Tackling health inequalities

Question 1

Why should health inequalities be a concern of doctors?

Answer 1

To reduce the costs associated with premature deaths and illness to the individual and to the state

Poor medical practice can compound the health effects of inequality for patients but good medical practice can make a difference

Key theme in government health policy

Question 2

How should health inequalities be tackled?

Answer 2

Intervention on a broad front - to improve education, employment, income, housing as well as health

Reduce poverty and income inequality

Improve material circumstances (e.g. housing)

Reduce inequities in access to health and other public services

Population wide approach

Target young children and their families

Question 3

What are the two types of approaches to tackling health inequalties?

Answer 3

Up-stream approaches: deal with wider influences - income, benefits, employment, education, housing

Down-stream approaches: deal with health behaviours - smoking, diet, acess to care.

Note: adopting only down-stream approaches will not significantly reduce health inequalities

Question 4

What are the three different approaches to tackling health inequalities?

Answer 4

Reducing health disadvantage

Narrowing the health gap

Reducing the health gradient

Question 5

Benefits of tackling health disadvanage in reducing inequality

Answer 5

Health inequalities are seen as health disadvantages associated with social disadvantage

Aims to improve the health of those with the poorest health

There are strong moral arguments for steering interventions at those with the poorest health

Con: Not a population wide strategy and therefore is not tackling the social gradient of health.

Question 6

Benefits of tackling the health gap in reducing inequalities

Answer 6

Focuses on reducing the health gap between the poorest groups and the population average

However this still directs efforts at the minority not the majaority of the population. This can obscure what is happening to intermediate groups.

Question 7

Benefits of tackling the social gradient in health to reduce inequalities

Answer 7

Population wide approach that aims to equalise the health chances across socio-economic groups

Seeks to obtain the highest standard of health for all

Approaches tackle systematic differences in life chances, living conditions and lifestyles

This requires having absolute improvements for all groups but a rate of improvement which increases at each step down the socio-economic ladder (gains need to be greatest for the poorest groups)

Question 8

Describe 3 upstream approaches to tackling health inequalities

Answer 8

Reducing poverty e.g. by income maintenance policies, creating employment, welfare to work programmes.

Improve material circumstances e.g. through local area regeneration schemes, reducing fuel poverty for the elderly

Reducing educational inequalities e.g.widening participation)

Question 9

Describe 3 down-stream approaches to tackling health inequalities

Answer 9

Targeting children and their families e.g. NHS interventions, children’s centres

Influencing the lifestyle e.g. tackling poor behaviours (smoking, obesity, teen pregnancies)

Tackling inequalities in access to care