Society and oral health

Question 1

what are the social determinants of health

Answer 1

1. social position
2. environment- work and living
3. food and transport policies
4. early children experience/ life course influences
5. poverty
6. unemployment
7. social and psychological circumstances
8. economic circumstances
9. international security- fear of travelling, not feeling safe

Question 2

what concept underpins social inequality

Answer 2

social structure

• a class system controlled by wealthy whereby poor are not allowed access to certain places/ resources
• place where you’re born is likely to determine your health, wealth, education, future occupation

Question 3

define health INEQUALITY

Answer 3

describes the DIFFERENCES in health between DIFFERENT GROUPS of people
e.g. age, disabled, socio-economic status, geographical area, sex, ethnicity

Question 4

define health EQUITY

Answer 4

describes the DIFFERENCES in OPPORTUNITY for different population groups which result in UNEQUAL access to OPPORTUNITIES AND RESOURCES, health services, nutritious food, adequate housing etc

these, together with differential exposure to risk factors and vulnerability, can lead to health inequalities in terms of health outcomes.

the differences are avoidable therefore unfair

Question 5

give examples of HEALTH INEQUALITY

Answer 5

there are differential health outcomes due to social inequality:

higher income countries= lower infant mortality rates, higher life expectancy

higher social classes= lower level of oral disease

north/ south divide in GB= higher levels of DMFT in north

the greater the social inequality in the society= the higher the disease level and mortality, lower life expectancy (this applies globally- portugal, USA= bigger inequality gap= more infant deaths per live birth BUT in japan, sweden, norway= smaller inequality gap= lower infant deaths

social positions in childhood influence health outcome in adulthood

Question 6

an aspect of social inequality is discrimination. people may be discriminated due to age, sex, gender, rase, disability.
what is racism

Answer 6

MacPherson report 1999

‘conduct/words/ practise which advantages or disadvantages people because of their colour, culture, ethnic origin’

Question 7

what is the BIO-PHYSICAL MODEL of health

Answer 7

1. implies that psychological and social factors influence biological functioning, and the interactions between these factors play an important role in health/ disease
2. suffering, disease and illnes are affected by multiple levels of organisation of factors - from social to molecule.
3. we can understand the patients subjective expereince and how various factors/ conditions impact on one another
4. to understand the determinants of disease, and to offer optimum treatment, we need to take into account the patient in their social context and lives etc

Question 8

give examples of health EQUITY

Answer 8

1. in UK, the proportion of adults without natural teeth is higher among manual and unskilled workers and the patterns have changed little with time
2. in AUS, tooth loss is higher in those who receive social benefits and fewer years of schooling
3. 2003, UK child dental health survey:
   - children attending deprived schools (measure of socio-economic) experience more tooth decay, poorer oral hygiene (this did not always lead to a higher level of gum disease)