Socioeconomic deprivation and health

Question 1

Describe the main determinants of health

Answer 1

social environment- income, gender
physical environment- housing environment
health services- access to healthcare. access to quality health care
health behaviours- alcohol and smoking use

Question 2

What is most effective in reducing health inequalities

Answer 2

Structural changes in the environment, fiscal policy, welfare support, improving accessibility of services, intensive input for disadvantaged groups are most likely to be effective in reducing health inequalities

Question 3

How to reduce health inequalities

Answer 3

1. Give every child the best start in life
2. Enable all children, young people and adults to maximise their capabilities and have control over their lives
3. Create fair employment and good work for all
4. Ensure healthy standard of living for all
5. Create and develop healthy and sustainable places and communities
6. Strengthen the role and impact of ill-health prevention.

Question 4

Describe the social determinants of health

Answer 4

the circumstances in which people are born, grow up, live, work and age and the systems put in place to deal with the illness. These circumstances are affected by economics, social policies and politics.

Question 5

List adverse childhood experiences

Answer 5

maltreatment
violence and coercion
prejudice
adult responsibilities 
bereavement 
adjustment (migration)

• -> more likely to intake high alcohol
• -> drugs like cocaine or heroine
• -> rarely feeling optimistic
• -> more likely to be in prison

Question 6

What is clinical audit

Answer 6

Clinical Audit is a quality process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change.

Question 7

why undertake clinical audit

Answer 7

best possible care for patient is provided
clinical practice is evidence based
to improve working between the multi-disciplinary group
Audit is an integral part of Clinical Governance

Question 8

Describe the placebo effect

Answer 8

Improvements in patients’ symptoms that are attributed to their participation in the therapeutic encounter, with its rituals, symbols, and interactions

Question 9

what does the placebo effect relies on

Answer 9

• Emotional and cognitive engagement with clinicians especially trust
• Social and physical value of interaction/intervention
• Setting
• Anticipation and expectation of clinical improvement
• Type of placebo e.g. larger pill

Question 10

What are the ethical issues surrounding placebo

Answer 10

Not approved by FDA or NICE
Deceiving patients unethical  
May be seen as rationing care
Safety and regulation concerns 
Not always successful in helping patients’ symptoms

Question 11

Where is placebo used

Answer 11

Randomised control trials