overview of health care inequalities

Question 1

why do poorer people have more need of healthcare?

Answer 1

• behavioural causes: ppl in deprived areas more likely to smoke, have poor diets, not do exercise
• psychosocial: stress of working in poorly paid, low status jobs with low autonomy
• material: direct effects of poverty
• access to healthcare: deprivation population have poorer healthcare

Question 2

what is the clinical iceberg?

Answer 2

the fraction of treatment that makes it into formal clinical healthcare (the bulk of the iceberg underneath the sea surface is dealt with in the informal sector or self-care)

Question 3

what factors affect access to healthcare?

Answer 3

• travel distance to facilities and transport
• requiring communication services e.g. immigrants
• waiting times
• availability of services/appointments (e.g. IVF not available to all)
• quality of treatments - providers (e.g. Staffordshire) and population groups (e.g. elderly care)
• charges to healthcare (non-UK)

Question 4

What is the inverse care law?

Answer 4

‘the availability of good medical care tends to vary inversely with the need for it’

i.e. those who need healthcare the most have the least access to it/most restricted.

Question 5

what is the difference between equality and equity?

Answer 5

equality = treat everyone the same regardless of need or ability

equity = recognising people have different needs and try to minimise the gap between level of healthcare so that those who are poorer/have more needs get more care > bring everyone to same level

Question 6

what are possible reasons for lower survival rates in more deprived populations?

Answer 6

differences in:
diagnosis - delays, more advanced stages of disease
treatment - delays, poorer access
general health
type of disease - more aggressive

Question 7

how can we reduce inequalities and inequity in healthcare?

Answer 7

• reviews
• guidlines
• targets and payments
• frameworks
• regulators

Question 8

what is the UK Quality and Outcomes Framework (QoF)?

Answer 8

• national scheme for GPs introduced in 2004
• assess inequalities in care e.g. socioeconomic, gender, age, ethnicity
• provide outcomes to reduce inequalities/inequity such as increased funding
• concern is that doctors could behave bad just for money e.g. Staffordshire hospital