Lect 19 to 20 Flashcards
Describe Socio economic position (SEP)
social and economic factors that influence what positions individuals or groups hold within the structure of a society
Describe how SEP must be measured
objective, measurable and meaningful
4 key association of SEP and population health
SEP measures the level of inequality within or between societies
may highlight change to population structures over time
SEP is needed to help understand the relationship between health and other social variables (age, sex, ethnicity
are associated with health and life chances within social groups
What are the 6 measures of SEP for an individual
Education Income Occupation Housing Assests and weath
SEP and population measures
Area measures
population measures
Describe Area measures
Deprivation
Access
Describe Population measures
Income inequality
literacy rates
GDP per capita
SEPS relation to the Dahlgren & Whitehead model
Individuals lifestyle factors
- Education, occupation and income
State and Describe the factors of SEP that influence the Dahlgren and Whitehead model (individual lifestyle) factors)
The decisions you make, influence your opportunities
Education (knowledge)
Income- material goods
Occupation- status, power
Education and SEP relation to health (individual lifestyle in the DWM
Education influences Occupation Income Health Assets/ wealth
DWM
Social and community association with SEP
Social and community influences
- parents education, occupation, income
Parents SEP can be associated with children SEP.
DWM
living and working conditions measures
association with SEP
NZ Index of Deprivation (NZ dep)
Index of Multiple Deprivation (IMD)
Other measures:
Social fragmentation and accessibility indices
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State what this acronym stands
State the Variables included in the NZDEP
Communication
Transport
Employment
Support
Owned home
Income
Income
Qualifications
Describe communication in terms of the NZdep
people ages over 65 with no access tot he internet at home
Describe transport in terms of the NZdep
people with no access to a car
Describe Employment in terms of the NZdep
people ages 18-64 unemployed
Describe Support in terms of the NZdep
People aged under 65 living in a single parent family
Describe Owned home in terms of the NZdep
people not living in own home
Describe Income in terms of the NZdep
People ages 18-64 receiving a means test benefit
Describe Income in terms of the NZdep
People living in controlled households with income below an income threshold
Describe SEP and the DWM in terms of the level
Socioeconomic, cultural and environmental conditions
NZ census mortality study can be used Global determinants include income inequality GDP literacy rates free trade agreements
Describe the social gradient with health
Most deprived areas face a proportionally higher impact
state the key sources for population health data
the census
Health Services and outcomes (HSU)
Integrated utilization and outcomes (IDI)
Describe the census
everybody answered in 2018, and who is usual resident.
Enumeration officers contact individual households in their mesh-blocks, containing about 100 people each.
Strength of the census
• Traditionally, nearly 100% coverage.
- Everybody who answered census in 2013, and who is usual resident.
• Data can be recoded
weaknesses of the census
- Homeless, people not living in their home (on holiday) not counted.
- Issues with 2018 online-first census.
Describe the health service utilization and outcomes HSUO
HSU population: based on people that have used health system at least once in 12 months
prior to given date e.g. census night.
MoH record and report publicly funded health information e.g.
hospitalisations, blood tests,
pharmaceutical dispensing.
strength of HSUO
Strengths:
• Based on internationally standard coded definitions for hospitalisations etc
weakness of HSUO
• Doesn’t include data of operations/utilisation from the private sector,
— don’t have a good picture of private sector operations e.g. surgeries.
HSU population under-represents compared w/ census population as younger age group tend not to go to doctor.
Describe the integrated data infrastructure
Based on people that have used health education, tax other services at least
once in 12 months prior to given date e.g. census night in 2013.
• To be counted one must have interaction w/ key services.
- Conglomerate of data from different government agencies
strength of integrated data infrastructure
Data from many sources can be linked to create a population base. Population repository
used to predict pathways.
weakness if integrated data
Possible bias as to who is recorded e.g. in crime reports therefore crime population may have
different demographic from general population.
• Over-representation of lower incomes/different ethnicities depending on usage of services.
Describe population pyramids
- Population structure — age and sex (counted or percentage) • Could be broken into sub population by ethnicity. • Population composition — other attributes, variables. - X-axis — males on left, females on right. - Y axis — age in single/five year increments. - Bars are count/percentage of people in each age/sex group. - Can be used to look into history — compare different demographics e.g. Māori/non-Māori.
what is the dependency ration
Number of children/elderly that working population support.
Child
0-14 years/ working age X 100
Elderly
over 65/working age X 100
- Total
- (youth+elderly populations)/working age population x 100
state the different ways to calculate demographic measures
CRUDE BIRTH RATE
GENERAL FERTILITY RATE
AGE-SPECIFIC FERTILITY RATE
TOTAL FERTILITY RATE
what is crude birth rate
- Number of births/number of total population per 1000.
- Males included in denominator, but do not produce babies.
what is general fertility rate
Denominator only females.
• Males excluded.
what is age specific fertility rate
- More specific patterns for younger/older mothers.
what is total fertility rate
- Average measure of fertility in a country.
• Good measure for international comparisons. - 2.1 births per woman known as replacement level.
• Indicates whether migration needed to keep population steady. - TFR sum of age-specific fertility rates x5, as five years in each age-specific band.
- Regional variations, e.g. urban/rural difference.
Describe and state the types if ageing
TYPES OF AGEING
Numerical ageing — absolute increase in population that is elderly; count of people who are
old.
• Due to better health treatments, life expectancy etc.
Structural ageing — increase in proportion of population that is elderly.
• Driven by decrease in fertility rates.
Describe the 2 ways population impact of ageing
- Natural decline occurs when there are more deaths than births in a population.
• Combination of absolute and structural ageing.
• More elderly means more deaths.
Absolute decline occurs when there is insufficient migration to replace ‘lost births’ and
increased deaths.
• Not expected in NZ for 70+ years.
