S2 4 - Health Inequalities Flashcards
Define the term ‘health inequality.’
Any preventable, unfair or unjust difference in health status between groups, populations or individuals
Draw out the circle of determinants of health.
see document
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
- 3
7. 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)
- 9
- 6
- 4
- 1
State 5 reasons why there are higher mortality rates (premature deaths) in more deprived areas?
cardiovascular disease cancer lung cancer chronic lower respiratory diseases suicide
State 4 reasons why there are wide inequalities in child health outcomes?
↑ 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)
What did the Black Report (1980) find?
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
State 3 important findings in health inequality.
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
State the 11 recommendations for action from the Acheson Report (1998).
poverty employment the environment nutrition gender child, adult, older people’s health education housing transport ethnicity the NHS
What must be noted about health promotion activities?
they may only reach the better off people
Efforts to change people’s environments may have a negative effect
Why must we tackle health inequalities?
Reducing health inequalities means giving everyone the same opportunities to lead a healthy life, no matter where they live or who they are
State how we are tackling health inequalities using a Programme for Action (2003)?
Set out plans to tackle health inequalities in general but also….
Set 2 national targets and….
Acknowledged the need for a long-term plan
Summarise the targets for tackling health inequalities by 2010.
By 2010:
Narrow the gap in life expectancy by geographical area
Reduce infant mortality
State 4 interventions to increase life expectancy.
Reduce smoking
Prevention and management in primary care
Environmental improvements
Targeting over 50’s
State 5 interventions to reduce infant mortality.
Sure Start ↓ smoking in pregnancy ↓ teenage pregnancy Improve housing Early intervention for NHS
State the 4 parts of Tackling Health Inequalities: 10 years on (published May 2009).
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)
State how we can intervene to reduce health inequalities as from PHE report (2017).
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
State how identifying the causes and understanding the interconnections is important.
Risk conditions, psycho-social risks and behavioural risk factors interconnect and result in changes in the body that either leads to illness or health
Draw out a diagram of the pattern of risks affecting health and well-being.
(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
State the 8 risk conditions (creators of health inequalities).
Poverty Low social status Poor education Unemployment Dangerous Environments Discrimination Steep power hierarchy Gaps/weaknesses in services and support
State the 7 things needed to tackle psycho-social risks (causes of the causes).
Isolation Lack of social support Poor social networks Low self-esteem High self-blame Low perceived power Loss of meaning/purpose of life
State 4 behavioural risks which psycho-social risks lead to.
Smoking
Poor diet
Lack of activity
Substance abuse
State 4 physiological (attributable) risks which behavioural risks lead to and state what they increase.
High blood pressure High cholesterol Chronic stress hormones Anxiety/depression These increase morbidity (being ill, having a disease or being unhealthy) and mortality (death)
What does an intervention at a life course approach mean?
means action to reduce health inequalities starts before birth through to old age
State 6 policy objectives to tackle health inequalities established by the Marmot review.
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
State 9 findings of the Marmot review.
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
State 5 ways we can break the cycle of inequalities.
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
State the 4 major killers to be tackled.
Smoking
Coronary heart disease
Obesity
Cancer
State the 3 major killers of children to be tackled.
fire deaths for children
suicide
diabetes
In which 2 ways can we improve access to public services and facilities?
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
State 4 ways to strengthen disadvantaged communities.
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
State 10 specific groups to be targeted for change.
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
