social inequalities in health: UK governmental policy Flashcards
what led to the start of inequality changes in the UK?
The post-war political enthusiasm for social justice and change which led to the establishment of the British Welfare State in the late 1940s, brought with it an expectation that social class differences in health outcomes would be narrowed.
what did the Acheson report show?
: ‘There is convincing evidence that, provided an appropriate agenda of policies can be defined and given priority, many of these inequalities are remediable’.
The report demonstrated that a widening health gap existed between socio-economic classes in Britain, and made 39 recommendations across a broad policy front.
what 4 recommendations did the Acheson report make
The recommendations were in four main areas of policy intervention:
- Medical Care - at level of morbidity to prevent early death
- Preventative approaches - to change individual risk
- In the workplace - to improve psychological conditions
- In social structure - to reduce social & economic inequalities
In 2001, the DoH set out two detailed targets for the reduction of health inequalities, what were these?
Starting with children under one year, by 2010 to reduce by at least 10 per cent the gap in mortality between manual groups and the population as a whole.
Starting with Health Authorities, to reduce by at least 10% the gap between the quintile of the area with the lowest life expectancy at birth and the population as a whole.
what was the Programme for Action 2003
The national health inequalities strategy, the Programme for Action (2003) was built on the ‘broad front’ for action set out in the Acheson Report.
It emphasised the crucial importance of working across government (at local, regional and national levels) and in partnership both with other service providers and with local communities.
The penetration of health inequalities priorities into the planning and performance regimes of the NHS and local government (known as ‘mainstreaming’) was seen as crucial to the success of the strategy.
what did the acheson report say about employment and what did the review show?
The Acheson report argued that employment was the glue that keeps society together, with unemployment being a major risk to health for working people and their families. The goal of ‘levelling up’ the opportunities for rewarding employment was seen as central to reducing health inequalities.
‘What the data shows’ – The UK unemployment rate was 25% lower in 2007 than in 1997, and has fallen for all educational groups over the last 10 years, including those with low levels of educational qualifications.
what did the acheson report say about housing? what did the review show?
The Acheson report had pointed to the link between poor quality housing and poor health outcomes and recommended policies to improve the quality of housing.
‘What the data shows’ - The proportion of households living in non-decent homes fell from 44% in 1996 to 26% in 2006. The proportion of social tenant households in non-decent homes fell by nearly half from 52% in 1996 to 28% in 2006
what did the acheson report say about educational achievement? what did the review show?
The Acheson report had noted that those with low levels of educational attainment have poor adult health. Academic and vocational qualifications are seen to provide additional opportunities for income and employment with improved consequences for health.
‘What the data shows’ - The percentage of 16-year-olds who achieve 5 or more A*–C passes at GCSE rose from 45% in 1996/97 to 61% in 2006/07.
what did the acheson report suggest about crime? what did the review show?
The Acheson report showed how crime and fear of crime can profoundly affect the quality of people’s lives. There is a link too between income inequality, social cohesion and crime.
‘What the data shows’ - Long-term trends show that crime as recorded by BCS rose steadily from 1981 peaking in 1995. A substantial fall then occurred until 2004/05, when BCS crime levels stabilised until a further decline in 2007/08.
what did the acheson report show about child poverty? what did the review say?
The Acheson report observed that poverty falls disproportionately on children and recommended measures to address poverty and increase the incomes of mothers and children.
‘What the data shows’ - Taking 60 % of median income in 1998/99 as the definition of poverty, the proportion of children living in poverty fell from 26% in 1998/99 to 22% in 2006/07, representing a reduction of 600,000 children before housing costs are deducted.
Statistics published by the Department of Work and Pensions in 2016 showed that the number of children in relative poverty had increased by over 200,000 that year up to 3.9 million. In 2019, this figure had increased still further to 4.2 million children in poverty.
define absolute measures of inequality?
measure the differences in rates of mortality, typically between the highest and lowest socio-economic groups
define relative measures of inequality?
assess change in the distribution of the rate of mortality measured as a ratio between socio-economic groups in a population.
what is the inverse care law?
The inverse care law was first described by Julian Tudor Hart in 1971, and states that “the availability of good medical care tends to vary inversely with the need for it in the population served.”
what did the health and social care act 2012 do to address inequalities in health?
New bodies were established such as the Health and Wellbeing Boards (HWB),Clinical Commissioning Groups (CCGs), HealthWatch and the NHS Commissioning Board (NHS CB).
While public health services reverting to local authorities (LAs) control (in April 2013), and Public Health England (PHE) was been established.
The HSCA organisational reforms acknowledged a continuing role for the NHS in addressing inequalities in health, but do not set out any quantifiable national targets for reducing the health gap.
The focus was now on addressing service provision inequities rather than the health inequalities (i.e differential health outcomes over a lifecourse).
what does th health and social care act say CCGs must do
The HSCA 2012 (Part 1; Section 26), states that each clinical commissioning group (CCG) must, in the exercise of its functions, have regard to the need to :
- reduce inequalities between patients with respect to their ability to access health services.
- reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.
