Theories Flashcards
Inverse care law
Inverse relationship between quality and access to healthcare and level of need
Highest deprivation and morbidity have poorer quality and lower access than high SES areas
Julian Tudor Hart
Personal and systemic barriers
Marmot indicators, health equity audits
Distributive justice
Theories of social justice
Utilitarianism- greatest good for greatest number of people. Bentham.
Distributive justice- basic equal rights for all but inequalities that favour those that are worst off. Veil of ignorance. Rawls.
Procedural justice- the procedures for decision making lead to fair outcomes, balance cost and benefit, and involve those affected by the decision.
Types of need
Felt
Expressed
Normative
Comparative
Measurements: surveys, waiting lists, HNA, deprivation and mortality data
Can have felt but not expressed, normative but not felt etc
Need for health is not the same as need for healthcare-may benefit more from other social interventions e.g. Better housing
Models of policy formation
Rationalist-explicit aims to rectify current and future problems in a prescriptive manner. Weighs up all the options and chooses most sensible one (cost/benefit, inequalities). In practice is never that easy!
Incrementalism- descriptive process of muddling through making small changes as you go that get wide agreement. Conservative, cautious and no room for innovation.
Mixed scanning-fundamental decisions regarding vision and strategy, followed by regular decisions made incrementally. No end in sight, difficult to distinguish between the two types of decision sometimes
Five ways to wellbeing and their uses
New economics foundation
Connect-speak don’t email, active listening
Active-exercise even if using stairs instead of lift, organise work activities
Take notice-of your desk space, of your environment, on how colleagues are feeling or acting
Learn-find out about colleagues, take classes, research, set up book clubs
Give-social activities or volunteering, random acts of kindness
Mental health strategies, organisational development, needs assessments, measure impacts of interventions
Measuring deprivation
Townsend-cars and houses
Jarman-gp payments for those with increased demand e.g. Young children, elderly, unemployed, overcrowded
Imd- SOA scored on issues such as crime, education, health, housing quality
National statistics socioeconomic classification- 1 to 8 based on reference person job
Maxwell quality
1R 2A 3E
Relevant Acceptable Accessible Effective Equitable Efficient
Sandman outrage
Perceived negative features of a situation Voluntariness Control Fairness Trustworthy government Morality e.g childhood cancer Familiarity Dread Diffusion in space and time
Components of community development
Health workers support development
Formal participation in decision making
Communities lobby for their own priorities
Support from strategy and funding
Develop ongoing close relationship with community leaders
Determinants of demand (3Cs)
Cash (price and income)
Complements (and substitutes)
Culture (tastes and preferences)
