Year Three - Health Inequalities Flashcards
What is the definition of sociology?
the study of the development, structure and functioning of human society
What does sociology study in relation to healthcare?
- people’s interactions with those engaged in medical occupations eg healthcare professional-patient relationships
• The way people make sense of illness eg illness versus disease
• The behaviour and interactions of healthcare professionals in their work setting eg professional values, interactions between healthcare professionals and other health care staff
What makes health promotion possible?
The understanding of how different groups in society operate
What is the sick role?
A role taken on by patients which:
- Exempts ill people from their daily responsibilities
What are the rules of the Sick Role?
o Patient is not responsible for being ill and is regarded as unable to get better without the help of a professional
o Patient must seek help from a healthcare professional
o Patient is under a social obligation to get better soon as possible to be able to take up social responsibilities again
What is the role of the health professional when interacting with someone taking on the sick role?
o Professional must be objective and not judge patients morally
o Professional must not act out of self-interest or greed but put patients interests first
o He/she must obey a professional code of practice
o Professional must have and maintain the necessary knowledge and skills to treat patients
o Professional has the right to examine patient intimately, prescribe treatment and has wide autonomy in medical practice
o Role of doctors in this is potentially controversial as we are the ones who have to justify any significant level of sickness eg medical certificates for those needing to be off work
What are the 9 categories used in the National Statistics Sociio-Economic Classification (NS-SEC) that determine social class?
- Large employers and higher managerial and administrative occupations
- Higher professional occupations
- Lower managerial, administrative and professional occupations
- Intermediate occupations
- Small employers and own account workers
- Lower supervisory and technical occupations
- Semi-routine occupations
- Routine occupations
- Never worked and long-term unemployed
What is the NS-SEC used for ?
to measure the employment relations and conditions of occupations. They show the socio-economic positions in modern societies and help explain variations in social behaviour and other social phenomena
What is the labour market?
Source of income, economic security and prospects of economic advancements
What is the work situation defined as ?
The location in systems of authority at work, degree of autonomy
What influences life chances at work ?
Employment People Role Place in Job Relationship with employer Health
How does gender influence health?
o Men have a higher mortality at every age
o Women have a higher morbidity
o Women consult more frequently in general practice setting
o More women consult GP for depression but suicide rates are 3x higher in men
o Females more likely to be carers
o Men do slightly more exercise than women on average
How does ethnicity influence health?
o Ethnicity includes social and cultural influences as well as genetic- as such there is some fluidity and change
o T2DM prevalence is higher in South Asian populations
o Greater prevalence of sickle cell disease in African origin groups
o Mortality in Scotland is higher in the majority ethnic (white) population than in the black and minority ethnic population
o Most minority ethnic groups have higher rates of abstinence and lower levels of drinking compared to people from white backgrounds
o People from mixed ethnic backgrounds are less likely to abstain ans more likely to drink heavily compared to other non-white minority ethnic groups
o Indian, Chinese, irish and Pakistani backgrounds on higher incomes tend to drink above recommended limits
What is the impact on physical environment on health?
o ¼ adolescents living in cold homes are at risk of multiple mental health problems compares to 1/20 living in warm homes
o Children living in cold homes are >2x likely to suffer from a variety of respiratory problems than children living in warm homes
o Excess winter deaths are almost 3x higher in the coldest quarter than in warmest
How does education influence health?
o Those with higher levels of education tend to be healthier than those of similar income who are less well educated eg better understanding of health, more effective engagement with health care services such as screening programmes, better engagement with health related advice and are better able to navigate health services
How does employment influence health?
o Provides income and financial security; this obviously varies and related in part to the previous slide on social class (deprivation is a major determinant of health inequalities)
o Provides social contacts
o Provides status in society
o Provides a purpose in life
o Unemployment is associated with increased morbidity and premature mortality
How should we deal with disparities in health on a patient level?
identify language concerns, understanding the system, beliefs
How should we deal with disparities in health on a provider level?
Attempt to understand the differences between ethnicities when it comes to health attitudes
Improve communication skills
Realise when we are being culturally incompetent
How should we deal with disparities in health on a system levels?
Improve organisation of appointments and referrals
What is culturally competent care?
o Combination of attitudes, skills and knowledge that allows an understanding and therefore better care of patients with a different background to our own
What sociological features does medicine incorporate into its occupation?
o Systematic theory o Authority recognised by its clientele o Broader community sanction o Code of ethics o Professional culture sustained by formal professional sanctions
What health risks are homeless people exposed to?
Infection Poor dental hygiene Assault Suicide Drug and Alcohol Abuse
What is the inverse care law?
people most in need of medical care are less likely to receive it, where as those who need it least tend to use health services more, and more effectively
What local charities (third sector parties) can help people facing homelessness?
Citizens Advice Bureau
Penumbra
Shelter
Alcohol and Drug Advice
How does birthweight and breastfeeding vary between areas of low and high deprivation?
Low Birthweight
- 13% in low deprivation
- 31% in high deprivation
Breastfeeding
- 15% in low deprivation
- 40% in high deprivation
When is non-fatal burden at its highest in deprived areas?
at aged 45-64
Drug use and alcohol disorders vary between high and low deprived areas in scotland by how much?
drugs =17 x higher in highly deprived areas
alcohol = 8.4 x higher in highly deprived areas
What barriers do people with a learning disability have when it comes to accessing healthcare?
A lack of accessible transport
Staff having a poor understanding of learning disability
Failure to diagnose/identify a learning disability in a patient
Poor coordination of care from different care providers
Inadequate aftercare or followup
Anxiety or lack of confidence in caring for people with a learning disability
What are the challenges for refugees settling in a new country?
Family integrity and social adjustments trump medical issues
Language barriers
Competing demands of social services, housing, education, public health, mental health, primary care
Underdeveloped health care systems in countries of origin can leave patients with undiagnosed illness
Public health screenings are often not communicated to primary care
Exposure to torture, warfare and violence are common amongst refugees and can leave a lasting impact such as depression and PTSD
Anti-immigrant sentiments can make settling difficult
How are LGBT groups viewed as vulnerable?
Higher rates of anxiety and depression amongst members of the LGBT community
Self harm is higher in LGBT communities compared to the general population
Only 10% of people who attend a GP consultation with their partner felt welcome
1/4 have experienced inappropriate advice or treatment due to sexual orientation or gender identity
What are the benefits of volunteering?
Gain confidence Make a difference Meet people Be part of a community Learn new skills Take on a challenge
