Week 8 Flashcards
health inequity
unjust or unfair differences in health between persons, often rooted in social, economic, environment, or systemic conditions that disadvantage certain groups
health inequality
observable or measurable health differences in health status or outcomes among different population groups
diversity with aging
as people age, experiences of health, support, and well-being vary widely based on social determinants of health, which can lead to health inequalities
health inequality in aging
measurable differences in health outcomes among older adults in various groups, such as varying levels of mobility, cognitive health, or life expectancy
health inequity in aging
often stem from lifelong disadvantages, such as poverty, racism, or limited access to healthcare, which effect older adults later in life
health outcomes
linked to physical and mental inequities
socio-economic factors
- education, income, housing
- strongly linked to health outcomes
health inequities and poverty
influence of poverty and disadvantage on health inequities is consistent over time
what does substantial evidence-based research show?
- older adults living in disadvantaged areas have less access to health care
- disadvantaged groups have higher mortality and lower changes of survival
- inequities and inequalities related to survival from various health conditions are closely linked to age, sex and ethnicity
risk factors related to health inequality and inequity
- poverty/lack of resources
- age and gender
- ethnicity
- sexual and gender identity
- geography
- health and disabilities
- life transitions
- knowledge and awareness
- social relationships
what is the opposite of a risk factor?
a protective factor
example of a protective factor
having access to affordable housing can protect against the risk of social isolation
indigenous people living in canada
- were in good health prior to colonization
- included nutritious diets, rich and diverse healing systems and active lifestyles
indigenous disparities
are largely due to colonial history
impact of colonialism on indigenous people
- have poorer health outcomes
- suffer from more chronic illness and disabilities, including heart disease and diabetes
- embedded racism and loss of support system had been a direct cause of poor health outcomes
- decades of systemic discrimination in the form of the residential school system
example of poor health outcomes for indigenous people after colonialism?
type-II diabetes continues to be 2-3 times more common amongst indigenous people
what did loss of cultural identity cause for indigenous people?
loss of health
what ethno-racial groups have higher risk of developing dementia?
- black
- hispanic/latino
- native hawaiian/pacific islander
- these differences persist despite similar rates of cognitive decline across groups
what are risk and expression of dementia influenced by?
- social determinants
- discrimination
- access to care
where are there disparities in dementia care?
access, diagnosis and outcomes in dementia care
influential factors of dementia
- socioeconomic status
- cultural diversity
- geographical location
how are the 12 risk factors for dementia influenced by health inequities?
individuals from marginalized or lower income groups groups face barriers for managing these risks
ex. those with low education have limited access to quality education which reduces cognitive reserve and influences dementia due to health inequities
those with more health inequities…
are less likely to prevent or manage these factors that reduce risk for dementia
canadas public health insurance
covers hospital and physician visits but generally does not cover prescription medications
prescription drug access
no comprehensive national policy exists for drug coverage or pricing, resulting in inconsistent access to mediations across the country
what does inconsistent access to medications lead to?
health inequities and social injustice amongst some canadians, disproportionately affecting those without private or provincial coverage options
people with private insurance or provincial drug benefit plans
may have better access to medication coverage
ex. older adults, people with disabilities
vulnerable canadians and drug prescription
struggle to afford medications, leading to poor adherence and health outcomes
ex. older adults, indigenous people, immigrants
oral health inequities
affect older adults in canada with coverage often based on income and private benefits and typically not included in provincial plans
why do many older adults avoid dental care?
due to lack of coverage and high costs
what does poor oral health cause?
- issues like lost or broken teeth negatively affect nutritional status = additional health complications
- stigma around poor oral appearance can affect mental health, potentially leading to social isolation
percentage of seniors that provided care to family members or friends with a long-term condition
almost 1/4 of seniors aged 65 and older (bout 1.5 million people)
what do older adults who are caregivers experience?
- increased burden
- depression, stress
- financial problems
- poor health
- loneliness
- social isolation
spousal caregivers
at greater risk of experiencing loneliness and decreased social support
what type of caregivers experience more health inequities?
female caregivers
caregiver interventions
- physical and financial support through informal assistance
- respite services
- home care or related services
- income and tax relief programs
- education and skills training
- psychological support
- interactive online activities and groups
immigrant older adults in canada
experience considerable diversity
- typically these individuals are significantly lonelier than canadian-born older adults
immigrants and successful aging
immigrant older adults had a lower prevalence of successful aging than their Canadian-born peers
healthy immigrant effect
immigrants were generally healthier than domestic-born Canadians when they first arrive to Canada
- “only people who are healthy decide to migrate”
challenges for immigrant older adults in Canada
- may experience psychological distress due to difficulty adjusting, economic hardships, lack of social support, discrimination
- more reluctant to seek professional health
- face barriers to accessing services
- face stereotypes and agism
***creates health inequities across this population
inclusive healthy aging interventions for immigrant older adults in Canada
- additional data collection and research on immigrant older adults in Canada
- culturally and linguistically appropriate programs and services (language programs, referral services, etc.)
- more age friendly areas/communities that are tailored for older adult immigrants
older adults in rural/remote areas
~ 23% of all seniors in Canada live in rural areas
challenges for older adults living in rural/remote areas
- increase risk of social isolation
- smaller support networks
- greater loneliness
- lower utilization rates of health and social services
rural populations
considered a health disparity group in part because these populations have higher rates of mental health concerns, chronic diseases and worse general health
risk for rural older adults
increased risk of…
1. morbidity
2. obesity
3. diabetes
4. coronary heart disease
5. cancer
6. COVID-19
7. excess mortality
strategies for improving healthy aging in rural/remote areas
- reducing
- joining
- developing
- improving
- developing
- stimulating
reducing strategy for improving healthy aging in rural/remote areas
reduce health inequalities by providing older people with better access to health and social care services in rural/remote areas
joining strategy for improving healthy aging in rural/remote areas
joining up transport, housing, health and social care services to improve cost-effective service provision and access to services
ex. community services with all these things in one area
developing strategy for improving healthy aging in rural/remote areas
developing cost-effective transport solutions to afford accessibility to services and better social integration
improving strategy for improving healthy aging in rural/remote areas
improving housing and local environment conditions to allow older adults to “age in place”
developing (2) strategy for improving healthy aging in rural/remote areas
developing volunteering and community-based initiatives to improve social integrations of older adults in rural/remote areas
stimulating strategy for improving healthy aging in rural/remote areas
stimulating bottom-up social enterprises and collab ventures to improve the economic diversity and attractiveness of rural areas to encourage further economic development
- so more people want to live there and create a better environment
low-income older adults
older adults in canada remain one of the most financially vulnerable canadian populations, especially those who live alone
- rate of older canadians considered as “low-income” is increasing
what older adults specifically are at risk?
- less education
- intermittent work histories and low wages
- older immigrants
- indigenous older adults
- those with chronic health conditions
- those with disabilities
what are low-income older adults experiencing?
- increased risk of loneliness
- increased risk of social isolation
- poor health outcomes
- lower quality of life
- premature mortality
high-income vs. low-income
high-income individuals experience considerably more years of good health than those with lower incomes
programs and services to help low-income older adults
- income assistance
- provincial and territorial programs
- residential rehabilitation assistance program (RRAP)
- advanced life deferred annuities (ALDAs)
- variable life payment annuities (VPLAs)
income assistance
low-income seniors who dont qualify for the full amount of Canada’s public pension programs may be eligible for income, disability or hardship assistance
provincial and territorial programs
many provinces and territories offer programs to provide extra support to people receiving the GIS or allowance
- include tax deferment, prescription drug subsidies, and rental subsidies
residential rehabilitation assistance program (RRAP)
offers financial assistance to create affordable housing for low-income seniors and adults with disabilities
advanced life deferred annuities (ALDAs)
allow individuals to put up to 25% of qualified registered funds into an annuity, which can start paying an income at age 85
variable life payment annuities (VPLAs)
provide payments based on pooled investment risk to help ensure that retirees have income at older ages
what can healthcare professionals do?
increase cultural competence
increase:
1. awareness
2. knowledge
3. skills
aspects needed to create culturally sensitive healthcare
- cultural competence
- identify under-served needs
- cultural targeted (not one size fits all - specific to culture)
- patient centered care/health literacy
health inequity vs. health inequality
inequity: unfair, preventable differences impacting diverse groups
inequality: measurable differences
cultural competence in the heathcare
culturally sensitive care is essential to address diverse needs and promote healthy aging among all older adults
