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SDoH > Unit 1,2,3 > Flashcards

Unit 1,2,3 Flashcards

1
Q

Social Democratic

A

emphasize universal welfare rights, provide benefits

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1
Q

Conservative

A

provides benefits through social insurance plans associated w/employment rank (emphasis on male wage earners)

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2
Q

Liberal

A

modest benefits - assistance only when economic market fails to meet citizens basic needs (minimal government)
- primary aim to strengthen economy (greater support tot advocacy positions in corporate & business sector)
- least developed in providing citizens with economic & social security

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3
Q

Latin

A
  • less developed
  • family oriented
  • most like conservative model
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4
Q

Social Gradient

A

Variation among individuals and groups due to income

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5
Q

Health in all policies (CNA)

A

considers health impacts of policies in areas such as finance, education, housing, employment, transport

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5
Q

Health Literacy

A

understandings individuals have about their health & how to access health services

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6
Q

Order of structural determinants

A
  1. socioeconomic and political context
  2. socioeconomic position
  3. intermediary determinants
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7
Q

Socioeconomic and political context

A

born into & lives in
- gouvernance
- policies
- values
ie. unequal distribution of material and monetary resources

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8
Q

Socioeconomic Position

A

Their place in society
- education
- occupation
- gender/race
- income
- ethnicity
exposure, vulnerability and outcome

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9
Q

Intermediary Determinants

A

material circumstances (housing, clothing)
psychosocial factors
behaviours biological factors

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10
Q

Social Cohesion

A

connectedness and solidarity among groups in society

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11
Q

Social Capital

A

the networks of relationships among people who live and work in a particular society, enabling that society to function effectively

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12
Q

What are the factors bridging structural and intermediary determinants

A

social cohesion & social capital

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13
Q

Largest contributing factor to one’s health

A
  1. socioeconomic factors (education, jobs, income, social support)
  2. health behaviours (drug use, diet)
  3. health care (access)
  4. physical environment
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14
Q

What is the WHO conceptual framework

A

Structural determinants (people in power) -> intermediary determinants

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15
Q

Upstream Approach

A

further from individual
- broader, structural, systemic determinants
(policies, norms, environment)

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16
Q

Downstream Approach

A

closer to the individual
- represent immediate SDoH
(health behaviours, healthcare access, psychosocial factors)

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17
Q

How do conditions make people sick

A

Psychosocial demands (stressors) + Resistance and vulnerability factors (coping responses) = psychobiological stress response (neuroendocrine, automatic/metabolic, immune)

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18
Q

Why study SDoH

A

Societal factors (inequities)
Societal forces (quality and distribution)

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19
Q

Describe health care in Canada

A

publicly financed, privately delivered
universal, comprehensive, medically necessary

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20
Q

What is the federal governments responsibility

A
  • setting & administering national principles or standards for the system
  • assisting in the financing of provincial health care services through fiscal transfer
  • deliver direct hc to specific groups
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21
Q

What is the provincial/territorial government’s responsibility

A
  • manage and deliver health services
  • plan, finance, evaluate the provisions of hospital care, physician and allied hc services
  • manage some aspects of prescription care and public health
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22
Q

Describe the history of medicare

A
  1. saskatch –> first country to establish public universal hospital insurance (tommy douglas)
  2. Fed shares cost of provincial hospital insuracne plans
  3. all of canada has public insurance plans
  4. saskatch - insurance for physicians services outside hospitals
  5. all of canada’s plans include doctors services
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23
Q

Describe the Lalonde Report (the white paper)

A

a questioning of the efficacy of medical interventions
- gov spending lots of money on health care but overall health of population was not rlly improving
- “sick care”
- described the determinants of health (biological factors, lifestyle, environment, health care)
- preventing illness is better than treating illness

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24
Q

Explain the importance of the Lalonde Report

A
  • 1st formal statement by any western government (new concept)
  • broadened “health care” to “health care field”
  • other countries based their hc system on lalonde report
  • began new proactive health promotion programs to increase awareness
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25
Q

What did the health services review reveal
What was the solution

A

extra billing by doctors and user fees caused a two-tiered system (not accessible to all!)

Created Canada Health Act
- dollar for dollar penalty if province permits charges

26
Q

What is the charter and the framework

A

offered a strategy for change that embraced criticisms of Lalonde report
- expanded White Paper –> focused more on broader social, economic and environmental factors
(income, education, physical environment)

27
Q

What did the Canadian Institute of Advanced Research say

A

SDoH shouldn’t be looked at individually,
should look at how determinants interact

28
Q

What’s the Canada Health Act

A

fed document
- ensures all residents have medically necessary services
- based on need, not ability to pay
- sets criteria prov/tert have to satisfy to receive cash transfers under Canada Health Transfer (CHT)

29
Q

What are the 5 criteria of CHA for CHT

A

1) public admin - insurance plan (OHIP)
2) comprehensiveness - medically necessary must be insured “what is covered”
3) universality - all insured persons must be covered under uniform terms and conditions “who is covered”
4) portability - covered when insured person travels within or outside country “where am I covered”
5) accessibility - reasonable access to services “where am I covered”

30
Q

Where does money for CHA come from

A
  1. fed and prov taxes
  2. direct purchase of private insurance
  3. direct purchase of medical and non-medical services
31
Q

What does the Fed Gov do with the money

A
  • CHT
  • equalization support to less wealthy provinces
  • programs for medical and non-medical research and public health
  • direct health services for: first nations, RCMP, military, inmates, refugees, veterans
32
Q

What does the prov/tert gov do with the money

A
  • program and service payments to providers, institutions and health authorities for “med necess” doctor and hospital services
  • supplementary programs not covered by the CHA (home care, long-term care, drug coverage)
  • programs for medical and non-medical research and public health
33
Q

What is the Canada Health Transfer

A
  • largest def transfer to provincial
  • cash payments and tax transfers to support health care
  • flexibility for prov/tert to allocate payments according to priorities
  • must adhere to the principles of the CHA to be eligible for full federal transfer payments
34
Q

What is the Canada Health Act Annual Report

A
  • produced by the federal minister of health, health Canada and department of justice
  • full examination of each prov/tert and their compliance to CHA
35
Q

Benefits of CHA system

A
  • percieved health status
36
Q

Weaknesses of CHA system

A
  • medical dominance
  • home care
  • health maintenance/promotion
37
Q

What is home care

A

maintenance/prevention
long term care substitution
acute care substitution

38
Q

What is the Romanow Report

A

focuses on DoH
home care
palliative care
regional and community delivery of health services
primary health care reform

39
Q

What has the gov been doing to improve hc recently?

A

shift away from acute care
def gov combine a Population health model with a Health promotion model

40
Q

whats the 10 year pan to strengthen hc

A
  1. reduce wait time and improve access
  2. strategic health human resource action plans
  3. home care
  4. primary care reform
  5. access to care in the north
  6. national pharmaceuticals strategy
  7. prevention, promotion and public health
  8. heath innovation
  9. accountability and reporting to citizens
  10. dispute avoidance and resolution
41
Q

what does health care reform look like in Ontario?

A
  1. local health integration networks
  2. patients first: action plan to health care
  3. bundled care teams
  4. connecting care act -> dissolution of LHIN, creation of Ontario Health and Ontario Health Tems
42
Q

What is primary health care

A

routine care, care for urgent but minor or common health problems, mental health, maternity & child care, psychological services, liaison w/home care, health promotion, disease prevention, nutrition counselling, end-of-life care

43
Q

What is Universal Health Coverage (UHC)

A

all people have access to the full range of quality health services they need wheneve/wherev, w/o financial hardships

44
Q

what are prov/tert drug benefit programs

A

income-based universal programs
specific programs for population groups that need more coverage (higher costs)
- seniors, social assistance recipients, diseased

45
Q

Absolute Poverty

A

having less than absolute minimum income level
- deprivation of basic needs
SURVIVAL

46
Q

Disadvantages to the absolute poverty measure

A

measured based on the cost of basic needs
1. difficult to select a minimum set of necessities (every region has different)
2. cut-off of what is considered the minimum income level changes over time

47
Q

Relative Poverty

A

having less than the average standard in a society
EXCLUSION

48
Q

Which is the more accurate measure of income in a population

A

Median income - midpoint level of income

49
Q

Difference between equality and equity

A

Equality: not fair, not leveraging necessities
Equity: fairness, justice, human rights

50
Q

Difference between inequality and inequity

A

Inequality: the condition of being unequal (may or may not be fair)
Inequity: unfairness or bias, occurs when differences relate to factors such as race, gender, sexuality, or intersectionality of factors

51
Q

Why is income important SDoH

A

Income Shapes
- overall living conditions affected physiological and psychological functioning

Income Determines
- quality of other SDoH such as food security, housing, education, early childhood development

52
Q

Wilkinson Ted Talk

A
  • income inequality is more significant within societies as opposed to between societies
    (w/in: people in communities)
    (b/w: 1 community to another community)
53
Q

What is the Social Gradient

A

variation among individuals and groups due to income
- poor people have the worst health
- countries lower on social gradient are more unequal

54
Q

Gini Coefficient

A

metric of income inequality
0 (0%) = perfect equality (everyone has same income)
1 (100%) = perfect inequality (one person has all income)

55
Q

Which are the hardest hit populations

A
  • women and children
  • older adults (65+)
  • people experiencing homelessness
  • radicalized groups
56
Q

Low Income Cutoff After Taxes (LICO-AT)

A
  • level below at which families or individuals spend 20% or more of after tax income than average on food, shelter and clothing
  • updated regularly
57
Q

Low Income Measure (LIM)

A
  • fixed percentage (50%) of median adjusted household income
  • considered low income if a family’s income is below the LIM for family type and size
58
Q

What is welfare in ontario

A

benefits to support people w/disabilities and people who can’t work

59
Q

What is basic income

A

government program that provides a certain sum of money to a country’s or certain region’s citizens
- guaranteed income so people can afford basic needs to help them thrive
- robust social safety net

60
Q

Why does income influence health

A
  1. underinvestment in human capital - skills, knowledge, and experience possessed by an individual
  2. underinvestment in social capitol - community solidarity/cohesion
  3. psychosocially mediated effects - frustration and biological processes that are harmful
61
Q

Whais welfare state

A

how society views what it owes members by virtue of citizenship or residence
- electoral system a barrier

62
Q

Policy Implications of income and health

A
  • increase minimum wage to living wage and boost social assistance levels for most disadvantaged
  • reduce inequalities with progressive taxation using revenues to provide universal programs and services
  • more unionization in workplaces
  • progressive taxation
63
Q

What is a social safety net

A

range of benefit programs & supports that protect citizens during life changes

64
Q

what is scarcity mentality

A

people act differently when they believe things to be scarce

65
Q

What do bigger income gaps result in

A

deteriorations in social relations, health and human capital

SDoH (2 decks)

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