Inequalities in health

Question 1

define health inequalities

Answer 1

Health inequalities are systemic differences in health groups of people and includes moral and ethical dimensions

Question 2

determinants of health

Answer 2

age, sex, genetics, social and community networks, food, education, work environment, living and working conditions, unemployment, water and sanitation

Question 3

Key findings of the Black report

Answer 3

Persistent problem in inequalities in health were widening rather than diminishing despite, not because of the NHS:
Health of the population had improved generally, but unequal across the social classes
The poorest had the highest rates of ill health and death
Not explained solely by income, education, housing, employment, mobility, or lifestyle
Caused by a lack of a coordinated policy that would ensure uniform delivery of services.

Question 4

recommendations from the Black report

Answer 4

government should adopt a policy of spending more money on health education and the prevention of illness aimed at reducing poverty in the UK

Question 5

6 recommendations from the Acheson report

Answer 5

Actions to reduce inequalities in health:
Reducing income inequality
Reducing unemployment and improving employment opportunities
Reducing risk of poverty in families
Improving housing conditions for less well off
Improving schooling for less well off
Improving living environment- crime reduction, reduction in cars, increasing walking, cycling, public transport.

Question 6

when was the Marmot review conducted

Answer 6

2010

Question 7

key themes of the marmot review 2010

Answer 7

Reducing health inequalities is a matter of fairness and social justice
Action is needed to tackle the social gradient in health- proportionate universalism
Action on health inequalities requires action across all the social determinants of health
Reducing health inequalities is vital for the economy- cost of inaction
Beyond economic growth to well-being

Question 8

6 policy objectives of the Marmot review 2010

Answer 8

Give every child the best start in life
Enable all children, young people and adults to maximise their capabilities and have control over their lives
Create fair employment and good work for all
Ensure healthy standard of living for all
Create and develop healthy and sustainable places and communities
Strengthen the role and impact of ill-health prevention

Question 9

Recommendations of the Marmot review for giving every child the best start in life

Answer 9

Increase proportion of expenditure allocated to early years
Support families (pre and post-natal, parenting, parental leave, transition points)
Quality early years and outreach

Question 10

Recommendations from Marmot review- enable all young people, children and adults to maximise their capabilities and take control over their own lives

Answer 10

Continued priority to reducing inequalities in education outcomes
Prioritise inequalities in life skills (whole child approach, full service schools, workforce)
Increase access and use of quality lifelong learning (16-25 year old support, work based learning, non-vocational courses)

Question 11

Recommendations Marmot review- create fair employment and good work for all

Answer 11

Prioritise active labour market programmes
Quality of jobs improved (equality legislation, well being, stress and mental health at work)
Security and flexibility of employment (retirement and people with poor health and caring responsibilities)

Question 12

Marmot 2010 recommendations for ensuring a healthy standard of living

Answer 12

Minimum income for healthy living
Remove cliff edges
Review taxation and welfare system

Question 13

Marmot review 2010 recommendations for Create and develop healthy and sustainable places and communities

Answer 13

Combining policies to mitigate climate change and health (active travel, green space, food environment, energy efficiency)
Integrate planning, transport, housing environmental and health systems
Regeneration based on reducing social isolation and remove barriers to action

Question 14

Marmot 2010 recommendations for Strengthen the role and impact of ill-health prevention

Answer 14

Prioritise prevention and early detection of those conditions most strongly related to health inequalities
Increase availability of long-term and sustainable funding in ill health prevention across the social gradient

Question 15

describe health inequalities today

Answer 15

Life expectancy gains are grinding to a halt in England with the poorest 10% mot affected and the most deprived women seeing an unprecedented fall

There are significant regional health inequalities with the North generally faring the worst

Clear social gradient for preventable mortality- poorest areas have highest preventable mortality rates

Austerity measures, cuts to services and the taxation/welfare system have hit the poorest the hardest

Children’s wellbeing in England ranks 27/38 rich countries

Question 16

current challenges for health inequalities

Answer 16

Effects of Covid
Economy vs health or economy=health
Political priority?
Timescales
Implications of Brexit

Question 17

Solutions provided by the Marmot 2020 review

Answer 17

develop a national stretegy for action on the social determinants of health with the aim of reducing inequalities in health

ensure proportionate universal allocation of resources and implementation of policies

early intervention to prevent health inequalities

develop the social determinants of health workforce

engage the public

develop whole systems monitoring and strengthen accountability for health inequalities

proportionate universalism