indicators of health inequalities - session 9

Question 1

what is a health indicator?

Answer 1

a single measure (usually expressed in quantitative terms - proportion, rate, count) that captures a key dimension of health (such as how many people suffer from chronic disease or have had a heart attack). indicators also capture various determinants of health (such as income) or key dimensions of the healthcare system (such as how often pts return to hospital for more care after they are treated)
- a variable susceptible to direct measurement, that reflects the state of health of persons in the community

Question 2

how are health indicators expressed?

Answer 2

as numbers and statistics

Question 3

what do health indicators enhance our understanding of?

Answer 3

• the health of canadians
• how the healthcare system works
• the factors that influence health

Question 4

what do health indicators assist with?

Answer 4

• informing health policy
• managing the healthcare system
• identifying gaps in health status and outcomes for specific populations (health disparities)

Question 5

what are the characteristics that are needed in health indicators to be useful? (6)

Answer 5

reliability
acceptability
validity
sensitivity
universality
feasability

Question 6

describe a reliable health indicator

Answer 6

repeated measurement under similar circumstances by the same or different individuals produce the same results (e.g. total mortality rate)

Question 7

describe a valid health indicator

Answer 7

the indicator measures qualities or characteristics that it is intended to measure (e.g. percieved health as a measure of health status)

Question 8

describe a sensitive health indicator

Answer 8

to be able to detect changes over time (e.g. proportion of people with DM or that are obese)

Question 9

describe a health acceptable indicator

Answer 9

the potential users find it understandable, credible, and useful (e.g. life expectancy)

Question 10

describe a feasible health indicator

Answer 10

there is data to support calculation and reporting of the measure (e.g. canada doesnt have good data to calculate and report number of homeless people so not a feasible indicator)

Question 11

describe a universal health indicator

Answer 11

it is adaptable to different population/settings (e.g. infant mortality rate: needs to be feasible and acceptable for many populations globally)

Question 12

what are health indicators divided into in canada? how many health indicators do we have?

Answer 12

5 dimensions

we have about 80

Question 13

who provides info for health indicators?

Answer 13

canadian health information institute and statistics canada

Question 14

what are the 5 dimensions of the health indicators framework?

Answer 14

health status
non-medical determinants of health
health system performance
community and health system characteristics
equity

Question 15

describe health status as a part of the health indicators framework. what does this provide information about?

Answer 15

indicators in this dimension provide information on the health of canadians (how healthy are canadians?)

• well-being
• death
• health conditions
• human function

Question 16

describe non-medical indicators of health as a part of the health indicators framework. what does this provide information about?

Answer 16

indicators in this dimension provide information on factors outside of the health system that affect health (known to affect our health and, in some cases, when and how we access healthcare)

• living and working conditions
• health behaviours
• personal resources
• environmental factors

Question 17

describe health system performance as a part of the health indicators framework. what does this provide information about?

Answer 17

indicators in this dimension provide insight into the quality of health services (how healthy is the health system?)

• accessability
• acceptability
• appropriateness
• competence
• continuity
• efficiency
• effectiveness
• safety

Question 18

describe community and health system characteristics as a part of the health indicators framework. what does this provide information about?

Answer 18

indicators in this dimension provide useful contextual information, but are not a direct measure of health status or the quality of healthcare

• community (size, sex ratio, indigenous background)
• health system (# of physicians or hospital beds; # of nurses)
• resources (where are the resources allocated; how mcuh funding goes to chronic vs acute care?)`

Question 19

describe equity as a part of the health indicators framework.

Answer 19

indicators in this dimension provide insight into health disparities. the other dimension must be reported in a certain way to be able to see the differences

Question 20

what is the main source of data for health indicators in canada?

Answer 20

the census (done every 5 years)

Question 21

what information does the census provide. what does it not>

Answer 21

provides basic demographic information on sex and age

• information on some determinants of health (ethnicity, marriage status, income, employment)
• lacks a lot of health information

Question 22

what are population registries? where are they used? how are they used in canada?

Answer 22

they are another source of data on population structure and dynamics.
in europe they have ones that are updated regularily and provide a more accurate estimation on population size and composition. in canada we get info from our universal heath insurance (in MB from MB health)

Question 23

describe the factors affecting population size, structure, and growth that together make up vital statistics.

Answer 23

deaths+ marriage +births +migration = vital statistics

Question 24

what are vital statistics used for?

Answer 24

to calculate certain measures such as birth rate, mortality rate, etc.
help us understand characteristics pf the population and factors that affect the population

Question 25

what did the WHO commission on the SDOH acknowledge in terms of addressing inequities?

Answer 25

the ability to address inequities requires a routine monitoring system in place focused on health inequities and the SDOH

Question 26

what did The WHO Commission on Social Determinants of Health (2008) suggest as the Minimum Health Equity Surveillance System (4). describe each

Answer 26

• measures of morbidity and mortality (stratified by sex; two social markers; at least one regional marker)
• summary measures about absolute health inequities (risk differences)
• summary measures of relative health inequities between social groups (rate ratios)
• use of good quality data, where available, on indigenous peoples