S3- Tackling health inequalities Flashcards
a) define social determinants of health
b) List some
a) The social determinants of health are the economic and social conditions that influence individual and group differences in health status
b) - employment and work conditions
- education history
- housing
- health care conditions
- water and sanitation
- gender
Outline the inequalities in a) life expectancy b) infant deaths, c) morbiditiy and d) disability and social determinants of health?
a) difference between richest and poorest people in england = 8 years!
b)
c) rates of limiting long illness among managerial occupations is hal that of people in manual occupations
d) people living in more deprived areas of britain are more than twice as likely to have one or more disability as those in least deprived areas
What is the relationship between deprivation and ill health?
The more deprived a person is the larger proprotion of their life will be spent in ill health and the more likely they are to die at a younger age
What is the artefact explanation for health inequalities?
- they are due to the way statistics are collected
- concerns about quality of data and method of measurement
- most discredited as an explanation
What is the social selection explanation for health inequalities?
- direction of causation if 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
- plausible
What is the behavioural-cultural explanation for health inequalities?
- ill health is due to peoples choices/decisions, knowledge and goals
- useful explanation i.e. health education
- limitations: behaviours are outcomes of social processes not individual chocies
What is a big preventable cause of cancer (aside from smoking)?
Obesity
What is a major preventable cause of early death?
Poverty
What is the materialist explanation for health inequalities?
- inequalities in health arise from differential access to material resources
- lack of choice in exposure to hazards and adverse conditions
- accumulation of factors across life-course
- most plausible
What is the psychosocial explanation for health inequalities?
- health is influenced more by differences in income than actual income
- some stressors are distributed on a social gradient e.g. negative life events, social support, autonomy at work, job security
- stress impact on health via different pathways dierct or indirect
What is the Income distribution explanation for health inequalities?
- relative (not average) income affects health
- countries with greater income inequalities have greater health inequalities
- it is not the richest but the most egalitarian societies that have the best health
Difference between inequality and inequity?
Inequality: when things are different (not equal)
Inequity: inequalities that are unfair and avoidable (or not accounted for by clinical need)
you can have inequality without inequitity
Inequities in access to health care?
More deprived groups seem to have:
- higher rates of use of Gp and emergency surfaces
- under use of preventative services e.g. screening and specialist services
What are some theories to explain the inequities in access to health care?
- tendency to manage health as a series of crises
- normalisation of ill health
- event based consulting may be required to legitimase consultation
- difficulty marshalling the resources needed for negotiation and engagement with health services
- tendency to use more porous services
- may refelct lac of cultural alignment between health services and lower socio-economic roups
- adjudications of technical and social eligibility by doctos affect referrals and offers
Factors associated with inequalities in health?
- socioeconomic status
- ethnicity
- gender
- age
- disability
- homelessness
