Heath Inequalities Flashcards
what is sociology?
The study of the development, structure and functioning of human society
application of sociology to healthcare
The sociology of health and illness (Medical Sociology) applies the methods and theories of sociology to the health field
Sociology studies peoples’ interactions with those engaged in medical occupations e.g. healthcare professional-patient relationships
Sociology studies the way people make sense of illness e.g. illness versus disease
Sociology studies the behaviour and interactions of health care professionals in their work setting e.g. professional values, interactions between health care professionals and other health care staff
Sociologists who studied professions in the 1950s identified characteristics of professions as opposed to other occupations:
Systematic theory Authority recognised by its clientele Broader community sanction Code of ethics Professional culture sustained by formal professional sanctions
Medicine incorporates all the above features
sick role patient
The sick role exempts ill people from their daily responsibilities
Patient is not responsible for being ill and is regarded as unable to get better without the help of a professional
Patient must seek help from a healthcare professional
Patient is under a social obligation to get better as soon as possible to be able to take up social responsibilities again
sick role healthcare professional role
Professional must be objective and not judge patients morally
Professional must not act out of self-interest or greed but put patient’s interests first
He/she must obey a professional code of practice
Professional must have and maintain the necessary knowledge and skills to treat patients
Professional has the right to examine patient intimately, prescribe treatment and has wide autonomy in medical practice
What are the social/socio-economic influences on our health?
A definition would be the collective set of conditions in which people are born, grow up, live and work. These include:
gender ethnicity housing education employment financial security health system environment
education as a social factor for health
A definition would be the collective set of conditions in which people are born, grow up, live and work. These include:
gender ethnicity housing education employment financial security health system environment
employment as a social factor for health
Provides income and financial security; this obviously varies and relates in part to the previous slide on social class. (Deprivation is a major determinant of health inequalities)
Provides social contacts
Provides status in society
Provides a purpose in life
Unemployment is associated with increased morbidity and premature mortality
environment - transport and health
There can be adverse effects on health from the expansion of car use e.g. RTAs, pollution (often worse in deprived areas with poor urban planning)
Active travel such as cycling and walking have a number of health benefits e.g. improved mental health, reduced risk of premature death, prevention of chronic diseases such as coronary heart disease, stroke, type 2 diabetes, osteoporosis, depression, dementia and cancer. Walking and cycling are also effective ways of integrating, and increasing, levels of physical activity into everyday life for the majority of the population, yet there has been a lack of investment in walking and cycling infrastructure.
Combining public transport and active travel can help people achieve recommended daily activity levels. Public transport is the most sustainable for longer journeys, yet it can be more expensive and less convenient. In rural areas travel infrastructure and public transport may present challenges
enviroment media and health
Shapes and stereotypes our views
Shapes our expectations
Consider the change in media attitude to mental health in recent years, aiming to reduce the previous stigma associated with mental illness
WHO definition of health inequalities
differences in health status or in the distribution of health determinants between different population groups
health inequalities in scottish children
Children in the most deprived areas have significantly worse health compared to children living in the least deprived areas; they are more likely to have lower birth weight, poorer dental health, higher obesity and higher rates of teenage pregnancy
There is a mixed picture of progress in tackling health inequalities. For some indicators e.g. deaths from coronary heart disease, inequalities have decreased, but others such as mental health, smoking, alcohol and drug misuse remain significantly worse in the most deprived parts of Scotland. Addressing issues affecting children can improve long term health outcomes in adult life
vulnerable groups - the homeless
Average age of death of longer-term homeless is 47 years for men and 43 years for women
Death by unnatural causes has been found to be four times more common than average amongst rough sleepers, and suicide 35 times more likely
Rough sleepers are more likely to be assaulted than the average person
Alcohol and drug problems are very high amongst rough sleepers, and people being resettled from the streets are more likely to face problems sustaining a tenancy if they have these problems
The prevalence of infectious diseases, such as tuberculosis, HIV and hepatitis C, is significantly higher than in the general populations
This population experiences poorer oral health than the general population.
Access to health care for this population is different to that of the general population: one third of rough sleepers are not registered with a GP; attendance at accident and emergency is at least eight times higher than the housed population.
Vulnerable groups-Learning Disability
People with a learning disability have worse physical and mental health than people without a learning disability. On average, the life expectancy of women with a learning disability is 18 years shorter than for women in the general population; and the life expectancy of men with a learning disability is 14 years shorter than for men in the general population (NHS Digital 2017).
Barriers thatstoppeople with a learning disability from getting good quality healthcare:
a lack of accessible transport links
patients not being identified as having a learning disability
staff having little understanding about learning disability
failure to recognise that a person with a learning disability is unwell
failure to make a correct diagnosis
anxiety or a lack of confidence for people with a learning disability
lack of joint working from different care providers
not enough involvement allowed from carers
inadequate aftercare or follow-up care
vulnerable groups - refugees
Challenges for refugees arriving in a new country (U.S. study)
Family integrity and social adjustments trump medical issues for most arriving refugees
Competing demands of distinct services such as: social welfare, education, housing, transportation, public health, mental health, primary care, and specialty care encountered by refugees may overwhelm them and limited resources
Language barriers impede the adjustment process
Some refugees with urgent and complex medical conditions are unable to establish care and specialty referrals in a timely manner
Underdeveloped or eroding health care systems in the countries of origin or first asylum leave many refugees with poorly controlled or undiagnosed chronic medical conditions
Most refugees are unfamiliar with the biomedical practice of preventive medicine and primary health care
Public health’s infectious disease screening results are not communicated to those providing ongoing medical care
Exposure to violence, torture, warfare, and internment is common, even among children
Loss upon loss is the nature of refugee life and so depression, PTSD, and anxiety are prevalent and often unrecognized
Anti-immigrant sentiments further burden refugee life in the U.S.
vulnerable groups - prisoners
50% of prisoners surveyed stated that they were drunk at the time of their offence and 38% report that their drinking affected their relationship with their family. This is in contrast to 14% of men and 9% of women in the Scottish population saying they had an alcohol problem
76% of Scottish prisoners report being smokers compared to the national average of approximately 24%. However, 56% of those surveyed stated that they wished to give up
Prisoners surveyed reported ‘feeling interested in people’, ‘feeling loved’ and ‘feeling close to other people’ (57%, 43%, 56%) only ‘some of the time’ or ‘rarely’
44% of surveyed prisoners reported being under the influence of illicit drugs at the time of their offence and 39% reported that drug use was a problem for them on the outside
In general, prisoners, both before and on liberation from prison, live in the poorest areas of Scotland. Their health inequalities are further exacerbated by the even higher rates of premature death that ex-prisoners experience, related to violence, accidents, substance misuse and suicide
