Patterns of health and health inequalities in the UK Flashcards
Define epidemiological transition.
A theory which describes the change in population patterns that occur following development, in terms of birth rates, death rates, and causes of death
Name the 5 stages of epidemiological transition.
1 – Pestilence & famine - high mortality, infectious disease, malnutrition
2 – Receding pandemics - reduction in rate of infectious disease mortality
3 – Degenerative & man-made disease - more non-communicable disease
4 – Declining cardiovascular disease mortality, ageing, and emerging diseases
5 – Aspired quality of life with persisting health inequalities
What is stage 1 of the epidemiological transition characterised by?
High mortality, infectious disease, malnutrition
What is stage 2 of the epidemiological transition characterised by?
Reduction in rate of infectious disease mortality
What is stage 3 of the epidemiological transition characterised by?
More non-communicable disease
List 4 indicators of population health.
Life expectancy
Infant mortality
Healthcare use (e.g. hospital or emergency admission)
Public health or disease-specific indicators
Give 2 reasons why infant mortality is a useful indicator of population health.
Correlates well with other measures (e.g. disability-adjusted life expectancy), but simple to measure
Sensitive to social determinants of health
Describe the overall basic trend for life expectancy from 1980 to now.
Life expectancy of both males and females have risen, with females having a higher life expectancy.
Recently, life expectancy has plateaued
Describe the overall basic trend infant mortality from 1980 to now.
Gradually reducing but beginning to level off
List the 5 leading causes of death in the UK, with percentages.
Dementia – 11.5%
Ischaemic heart disease – 10.3%
Chronic respiratory disease – 5.2%
Cerebrovascular disease – 5.1%
Lung cancer – 5%
Which measure can be used to assess the relative level of deprivation in different small geographic areas?
Index of multiple deprivation
Which sex spends more of their life in poorer health?
Females
Describe how infant mortality rates change with ethnicity.
Black and Asian ethnicities have higher infant mortality rates than white ethnicity
Describe how life expectancy changes in north and south England.
Northern areas have a lower life expectancy than southern areas of England
Define equality.
Equal rights, treatment, or opportunities that are of the same form, value and benefit
Define equity.
Fair and impartial rights, treatments or opportunities, so everyone has the same overall benefit
Give a healthcare example of equality vs equity involving vaccinations.
Equality – available to all if you attend a central vaccination clinic
Equity – mobile vaccination clinic sent to remote, underserved areas
Define inequality.
Measurable differences in health between different groups – may be avoidable or unavoidable
Define inequity.
Avoidable differences in health between different groups
Give an example of inequality in health.
Life expectancy is different in those born male and those born female
Give an example of inequity in health.
Geographical access – rural residents find it more difficult to access facilities
What are the 2 types of inequity in relation to access to healthcare?
Horizontal
Vertical
Define horizontal inequity.
Those with the same need do not have the same access
Define vertical inequity.
Those with different needs are not provided with the level of resource appropriate for those needs
What are the 4 potential explanations / models for the social gradient in health?
Behaviour model
Materialist and neo-materialist model
Psychosocial model
Life course model
The behavioural model of health inequities asserts that inequities result from what?
Variations in lifestyle behaviours
The materialist model of health inequities asserts that inequities result from what?
Differences in direct access to material resources, e.g. housing quality, income, working conditions
The neo-materialist model of health inequities emphasises the additional importance of what? Give 3 examples.
Access at a community level, e.g. access to good education, healthcare, nutritious food
The psychosocial model of health inequities asserts that inequities result from what?
Stress – due to low income, poor social networks
Give an example of how stress can affect health both directly and indirectly.
Directly – neuroendocrine response to stress
Indirectly – adoption of unhealthy behaviours
What is the lifecourse explanation of health inequities?
The idea that health inequities develop over a person’s life due to cumulative social, economic, and environmental factors starting from before birth
Which type of inequity can be summed up as “unequal treatment of equals”?
Horizontal inequity
Which type of inequity can be summed up as “equal treatment of unequals?”
Vertical inequity
