Health inequalities

Question 1

What are the 3 core principles of the NHS?

Answer 1

1. Meets the needs of all
2. Free at the point of delivery
3. Based on clinical need (not the ability to care)

Question 2

Define health inequality

Answer 2

Preventable, unfair and unjust differences in health status between individuals/groups/populations

Question 3

What is the inverse care law?

Answer 3

Availability of good medical/social care tends to vary inversely with the needs of the population served

Those who access health care the least tend to be those who need it the most

Julian Tudor Hart in 1971

Question 4

Who are vulnerable groups?

Answer 4

Homeless, travellers, refugees/asylum seekers, LGBT, ex-prisoners, disabilities (learning or physical), health problems, frail

Question 5

What is Maslow’s hierarchy of need?

Answer 5

Maslow’s hierarchy of needs is a motivational theory in psychology comprising a five-tier model of human needs, often depicted as hierarchical levels within a pyramid. … From the bottom of the hierarchy upwards, the needs are: physiological, safety, love and belonging, esteem, and self-actualization

Question 6

Who is likely to take good care of themselves using Maslow’s hierarchy of need?

Answer 6

Those in the top

Question 7

Who is likely to not prioritise health?

Answer 7

Those in the bottom

Question 8

Define a traveller

Answer 8

Traditional travelling community, normally Roma background

Question 9

Give 2 types of travellers

Answer 9

Roma

irish

Question 10

Barriers to working with travellers

Answer 10

Language and communication

Mistrust of outsiders

Constantly moving - no address

Big problem for antenatal and baby care/ checks

Childhood immunisations cannot be arranged

Continuity of care for chronic disease is difficult

Discrimination

Illiteracy

Question 11

What services are available in Sheffield

Answer 11

Travellers’ Team - liaise between all the facilities

Only one Roma translator - not enough

Question 12

Define homelessness

Answer 12

Having no home

Question 13

Causes of homelessness

Answer 13

• Relationship breakdown - main cause
• Mental illness
• Domestic abuse
• Drug/ alcohol abuse
• Bereavements/ disputes - no family to ask for help

Question 14

Causes of death for homeless individuals

Answer 14

• Accidents & suicide, assault, alcohol and drug, CHD, pneumonia
• 47yo average age of death

Question 15

Barriers to healthcare for those that are homeless

Answer 15

Access

Logistics: opening times, location, finding out about appointments (no address)

Integration with other agencies
- housing, social, crime, etc.

Maslow’s hierarchy - do not prioritise their long term health when they need to ficus on their short term survival

Do not know where to find help

Question 16

Define refugee

Answer 16

Cannot return to own country due to fear of persecution

Due to race, nationality, religion, political alliance, etc.

Question 17

Define asylum seeker

Answer 17

Submitted application to Home Office to be recognised as a refugee and is waiting for the decision

Entitled to money (£35 per week), NHS care and housing (<18 => social service and schooling)

Not allowed to work.

Question 18

What does the Geneva Convention 1951 state?

Answer 18

Anyone has the right to apply for asylum and can remain in the country until the decision is made

Granted status => ILR (indefinite leave to remain) => all the rights of citizens

Family reunion - one spouse and all children (<18yo)

Question 19

Barriers to healthcare for AS

Answer 19

Lack of knowledge and understanding of NHS

Language and culture

Maslow’s Hierarchy of need - health is not a priority

Health problems - biopsychosocial

• Infectious disease
• malnutrition
• violence and torture
• sexual abuse
• psychological trauma
• PTSD, etc.
• all the conditions we can get in the UK

Question 20

Important for asylum seeker health

Answer 20

Rapid access
Screening
Immunisations - catch up
Education, especially about the asylum seeker process