How to think as a Public Health Professional

Question 1

What are health profiles?

Answer 1

-Snapshot of health & wellbeing in local authorities
-Highlights local issues - so know what to focus on - discuss @ health & well-being boards

Question 2

What are the key indicators of health that health profiles include?

Answer 2

-Life expectancy = based on demographic where live (+ve LE = how long will live in good health)
-Healthy life expectancy/Disability adjusted life years (HLE based on healthy life style0
-Morbidity - illness
-Mortality - death

Question 3

What does a health summary look like e.g., Sunderland?

Answer 3

Question 4

What is the name of the differences between north compared to the south, what does this mean?

Answer 4

North south divide
–> shows clear inequalities in England

Question 5

Define health inequalities.

Answer 5

Differences in health between people or groups of people that may be considered unfair
(can be reduced)
–> seen within & between countries (WHO, 2020)

Question 6

Give examples of some health inequalities.

Answer 6

-Infant mortality rates - diff in diff ethnicities (higher in ethnic minorities)
-Disease no.s in relation to level of deprivation (most deprived = higher no.s)
-Birth weight in relation to level of deprivation (lowest birth rates in most deprived)
-Mammogram screening in relation to disability status (fewer disabled women attend mammograms)
-Covid-19 mortality rates in relation to age and/or gender

Question 7

Define social determinants of health.

Answer 7

Conditions in which people are born, grow, live, work & age
–> these circumstances are shaped by the distribution of money, power & resources at global, national and local levels

Question 8

What are social determinants mostly responsible for?

Answer 8

Health inequalities

Question 9

Give the rainbow model to show social determinants.

Answer 9

Broad social & economic circumstances that together determine the quality of pop health = ‘social determinants of health’
-Genetics = only factor NOT social

Inside to outside
1 - bio factors
2 - friend groups - sporty family? family that don’t talk about cancer? - how much they eat, drink, , move?
3 - does society encourage: cycling, legislative policies e.g., smoking, sugar tax?
4 - do you feel safe @ home?

Question 10

List some social determinants of health (SDOHs).

Answer 10

Question 11

How does poverty impact health - SDOH?

Answer 11

E.g., early childhood disadvantages

Question 12

How do households impact health - SDOH?

Answer 12

-Heating
-Respiratory conditions
-If 1 warm room in house - where can children study & not be distracted? –> affects education

Question 13

How does family, friends & communities impact health - SDOH?

Answer 13

-to do with social isolation & loneliness = inc risk of heart disease & stroke
-People who = more socially connected to fam/friends = happier, live longer, better health, fewer physical & mental health problems, than less connected people

Question 14

How does education impact health - SDOH?

Answer 14

-Heating link - if 1 warm room in house to study/homework = education affected
-People w/ lower LIs = more likely to have no qualifications than w/ higher LIs
-45.6% kids receiving free school meals in 2015 &16 didn’t reach good development vs those not eligible
-Only 1/3 of children eligible for free school meals do ‘well’ @ GCSE vs 2/3 for those not eligible

Question 15

How does employment conditions impact health - SDOH?

Answer 15

-Zero hour contracts = insecure employment
–> has been inc in along w/ poor quality work, part-time work
-Unemployed adults = more likely to suffer from mental ill health than those in work
-Stress caused by work has inc since 2010

Question 16

How does our environment impact health - SDOH?

Answer 16

Children in deprived areas = 9 times LESS likely to have access to green space & places to play (The Health Foundation, 2018)

Question 17

How does nutrition impact health - SDOH?

Answer 17

-3 times more expensive to get needed energy from healthy food vs unhealthy food
-Poor diet of people in poverty = mostly due to poverty - not poor choices (Marmot, 2020)

Question 18

Summary of SDOH.

Answer 18

Question 19

What are Marmot’s 8 principles to target inequalities?

Answer 19

1 - Give every child the best start in life
2 - Enable all children, young people and adults to maximise their capabilities and have control over their lives
3 - Create fair employment and good work for all
4 - Ensure healthy standard of living for all
5 - Create and develop healthy and sustainable places and communities
6 - Strengthen the role and impact of ill-health prevention.
7 - Tackle discrimination, racism and their outcomes
8 - Pursue environmental sustainability and health equity together

Question 20

What are some of the SDOH in Sunderland?

Answer 20

Question 21

What are Sunderland doing to target these SDOH?

Answer 21

Question 22

What is the population intervention triangle?

Answer 22

Describes how can address health inequalities at scale by systematic collaborative leadership & action – drawing together civic activity (e.g., local authorities), services (e.g., the NHS), & community centred approaches, in a way sensitive to local needs & priority

Question 23

So, how are health inequalities tackled?

Answer 23

Take action on causes of health inequalities (= SDOH)

Question 24

Link poverty & health.

Answer 24

-Poverty leads to unhealthy choices
-People living in poverty experience direct health impacts associated w/ stresses & poor conditions resulting from poverty

Question 25

What determines health?

Answer 25

Complex interaction between individual characteristics, lifestyle & the physical, social & economic environment
–> so focussing on lifestyle factors alone = unjust