Week 26 - social and behavioural sciences Flashcards
Social and Behavioural Science
Public health has the key feature of focus on the health of a
population of people
Kings fund
The King’s Fund is an independent charitable organisation working to improve health and care in England
->An approach aimed at improving the health of an entire population, it is about improving the physical and mental health outcomes and wellbeing of people within and across a defined local, regional or national population, while reducing health inequalities
5 waves of public health
1)Structural
2)Biomedical
3)Clinical
4)Social
5)Cultural
Population
A group of people with some shared characteristic
->Populations have shared social and environmental influences.
These influences may be positive, but frequently populations have influences such as poverty, weak social support, unsafe communities, or poor literacy, and each of these can impinge on individual behaviour
Social determinants of health
Social determinants of health
(SDOH) are conditions in which
individuals are born, live, work, learn, play, and age that affect health, risks, functioning, and outcomes
Examples of SDOH include:
-Economic stability
-Education, social and community context
-Health care accessibility
-Environment
Definitions of 5 key features of social determinants of health
Economic stability -> connection between financial resources and health
Neighbourhood and built environment -> connection between residential health and location
Social and community context -> connection between health and access to care, insurance coverage and health literacy
Education access and quality -> connection of health to education level
Social determinants of health in pharmacy practice
-Despite national advances in medical technology, health disparities remain, and
minorities experience higher morbidity and mortality because of these disparities
-Tackling these social factors will
contribute to reduced health disparities
-Pharmacists play an important in screening for SDOH and social needs
The impact of SDOH on health outcomes
-> SDOH can have profound effects on patient outcomes.
Individuals from lower socioeconomic backgrounds have worse health outcomes
from birth and throughout life partly as a result of the degraded environments they live
in, which can lead to higher exposure to risk factors for certain diseases
The impact of SDOH on health outcomes
-Children from unstable homes with prevalent abuse, drug use, or domestic violence are more
likely to attempt suicide and use illegal drugs as adults
-More social complexity factors, such as housing, income, mental health, newcomer status, family structure, and involvement with
the justice system, were less likely to receive vaccines, screening tests, or take appropriate prescribed medical treatments
The impact of SDOH on health outcomes 2
-Housing instability may be associated with poorer reported health and disproportionately
affects Black and middle east/N African households more than Whites based on rent cost
burdens
-Lack of adequate nutrition can have adverse effects on growth and development throughout
life but more specifically during pregnancy and childhood
->The culmination of these social factors contributes to poorer health outcomes in patients
Role of pharmacists in addressing SDOH
Pharmacists are among the most trusted health care professionals and are highly accessible to the community
-Community pharmacies provide accessible health services -> often located in areas of higher deprivation – ideal for improving inequalities
-Can address the inverse care law (which states that people who need health care the most are the least likely to receive it)
Role of pharmacists in addressing SDOH 2
The consistent relationships pharmacists build with patients place them in an ideal position to influence outcomes associated with SDOH through screening and intervention methods that focus on medication adherence and addressing social barriers
->As pharmacists continue to manage chronic diseases, provide preventive care services,
incorporating screening for SDOH into community interactions with patients affords the pharmacist the opportunity to identify and mitigate social barriers to achieving optimal health outcomes
Social and behavioural science
-With skills in behavioural science, pharmacists can better understand the communities
in which they work and develop empathic approaches for targeting factors that could
improve medication use in their communities
-Pharmacists can address social and behavioural issues in the community by being culturally competent, promoting diversity in the pharmacy workforce, and providing assistance to patients
-Health screening is another example of public health outreach of pharmacists
-Screenings can and should be targeted to unique needs of a community; an example is
screening for human immunodeficiency virus (HIV) in communities with a high incidence of HIV infections
What can pharmacists do? - to widen understanding
Deepen our understanding
->Understand the population of our pharmacy: Demographics, but also reach out to community groups
->Understand any biases: make everyone feel they can engage with our services
->Identify pharmacy-related barriers: may be conflicting for different groups
EMPHASIS ON PATIENT CENTRED CHOICE!!!
What can pharmacists do? - to improve pharamacy culture
Understand and improve our pharmacy culture.
-Are people welcomed?
-Are they shamed?
-Are people comfortable to ask for help?
-Are staff attitudes patronising and oppressive?
-Is the pharmacy team actively reaching out to different parts of the local population?
->Important to show active listening and empathy for users of services
What can pharmacists do?
Improve Structural barriers
->Literacy
Are sources of information tailored to a person’s comprehension level, reading age and disabilities -> this includes digital competence
Language -> are sources available in a range of languages / is their access to an interpreter
Tobacco control
The biggest public health success story of the 21st century may be the reduction in tobacco
use and smoking-related diseases -> behavioural and social sciences have been
used to understand and develop a range of interventions to address this significant public
health issue
Tobacco control interventions
The interventions have been implemented at various levels, from the political, to the environmental, to the
individual, and included:
1. Informing the population of the risks associated with
smoking
2. Providing evidence-based stop smoking services to support people attempting to go smoke free
3. Providing a national accessible training programme for practitioners
4. Increasing tobacco taxes
5. Banning advertising
6. Banning smoking in public places and indoors
7. Requiring plain packaging
-> Interventions by pharmacists included:
1. No Smoking Day
2. Stoptober,
3. Targeted clinical interventions, in the form of brief opportunistic advice from pharmacists (MECC), and provision of stop-smoking support
Obesity control
Obesity is a complex contemporary public health problem that involves a range of social, environmental, individual, physiological, biological and cultural components
Strategies to tackle obesity include a mix of:
->Preventative population level approaches (e.g. the soft drinks industry levy, improving the nutrient content of food and drink at the point of purchase)
->Curative secondary prevention services (e.g. family and adult weight management services)
->Targeted community asset based approaches
Obesity control -> the role of the pharmacist
New service in England (2022)
People struggling to lose weight will now be offered help from their local high street pharmacy as part of the NHS’s radical action to tackle rising obesity levels:
- Community pharmacy teams can now refer adults living with obesity to the 12-week online NHS weight management programme
- GPs have already referred over 50,000 adults living with obesity at risk of developing weight-
related conditions
- People will be able to start the programme within 10 days of visiting their local pharmacy, with support for some people including one-to-one coaching from a weight loss expert
- Adults living with obesity plus hypertension or diabetes will qualify for the service, which people can access via an app on their smartphone or online
