S2 4 - Health Inequalities

Question 1

Define the term ‘health inequality.’

Answer 1

Any preventable, unfair or unjust difference in health status between groups, populations or individuals

Question 2

Draw out the circle of determinants of health.

Answer 2

see document

Question 3

Finish the following:

A man living in the most deprived area of England will live ———– years less than a man living in the least deprived area. For women, the gap is —– years

Answer 3

9. 3

7. 4

Question 4

Finish the following:

The gap in healthy life expectancy is ——years for men and —– for women but can be more in local areas (average healthy life expectancy is ——- years for men, —–for women)

Answer 4

18. 9
19. 6
20. 4
21. 1

Question 5

State 5 reasons why there are higher mortality rates (premature deaths) in more deprived areas?

Answer 5

cardiovascular disease
cancer
lung cancer 
chronic lower respiratory diseases
suicide

Question 6

State 4 reasons why there are wide inequalities in child health outcomes?

Answer 6

↑ chance of being born with low birth weight
↑ infant mortality rate
↑ tooth decay
↑ obesity

(Note that: deprivation is not the only determinant of health inequality, but it does play a major role)

Question 7

What did the Black Report (1980) find?

Answer 7

The Black Report (1980):
Upper socio-economic classes have a greater chance of avoiding illness and staying healthy than those in lower classes
Differences in the risks to men and women
Variations in ‘healthiness’ of living in different parts of the country

Question 8

State 3 important findings in health inequality.

Answer 8

a small income difference across society is associated with better health (egalitarian society)
health can be improved by building social capital
differences in health experience are not just about differences in social class

Question 9

State the 11 recommendations for action from the Acheson Report (1998).

Answer 9

poverty
employment
the environment
nutrition
gender
child, adult, older people’s health
education
housing
transport
ethnicity
the NHS

Question 10

What must be noted about health promotion activities?

Answer 10

they may only reach the better off people

Efforts to change people’s environments may have a negative effect

Question 11

Why must we tackle health inequalities?

Answer 11

Reducing health inequalities means giving everyone the same opportunities to lead a healthy life, no matter where they live or who they are

Question 12

State how we are tackling health inequalities using a Programme for Action (2003)?

Answer 12

Set out plans to tackle health inequalities in general but also….
Set 2 national targets and….
Acknowledged the need for a long-term plan

Question 13

Summarise the targets for tackling health inequalities by 2010.

Answer 13

By 2010:
Narrow the gap in life expectancy by geographical area
Reduce infant mortality

Question 14

State 4 interventions to increase life expectancy.

Answer 14

Reduce smoking
Prevention and management in primary care
Environmental improvements
Targeting over 50’s

Question 15

State 5 interventions to reduce infant mortality.

Answer 15

Sure Start
↓ smoking in pregnancy
↓ teenage pregnancy
Improve housing
Early intervention for NHS

Question 16

State the 4 parts of Tackling Health Inequalities: 10 years on (published May 2009).

Answer 16

Fair Society, Healthy Lives- strategic review of health inequalities post 2010 (Marmot Review)
UCL Institute for Health Equity launched November 2011
Public Health Outcomes Framework 2013
Public Health England:
- Public Health Matters (2017)
- Reducing health Inequalities: system, scale and sustainability (2017)

Question 17

State how we can intervene to reduce health inequalities as from PHE report (2017).

Answer 17

Intervening at different levels of risk
Intervening for impact over time
Intervening across the life course
Whatever is done has to be sustainable, delivered systematically and needs to reach large sections of the population

Question 18

State how identifying the causes and understanding the interconnections is important.

Answer 18

Risk conditions, psycho-social risks and behavioural risk factors interconnect and result in changes in the body that either leads to illness or health

Question 19

Draw out a diagram of the pattern of risks affecting health and well-being.

Answer 19

(see document)
A comprehensive approach to reducing health inequalities means having interventions across all 3 areas of A, B and C as well as tackling the risk conditions

Question 20

State the 8 risk conditions (creators of health inequalities).

Answer 20

Poverty
Low social status
Poor education
Unemployment
Dangerous Environments
Discrimination
Steep power hierarchy
Gaps/weaknesses in services and support

Question 21

State the 7 things needed to tackle psycho-social risks (causes of the causes).

Answer 21

Isolation
Lack of social support
Poor social networks
Low self-esteem
High self-blame
Low perceived power
Loss of meaning/purpose of life

Question 22

State 4 behavioural risks which psycho-social risks lead to.

Answer 22

Smoking
Poor diet
Lack of activity
Substance abuse

Question 23

State 4 physiological (attributable) risks which behavioural risks lead to and state what they increase.

Answer 23

High blood pressure
High cholesterol
Chronic stress hormones
Anxiety/depression
These increase morbidity (being ill, having a disease or being unhealthy) and mortality (death)

Question 24

What does an intervention at a life course approach mean?

Answer 24

means action to reduce health inequalities starts before birth through to old age

Question 25

State 6 policy objectives to tackle health inequalities established by the Marmot review.

Answer 25

Give every child the best start in life
Enable all children, young people and adults to maximise their capabilities and have control over their lives
Create fair employment and good work for all
Ensure a healthy standard of living for all
Create and develop healthy and sustainable places and communities
Strengthen the role and impact of ill health prevention

Question 26

State 9 findings of the Marmot review.

Answer 26

A system for health and wellbeing demands a broader focus than healthcare services
Only 20% of health outcomes result from clinical interventions
80% are driven by wider determinants of health (lifestyle choices, social networks, environmental factors)
Need a cross-sector approach at local and national level
Need to break the cycle of inequalities
Tackle the major killers
Improve access to public services
Strengthen disadvantaged communities
Target specific groups

Question 27

State 5 ways we can break the cycle of inequalities.

Answer 27

child’s health is significantly affected by parent’s socio-economic status
need to tackle poverty and deprivation if the health gap is to reduce
education and employment are fundamental determinants of health inequalities
reduce differences in early years’ development of children
teenage pregnancy is strongly associated with deprivation and associated health risks for the baby

Question 28

State the 4 major killers to be tackled.

Answer 28

Smoking
Coronary heart disease
Obesity
Cancer

Question 29

State the 3 major killers of children to be tackled.

Answer 29

fire deaths for children
suicide
diabetes

Question 30

In which 2 ways can we improve access to public services and facilities?

Answer 30

Those in greatest need of public services often have the lowest levels of use and poorest access
Need to consider access to, and use of NHS, local authority services, employment services, housing and social services, community facilities

Question 31

State 4 ways to strengthen disadvantaged communities.

Answer 31

Many areas suffer multiple deprivation
Strong link between area-based deprivation and health inequality
Poor physical environment has negative effect on health
Government strategies included Neighbourhood Renewal, Health Action Zones

Question 32

State 10 specific groups to be targeted for change.

Answer 32

Vulnerable older people
Vulnerable members of BME communities
‘Fuel poor’
Rough sleepers
Prisoners and their families
Refugees and asylum seekers
Looked after children
People with physical or learning difficulties
Long-term medical conditions
Mental health problems