country leave many with poorly controlled or undiagnosed chronic conditions
Most unfamiliar with biomedical practice or preventative medicine
Exposure to violence, warfare, torture, and internment is common, even in children
Depression, anxiety, PTSD common
Anti-immigrant sentiments from general population

Question 32

What are factors that make LGBT people vulnerable?

Answer 32

Higher rates of depression and anxiety
Much higher rates of self harm than general population
Haven’t come out to their GP
Lack of understanding of trans people from mental health services
Homophobic staff or inappropriate advice due to sexual orientation or identity

Question 33

What is the inverse care law?

Answer 33

Those who most need medical care are least likely to receive it and conversely, those with least need of health care tend to use health services more, and more effectively

Question 34

What factors can reduce health inequalities?

Answer 34

Effective partnership across a range of sectors and organisations
Evaluate and refine integration of health and social care
Government policies and legislation
Invest in more vulnerable patient groups
Improve access to services
Reduce poverty
Social inclusion policies
Improved employment opportunities for all
Ensure equal access to education in all areas
Improved housing in deprived areas

Question 35

What benefits do voluntary sector organisations provide?

Answer 35

Provide means of engaging effectively with communities and individuals
Deliver range of services which may help reduce health inequalities such as, promoting healthy living to groups of people who may not use mainstream services, and supporting people to access relevant services in the NHS

Question 36

What benefits do patients get from volunteering?

Answer 36

Gain confidence
Make a difference
Meet people
Be part of a community
Learn new skills
Take on a challenge
Have fun