Patterns of health and health inequalities in the UK

Question 1

Define epidemiological transition.

Answer 1

A theory which describes the change in population patterns that occur following development, in terms of birth rates, death rates, and causes of death

Question 2

Name the 5 stages of epidemiological transition.

Answer 2

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

Question 3

What is stage 1 of the epidemiological transition characterised by?

Answer 3

High mortality, infectious disease, malnutrition

Question 4

What is stage 2 of the epidemiological transition characterised by?

Answer 4

Reduction in rate of infectious disease mortality

Question 5

What is stage 3 of the epidemiological transition characterised by?

Answer 5

More non-communicable disease

Question 6

List 4 indicators of population health.

Answer 6

Life expectancy

Infant mortality

Healthcare use (e.g. hospital or emergency admission)

Public health or disease-specific indicators

Question 7

Give 2 reasons why infant mortality is a useful indicator of population health.

Answer 7

Correlates well with other measures (e.g. disability-adjusted life expectancy), but simple to measure

Sensitive to social determinants of health

Question 8

Describe the overall basic trend for life expectancy from 1980 to now.

Answer 8

Life expectancy of both males and females have risen, with females having a higher life expectancy.

Recently, life expectancy has plateaued

Question 9

Describe the overall basic trend infant mortality from 1980 to now.

Answer 9

Gradually reducing but beginning to level off

Question 10

List the 5 leading causes of death in the UK, with percentages.

Answer 10

Dementia – 11.5%

Ischaemic heart disease – 10.3%

Chronic respiratory disease – 5.2%

Cerebrovascular disease – 5.1%

Lung cancer – 5%

Question 11

Which measure can be used to assess the relative level of deprivation in different small geographic areas?

Answer 11

Index of multiple deprivation

Question 12

Which sex spends more of their life in poorer health?

Answer 12

Females

Question 13

Describe how infant mortality rates change with ethnicity.

Answer 13

Black and Asian ethnicities have higher infant mortality rates than white ethnicity

Question 14

Describe how life expectancy changes in north and south England.

Answer 14

Northern areas have a lower life expectancy than southern areas of England

Question 15

Define equality.

Answer 15

Equal rights, treatment, or opportunities that are of the same form, value and benefit

Question 16

Define equity.

Answer 16

Fair and impartial rights, treatments or opportunities, so everyone has the same overall benefit

Question 17

Give a healthcare example of equality vs equity involving vaccinations.

Answer 17

Equality – available to all if you attend a central vaccination clinic

Equity – mobile vaccination clinic sent to remote, underserved areas

Question 18

Define inequality.

Answer 18

Measurable differences in health between different groups – may be avoidable or unavoidable

Question 19

Define inequity.

Answer 19

Avoidable differences in health between different groups

Question 20

Give an example of inequality in health.

Answer 20

Life expectancy is different in those born male and those born female

Question 21

Give an example of inequity in health.

Answer 21

Geographical access – rural residents find it more difficult to access facilities

Question 22

What are the 2 types of inequity in relation to access to healthcare?

Answer 22

Horizontal
Vertical

Question 23

Define horizontal inequity.

Answer 23

Those with the same need do not have the same access

Question 24

Define vertical inequity.

Answer 24

Those with different needs are not provided with the level of resource appropriate for those needs

Question 25

What are the 4 potential explanations / models for the social gradient in health?

Answer 25

Behaviour model Materialist and neo-materialist model Psychosocial model Life course model

Question 26

The behavioural model of health inequities asserts that inequities result from what?

Answer 26

Variations in lifestyle behaviours

Question 27

The materialist model of health inequities asserts that inequities result from what?

Answer 27

Differences in direct access to material resources, e.g. housing quality, income, working conditions

Question 28

The neo-materialist model of health inequities emphasises the additional importance of what? Give 3 examples.

Answer 28

Access at a community level, e.g. access to good education, healthcare, nutritious food

Question 29

The psychosocial model of health inequities asserts that inequities result from what?

Answer 29

Stress – due to low income, poor social networks

Question 30

Give an example of how stress can affect health both directly and indirectly.

Answer 30

Directly – neuroendocrine response to stress Indirectly – adoption of unhealthy behaviours

Question 31

What is the lifecourse explanation of health inequities?

Answer 31

The idea that health inequities develop over a person’s life due to cumulative social, economic, and environmental factors starting from before birth

Question 32

Which type of inequity can be summed up as "unequal treatment of equals"?

Answer 32

Horizontal inequity

Question 33

Which type of inequity can be summed up as "equal treatment of unequals?"

Answer 33

Vertical inequity