health inequities

Question 1

Identify the causes of variations in health between and within communities

Answer 1

health differentials; the differences in health status and life expectancy that exist between and within social groups
-focors include 
socioeconomic status 
-ethnicity 
-gender 
-working conditions 

life expectancy in different counteries
1 is Japan; 83.7 and top 10 are simular
bottom is
Sierra Leone/south sudan/somalia bottom 10 counteries is 50.
they have 30+ years less.
many in top 10 are in Europe and bottom 10 are in Africa

highest life expectancy =lowest level of deprivation/ lower life expectancy =higher deprivation
people living in lower

Question 2

Discuss the impact of socioeconomic deprivation on health and theories of why this occurs

Answer 2

socioeconomic conditions; more likely to suffer from chronic diseases and mental illness, live shorter lives, more likely to engage in unhealthy behaviours such as smoking and drinking

Australia; like expectancy is 5th hgihest in the world but indigenous Australian men have a 10.6 years lower life expectancy and women have a 9.5 lower life expectancy

theories:
social causation-being in a low SSES group “causes” health problems

-social drift- as a consequence of developing a health problem, a person to “drift” downward in SES
eg. doctors 2x more likely to develop CHD before 50, if they came from a lower SES group.
SES has huge impact on health outcomes.
overall SES is more like

lower SES groups more likely to engage in health-damaging behaviours
-2x smoking prevalence in the most disadvantaged group
-less fruit in families experiencing financial stress
However, SES still accounts for at least a third of the variation in health outcome after taking all these behaviour into account.
it has a huge impact.
-healthcare access, under Medicare, lower SES groups access healthcare more frequently.
however, access to health service mediated by
Availability (e-health online mental health)
Cost
Waiting times
Outpatient specialist services
Elective procedures
-Lower SES groups may be less likely to access appropriate care when needed.

• poorer areas may be affordable but lack in facilities lacking in education and living in poor housing
• Avalibility to supermarkets, selling fresh foods instead of side-by -side fast food outlets
• access to recreational facilities like bike parks, or even just the presence of sidewalks, higher crime rates will further discourage outdoor exercise
• poor suburbs often contain the most polluting industries (waste dumpd etc)

Stress:
stress hypothesis, differences in stress experienced as a result of many factors may contribute to health differences across social groups
some stressors,
-childhood- instability, poor diet
-adolescence- family strife, passive smoking behaviours, reduced education
Adulthood- working in hazardous conditions, financial insecurity
Old age- reduced superannuation, inadequate heating/food

Inequality in wealth and the negative feelings, like anger, that accompany knowing other people dont have to suffer the same way are also stressfull

Leads to a lack of social capital in a society (less cohesion, solidarity, and trust in ones community)

work status and stress
-part of the excess mortalirt linked with low SES may be due to different work environments
-job demands
Job autonomy (decision making freedom)
Available social support
-worst combination, is high demand+low autonomy+ low social support+ +job stress and increases health risk.

Question 3

recognize the health impact of having a minority status in society

Answer 3

Indigenous Australians
-reduced in: access to education and housing
-discrimination/racism
-remoteness
-difficulty in accessing health services
-differences in health behaviours (smoking and alcohol)
life expectancy for indigenous in 10 years less then other Australians. = explanations, chronic disease

-the rate of hospitalization for indigenous Australians is over twice that of non-indigenous, common reasons are injury and accidents, diseases of respiratory and digestive system, pregnancy and childbirth, and mental illness

Chronic kidney disease and dialysis rates are 10 times more likely and diabetes is 4 times more likely to affect Indigenous Australians

75% of Indigenous peoples reported sedentary behaviour/low levels of activity

reasons;
need to account for diversity when examining 'ethnic minorities'
-language
-religion
-Migration 
-culture
-ancestry
-Identity

Migrants can have better health outcomes than native born residents

Question 4

discuss the impact of gender on health

Answer 4

longer life expectancy among women is common in industrialized countries (+4 years in AUS)

• men have earlier onset of CHD (genetics) and are ore likely to die from accidents and suicide
• on average, men engage in risk behaviours at higher rates