module 2: identifying the causes of health and dis-ease in populations Flashcards
lectures 13-21 (62 cards)
What proportion of health outcomes/variation in health outcomes is thought to be about the medical care we receive?
11% (10-20%)
What are some of the current health challenges in New Zealand
Workforce pressures, infrastructure
Shortage of hospital beds
Budget issues
What are the three goals in the Government Policty Statement on Health
Access, timeliness, quality
What are the health targets in the Government Policy Statement
Faster cancer treatment
Improved immunisation for children
Shorter stays in ED (95% of patients to be discharged from an ED within 6 hours)
Shorter wait times for first specialist assessment
Shorter wait times for elective treatment (95% of people to wait less than 4 months)
What does ‘gaming’ mean in health
Behaviour that makes the measurement of performance better, while not actually improving the quality of care
What are the alternatives to prevent ‘gaming’
Make independently verified targets
Have a series of targets that produce a tension - balance across targets
Choose targets that are hard to ‘fix’
What is socio-economic position?
The social and economic factors that influence what positions individuals or groups hold within the structure of society
What are the measures of SEP for individuals
Education, income, occupation, housing, assets and wealth
Why do we measure SEP?
To quantify the level of inequality within or between societies
May highlight changes to population structures over time, between census periods or generations
To help understand the relationship between health and other variables
What are the measures of SEP for populations
Area measures - deprivation and access
Population measures - income inequality, literacy rates, GDP per capita
How does SEP relate to health
The factors that determine one’s SEP directly influence health
What is deprivation?
A state of observable and demonstrable disadvantage relative to the local community or wider society or nation to which an individual, family or group belongs
Applied to conditions and quality of life that are of a lower standard RELATIVE to others in society
How is poverty defined
Living in poverty refers to a lack of income and resources to obtain the normative standard of living
What are the variables in NZDEP2023
Communications - access to internet
Owned home - living in own home
Income - Ages 18-64 receiving a main means tested benefit
Living space - overcrowdedness
Qualifications - Aged 18-64 with no qualifications
Income - income below income threshold
Living condition - Always damp / mould greater than A4 size
Employment - 18-64 unemployed
Support - Aged <75 living in a sole-parent family
What are global determinants of SEP
Income inequality
National income (GDP)
Literacy rates
Free trade agreements
What is a social gradient?
A linear trend where people who are less advantaged in terms of socioeconomic position have worse health outcomes
What are inequalities
Measureable differences or variations in health
Differences in health experience and outcomes between different population groups
What are inequities
Inequalities that are deemed to be unfair or stemming from some form of injustice
Health inequities are differences in the distribution of resources which do not reflect health needs
Define inequities (MOH definition)
Differences in health that are not only avoidable but unfair and unjust
What are the factors of the PROGRESS model of inequity
Place of residence
Religion
Occupation
Gender/sex
Religion
Education
Social capital
Socioeconomic status
Why should we reduce inequities?
They are unfair
They are avoidable
They affect everybody
Reducing inequities can be cost effective
What is the Gini Coefficient
The ratio between the area between the line of perfect equality and the observed Lorenz curve : The area between the line of perfect equality and the line of perfect inequality
What is the equation to find Gini Coefficient
Gini = (A)/(A+B)
What does the Gini coefficient indicate
The more concave, the income inequality in a population
0 = very equal society
1 = very unequal society