(O.3) Health Inequities: Case Study

Question 1

Health inequities are a health and societal concern because:

Answer 1

• They are inconsistent with Canadian values
  (Canadian Health Act - everyone should have access)
• They are unfair
• They cause preventable suffering
• They threaten the cohesiveness of community and society
• They challenge the sustainability of the health system
• They have an impact on the economy
  (Disproportionately effect sectors in workforce)

Question 1

Differences in health are commonly referred to as:

Answer 1

Health disparities or Health inequalities

Question 2

Correlation not causation - ex. women’s shoe size and life expectancy

Answer 2

Yes there is a difference, doesn’t mean we should allocate resources to it

Question 3

Health inequities

Answer 3

differences in health which are unnecessary and avoidable but, in addition, are considered unfair and unjust

Question 4

T or F: Health inequities are any difference in health

Answer 4

F:
*Unnecessary
- Genetic and biological conditions
- lead to different health outcomes, no means to do anything about it

*avoidable
*unfair
*Unjust

Question 5

Unnecessary differences in health

Answer 5

*different life expectancies in first nations metis inuit vs non (10 yr)
* life expectancy by income (4yr)
* based on education - lowest ed have on avg 3 yrs less than those in highest quintile

• not a biological difference, man made issues, not fair
• unnecessary doesn’t have to be that wau

Question 6

Avoidable differences in health

Answer 6

*suicide death rates by deprivation

*Life expectancy at birth for those with cystic fibrosis
- is this truly avoidable, because people have genetic conditions?

*life expectancy in canada vs us
- avoidable because man made border creating 10 year difference

social phenomena affecting it = avoidable

Question 7

Unjust differences in health

Answer 7

“… equality for its own sake can become absurd if it requires depriving people of some good, even if everyone has sufficient amounts of that good, simply in order for equality to obtain– imagine blinding people in order that everyone is equally sighted.” - smith

	○ Observe how one group is doing as opposed to another, and deprive them to make them equal

Question 8

Unfair differences in health

Answer 8

“If we already thought that a given health inequality was unjust.. I do not think that being also told that the inequality was ‘unnecessary and avoidable’ would add anything. Conversely, if we did not know whether a difference in health was inequitable, discovering that the difference was unnecessary and avoidable would not provide a reason in and of itself to think the difference in question was inequitable.” - wilson

Question 9

Approaches to defining health inequities: Free-standing & Derivative

Answer 9

• ‘Free-standing’: any and all health inequalities/disparities are unjust

*‘Derivative’: health inequalities are unjust if and only if they are caused by unjust socially controllable causes
○ Racism = worse health outcomes

Question 10

T or F: social justice is a matter of life and death

Answer 10

T: WHO

Question 11

T or F: The social determinants of health are addressed via policies in health sectors

Answer 11

F: via policies in non-health sectors

• Education, finance, environment, etc.
• Often need to intervene in other sectors to make significant changes

Question 12

T or F: the reduction of health inequities is not dependent on interventions in non-health sectors

Answer 12

T: IS!!!

Question 13

T or F: Difficult to get public on board to care about health inequities

Answer 13

T

Question 14

Brian Sinclair

Answer 14

• dies after waiting 34hrs in Winnipeg emergency room with bladder infection
• Aboriginal double amputee

*Question whether racism played role in his death
- Dead for 7 hours before declared
- “assumed he was drunk and sleeping it off”

*Underlying assumptions cause racism

Question 15

Policy approaches to health inequities

Answer 15

1. Universal policy approaches
2. Targeted policy approaches
3. Proportionate universal policy approaches

Question 16

which policy approach to health inequities: a policy approach where eligibility and access to intended benefits are based simply on being part of a defined population without any further qualifiers such as income, education, class, race, place of origin, or employment status

Answer 16

Universalism (universal policy approaches)

**Apply to everyone
**Ensuring there are no barriers, restrictions, ineligible populations for said policy

*COVID vax available to anyone 6 months+
*Canada Health Act = accessibility

Question 17

which policy approach to health inequities: a policy approach where eligibility and access to intended benefits are determined by selection criteria, such as income, health status, employment status, or neighbourhood

Answer 17

Targeted approach

*If you want to target inequities = target policies specifically to disadvantaged

Question 18

which policy approach to health inequities: a policy approach that “encompasses both targeted and universal approaches to ensure the population as a whole is proportionately allocated benefits and services

Answer 18

Proportionate universalism approach

*Everyone will be eligible but benefit is in proportion to needs
* Use resources to those who need more

• Ex. Healthy babies, healthy children policy
  ○ Provide no cost home visits to new mothers
  ○ Universal - everyone is eligible
  Low income/other criteria may receive additional resources

Question 19

T or F: targeted policy approach is most difficult to design

Answer 19

F: Proportionate universalism approach