S3 Flashcards
Why care about inequality and social determinants of health?
Life expectancy differences between rich and poor wards
Infant deaths higher in different areas
Morbidity - higher longstanding illness among people in routine/manual occupations
Disability: live in more deprived areas twice more likely to have one or more disability as those in least deprived areas
What is the inverse care law?
The availability of good medical care tends to vary inversely with the need of the population served
How is deprivation strongly associated with ill health?
The more deprived a person is, the larger proportion of their life will be spent in ill health, and the more likely they will die at a younger age
Inequalities in health: what is the artefact explanation?
The idea that the relationship between class and health is artificial rather than real. It is a measurement phenomenon - the (inadequate) measurement of social class and/or health, or in the measurement of the relationship between the two. Mostly discredited as an explanation.
Inequalities in health: what is the social selection explanation?
Direction causation is from health to social position. Sick individuals move down social hierarchy, healthy individuals move up. Chronically ill and disabled people are more likely to be disadvantaged
Inequalities in health: what is the behavioural-cultural explanation?
Ill health is due to people’s choices/decisions, knowledge and goals.
Limitations: behaviours are outcomes of social processes, not simply individual choice. Choices may be difficult to exercise in adverse conditions and may be rational for those whose lives are constrained by lack of resources.
Inequalities in health: what is the materialist explanation?
the role of economic and associated socio-structural factors in distribution of health and well-being
differential access to material resources. Lack of choice in exposure to hazards and adverse conditions.
Limitations: further research needed into precise routes through which material deprivation causes ill-health
Inequalities in health: what is the psychosocial explanation?
Health is influenced more by differences in income than actual income
Psychosocial explanations focus on how social inequality makes people feel—domination/subordination, superiority/inferiority—and the effects of the biological consequences of these feelings on health- direct (physiological, immune system) and indirect (health-related behaviours, mental health)
Inequalities in health: what is the income distribution explanation?
Relative (not average) income affects health
Countries with greater income inequalities have greater health inequalities. Most egalitarian societies have the best health
Redistributive policies: reducing income inequality in a society can improve social well-being, and in turn many other health and social factors
What are the four actions that can be done to reduce health inequalities?
Strengthening individuals, strengthening communities, improving living and working conditions, promoting healthy macro-policies
What is the difference between inequality and inequity?
Inequity: unfair, avoidable differences arising from poor governance, corruption or cultural exclusion
Inequality: uneven distribution of health or health resources as a result of genetic or other factors or the lack of resources
You can have inequality without inequity
What inequities are there in access to healthcare?
More deprived groups seem to have higher rates of use of GP services and emergency services and under-use of preventive services and specialist services
What are inequalities in health related to?
Socioeconomic factors, diversity, ethnicity, gender and age. The relationships between factors are complex.
Factors associated with inequalities in health are…
Ethnicity, gender, age, disability and homelessness.
Describe the association with gender and health
Males- higher mortality rates, more suicide and violent death
Women: higher life expectancy, higher reported mental health, higher rates of disability and limiting longstanding illness
