EH2 W2 - Inequalites in Health

What are the social determinatns of health?

Those factors that impact on health and wellbeing. The circumstances into which we are born, grow up, live, work, and age including the health system

What do the social determiants of health effect?

The risk associated with developing disease/illness.
The disease.
The capacity that people have to take action to prevent & treat disease/illness

What are health inequalites?

Differences in health status among the population.
Can be things you can or cannot change.

What is health inequity?

Differences in health status or health outcomes due to factors that are unjust, unfair or preventable.

What are the 10 social determinants that can affect health (the solid facts)?

1. Social gradient
2. Stress
3. Early life
4. Social exclusion
5. Work
6. Unemployment
7. Social support
8. Addiction
9. Food
10. Transport

What is the social gradient?

The graded relationship between socioeconomic status and health where the poorest have the worst health status

What is the inverse care law?

The mismatch between patients medical needs and care supply

What are the 4 explanations for the social gradient?

1. natural selection
2. behavioural/cultural
3. structural
4. psychosocial/social capital

What is the natural selection explanation for the social gradient?

People who are poorer have a biological inferiority or early events in life predispose them to subsequent inequality.

What is the behavioural/cultural explanation for the social gradient?

The behaviour/culture of people who are poorer triggers their disproportionate ill-health

What is the structural explanation for the social gradient?

Factors like poor housing, overcrowding, poor access to education, unemployment and so on, lead to inequalities.

What is the psyschosocial/social capital explanation for the social gradient?

inequalities are due to a range of stress inducing factors in the community that impact on the poort, or those who have less of anthing than others do

What is victim blaming?

The tendency to blame the individual for their illness and health risk factors without considering the social contect in which these occur

Why is victim blaming problematic?

Forget to consider the causes of the causes.
Social gradient affects peoples health in ways beyond their control

What is maslows hierarchy on needs?

the theory that basic needs supersede others and an individuals ultimate potential cannot be reached unless basic needs are addressed and satisified.

From bottom to top what are the 5 needs on maslows heirarchy?

1. Physiological
2. Safety
3. Love/Belonging
4. Esteem
5. Self-actualisation

What is stereotyping?

Placing people with certain characteristics in a group and making assumptions about them to predict behaviour

What is instituationalised racism?

Racism structured into political and social or health institutions

3 steps to indentifying institutionalised racism?

1. structured into political and/or social institutions
2. may privilege some groups and disadvantage others
3. reduces service access for those most in need

What is social exclusion?

Social and institutional factors that put people in an involuntary position of being excluded from accessing resources, assets and services retraining freedom of choice and capabilities

What is health literacy?

the degree to which individuals have the capacity to obtain, communicate, process, and understand basic health information and services needed to make appropriate health decisions

What are the 3 broad factors addressing health inequities?

1. Health care providers
2. Health care system
3. Health care services

How to adress health inequities at the provider level?

Providers need to be patient centred, use communication techniques such has teach-back

How to adress health inequities at the service level?

organisational influences, information systems, delivery systems, health literacy and self-management support, community and other health linkages

How to adress health inequities at the system level?

universal coverage, access to primary health care, workforce innovation, financial subsidies/incentives, better integration between health systems for the continuity of care

How do you measure socioeconomic disadvantage?

Individual - taking a social history
Population - index of relative socio-economic disadvantage