Inequalties

Question 1

What are inequalities

Answer 1

Measurable differences or variations in health

Question 2

What is the social gradient

Inequalities

Answer 2

Differences in health experience and outcomes between different populations groups according to SEP, area, age, disability, gender, ethnic group/

Question 3

What are inequities

Answer 3

Inequalities that are deemed to be unfiar or stemming from some form of injustice

Question 4

What are health inequities

Answer 4

Differences in the distribution of resources/services across populations which do not reflect health needs

Question 5

Why reduce inequalities

Answer 5

1. They are unfair
2. Unavoidable
3. Affect everybody
4. Reducing inequities can be cost effective

Question 6

Describe Maori health status using key indicators

Question 7

Maori ehalth is exemplified by what systematic disparities

Answer 7

• Health outcomes
• in exposure to the determinants of health
• in health system responsiveness,
• in representation in health workforce

Question 8

What does structural interventions refer to from the lessons from the titanic

Answer 8

More lifeboats and no barriers

Question 9

Social interventions from lessons from the titanic

Answer 9

• rights based approach, commitment to review and ‘level playing field’
• not aimed at individual behavior

Question 10

three

What are the determinants of ethnic inequities in health

Answer 10

1. differential access to health determinants or exposures leading to differences in disease incidence
2. differential access to health care
3. differences in quality of care received

Question 11

Structural contribution in Maori health

Answer 11

That the power, resources and opportunities of NZ society are organised by ethnicity

Question 12

Societal contribution in Maori health

Answer 12

There are values and assumptions widely held in NZ society about the deservedness of different groups of people

Question 13

What are downstream determinants

Answer 13

A determinate of health that is proximate or near to the change in health of status

Question 14

What is an upstream determinate

Answer 14

A determinate of healht that is either distant in time and/or plae from the change in health status

Question 15

What is the difference between upstream and downstream determinants

Answer 15

Upstream - what cases people to smolke
* interventions operate at the macro (proximal) level including treatment systems and disease management

Downstream - what causes exposure to cigartte smoke
* interventions operate at the macro (distal) level such as the government

Question 16

What are the four capitals

Answer 16

Intergenerational wellbeing relying on growth, cultural and environmental conditions. They are interdependent and workd together

Question 17

What is natural capital

Answer 17

Refers to all aspects of the natural environment needed to support life and human activity
e.g land, soil, water, plants

Question 18

What is social capital

Answer 18

The norms and values that underpin society
* includes trust, the rule of law, the Crown-Maori relationship, cultural identity and the connections between the people and the communities

Question 19

What is human capital

Answer 19

• people’s skills, knowledge and physical and mental health
• things that enable people to partake fully in work, study, recreation and society more broadly

Question 20

What is financial capital

Answer 20

• Inclues things like houses, roads buildings
• make up the countries physical and financial assets which have a direct role in supporting incomes and material living conditions

Question 21

What is structure in population health

Answer 21

• Social and physical environment conditions/pattersn (sometimes refered to as social determinants) that influence chouss and opportunities available

Question 22

What is agency in population health

Answer 22

The capacity of an individual/community to act independently and make free choices

Question 23

What is the purpose of the Dahlgren and Whitehead framwork

Answer 23

Identify determinants of health (risk or protective factors of disease) and consider levels of intervention

Question 24

What does it mean when there is permeability between the factors of the D&W model

Answer 24

• No arch operates in isolation from the others
• Events at one level may impact on factors at another

Question 25

What is social-economic position

Answer 25

The social and economic factors that influence what positions individuals or groups hold within the structure of society

Question 26

What three things must the determinatns of SEP be

Answer 26

Objective, measurable and meaningful

Question 27

Why do we measure SEP

Answer 27

* quanitify the level of inequality within or between our socities * highligh changes to population structures over time * understand relationship between health and other social variables (age, sex, ethnicity)

Question 28

What factors do we look at when measuring SEP for individuals

Answer 28

Education, income, occupation, housing and assets and wealth

Question 29

What do we look at when measuring SEP for populations

Answer 29

**Area measures:** deprivation, and access **Population measures:** income inequality, literacy rates, GDP per capita

Question 30

SEP on living and working conditions

Answer 30

Using area based measures of SEP, other measues include social fragmentaion, and accessibility indices

Question 31

What is the definition of deprivation

Answer 31

A state of observable and demonstrable disadvantage relative to the local community of the wider socity or nation to which an individual, family or group belongs

Question 32

Where should deprivation be applied to

Answer 32

Conditions and quality of life that are of a lower standard that is ordinary in a particular society

Question 33

What are the variables included in NZDep2013

Answer 33

* Communication * income * employment * qualification * owned home * support * living space * living conditions

Question 34

SEP on the general socio-econimic, cultural and environmental condotions

Answer 34

* Group populations with similar SEP levels together and compare * cross sectional or longitudinal analyses

Question 35

Advantage of prioritised output

Answer 35

* ensures that where some need exists to assign people to a single ethnic group * produces data easy to work with as each individual appears once. sum of ethnic group will add up to total NZ population

Question 36

Disadvantage of prioritised output

Answer 36

* Places people in specific ethnic groups which simplifies yet biasses the resulting statistics as it over-represents some groups at the expenes of others in ethnic group counts * externally applied single ethnicity which is inconsistent with the concept of self-identifcation.

Question 37

Advantage of total response output

Answer 37

Potential to represent people who do not identify with any given ethnic group, depending on the level of detail reported

Question 38

Disadvantages of total response output

Answer 38

* Create complexities in the distribution of funding ased on population numbers or in monitoring changes in the ethnic composition of a population in health * create issues in interpretation of data reported by ethnic groupings where comparisons between groups include overlapping data.

Question 39

What is numeral ageing

Answer 39

The absolute increase in the population that is elderly * reflects previous demographic patterns * improvements in life expectancy

Question 40

What is structural ageing

Answer 40

The increase in the proportion of the population that is elderly * driven by decreases in fertility rates

Question 41

What is a natural decline of the population

Answer 41

Occurs when there are more deaths than births in a population * combination of absolute and structural ageing * more elderly = more deaths

Question 42

What is absolute decline of the population

Answer 42

Occurs when there is insufficient migration to replace the 'lost' births and increased deaths