WEEK 4: SOCIAL INEQUALITIES IN HEALTH

Question 1

What is meant by access to health services?

Answer 1

Access to health services refers to the availability of services that are timely, appropriate, easy to get to and use, and sensitive to user choice and need.

Question 2

What are health inequalities?

Answer 2

Health inequalities are the unjust and avoidable differences in people’s health across the population and between specific population groups.

Question 3

What is the difference between inequalities and inequities?

Answer 3

inequalities’ to differences between groups and ‘inequities’ to denote unjust differences between groups.

Question 4

Health outcomes such as life expectancy, healthy life expectancy and rate of disease are comparedusing groupingssuch as:

Answer 4

gender
ethnicity
social class
area deprivation
employment status
educational attainment

Question 5

What is the simplest measure of health inequalities?

Answer 5

Simplest measure of health inequalities is to compare the health of those in the lowest socio-economic group with those in the highest group.

This indicates the gap in health outcomes.

Question 6

There are a wide range of measures for health inequalities including:

Answer 6

*child poverty
*life expectancy
*teenage pregnancy
*out-of-work benefits
*all-cause mortality amongst 15-44 year olds
*young people not in education, employment or training.

Question 7

Describe factors associated with health inequalities.

Answer 7

*Equity from the start: Early childhood development and education are powerful equalizers. Education, preschool and beyond, fundamentally shapes children’s lifelong trajectories and opportunities for health.

*Educational attainment is linked to improved health outcomes, partly through its effect on adult income, employment and living conditions.

*Healthy places-healthy people: Why place matters for health equity? Where people live affect their health and chances of leading flourishing lives.

*Fair employment and decent work: Employment and working conditions have powerful effects on health and health equity.

*Social protection across the life course: The relationship between social protection and health. Poverty and living standards are powerful determinants of ill-health and health inequity.

Question 8

Describe health inequalities global examples.

Answer 8

Evidence of women from ethnic minority backgrounds experiencing ‘stereotyping, disrespect, discrimination and cultural insensitivity’ when using maternal and neonatal healthcare services.

2018 studyby Stonewall, 13 per cent of LGBT respondents reported experiencing unequal treatment from health care staff because they were LGBT, with this number rising to 32 per cent for people who are transgender and 19 per cent for LGBT people from ethnic minority backgrounds.

Income
*Housing
*Environment
*Transport
*Education
*Work

Question 9

Give examples of health inequalities from Botswana.

Answer 9

Orphaned and vulnerable children (OVC) may have worse health than nonorphans due to a variety of interconnected biological, economic, and caregiving reasons, ranging from their own HIV infection.
-being cared for by destitute and/or sickly caregivers
-facing stigma or neglect in foster care

Keetile & Yaya: Socioeconomic inequalities and determinants of health care utilization in Botswana: a decomposition analysis
Concentration indices show that poor people did not seek health care when sick (CI = −0.0084),
did not receive health care when they needed it (CI = –0.0175)
often used public health facilities (CI = –0.0531)
Seeking health care for NCDs was slightly concentrated among the non-poor (CI = 0.0465).
Education and wealth status were key contributing factors to inequalities for all health care utilization indicators.