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SDoH > Unit 1,2,3 > Flashcards

Unit 1,2,3 Flashcards

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1
Q

Social Democratic

A

emphasize universal welfare rights, provide benefits

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1
Q

Conservative

A

provides benefits through social insurance plans associated w/employment rank (emphasis on male wage earners)

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2
Q

Liberal

A

modest benefits - assistance only when economic market fails to meet citizens basic needs (minimal government)
- primary aim to strengthen economy (greater support tot advocacy positions in corporate & business sector)
- least developed in providing citizens with economic & social security

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3
Q

Latin

A
  • less developed
  • family oriented
  • most like conservative model
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4
Q

Social Gradient

A

Variation among individuals and groups due to income

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5
Q

Health in all policies (CNA)

A

considers health impacts of policies in areas such as finance, education, housing, employment, transport

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5
Q

Health Literacy

A

understandings individuals have about their health & how to access health services

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6
Q

Order of structural determinants

A
  1. socioeconomic and political context
  2. socioeconomic position
  3. intermediary determinants
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7
Q

Socioeconomic and political context

A

born into & lives in
- gouvernance
- policies
- values
ie. unequal distribution of material and monetary resources

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8
Q

Socioeconomic Position

A

Their place in society
- education
- occupation
- gender/race
- income
- ethnicity
exposure, vulnerability and outcome

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9
Q

Intermediary Determinants

A

material circumstances (housing, clothing)
psychosocial factors
behaviours biological factors

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10
Q

Social Cohesion

A

connectedness and solidarity among groups in society

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11
Q

Social Capital

A

the networks of relationships among people who live and work in a particular society, enabling that society to function effectively

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12
Q

What are the factors bridging structural and intermediary determinants

A

social cohesion & social capital

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13
Q

Largest contributing factor to one’s health

A
  1. socioeconomic factors (education, jobs, income, social support)
  2. health behaviours (drug use, diet)
  3. health care (access)
  4. physical environment
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14
Q

What is the WHO conceptual framework

A

Structural determinants (people in power) -> intermediary determinants

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15
Q

Upstream Approach

A

further from individual
- broader, structural, systemic determinants
(policies, norms, environment)

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16
Q

Downstream Approach

A

closer to the individual
- represent immediate SDoH
(health behaviours, healthcare access, psychosocial factors)

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17
Q

How do conditions make people sick

A

Psychosocial demands (stressors) + Resistance and vulnerability factors (coping responses) = psychobiological stress response (neuroendocrine, automatic/metabolic, immune)

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18
Q

Why study SDoH

A

Societal factors (inequities)
Societal forces (quality and distribution)

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19
Q

Describe health care in Canada

A

publicly financed, privately delivered
universal, comprehensive, medically necessary

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20
Q

What is the federal governments responsibility

A
  • setting & administering national principles or standards for the system
  • assisting in the financing of provincial health care services through fiscal transfer
  • deliver direct hc to specific groups
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21
Q

What is the provincial/territorial government’s responsibility

A
  • manage and deliver health services
  • plan, finance, evaluate the provisions of hospital care, physician and allied hc services
  • manage some aspects of prescription care and public health
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22
Q

Describe the history of medicare

A
  1. saskatch –> first country to establish public universal hospital insurance (tommy douglas)
  2. Fed shares cost of provincial hospital insuracne plans
  3. all of canada has public insurance plans
  4. saskatch - insurance for physicians services outside hospitals
  5. all of canada’s plans include doctors services
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23
Describe the Lalonde Report (the white paper)
a questioning of the efficacy of medical interventions - gov spending lots of money on health care but overall health of population was not rlly improving - "sick care" - described the determinants of health (biological factors, lifestyle, environment, health care) - preventing illness is better than treating illness
24
Explain the importance of the Lalonde Report
- 1st formal statement by any western government (new concept) - broadened "health care" to "health care field" - other countries based their hc system on lalonde report - began new proactive health promotion programs to increase awareness
25
What did the health services review reveal What was the solution
extra billing by doctors and user fees caused a two-tiered system (not accessible to all!) Created Canada Health Act - dollar for dollar penalty if province permits charges
26
What is the charter and the framework
offered a strategy for change that embraced criticisms of Lalonde report - expanded White Paper --> focused more on broader social, economic and environmental factors (income, education, physical environment)
27
What did the Canadian Institute of Advanced Research say
SDoH shouldn't be looked at individually, should look at how determinants interact
28
What's the Canada Health Act
fed document - ensures all residents have medically necessary services - based on need, not ability to pay - sets criteria prov/tert have to satisfy to receive cash transfers under Canada Health Transfer (CHT)
29
What are the 5 criteria of CHA for CHT
1) public admin - insurance plan (OHIP) 2) comprehensiveness - medically necessary must be insured "what is covered" 3) universality - all insured persons must be covered under uniform terms and conditions "who is covered" 4) portability - covered when insured person travels within or outside country "where am I covered" 5) accessibility - reasonable access to services "where am I covered"
30
Where does money for CHA come from
1. fed and prov taxes 2. direct purchase of private insurance 3. direct purchase of medical and non-medical services
31
What does the Fed Gov do with the money
- CHT - equalization support to less wealthy provinces - programs for medical and non-medical research and public health - direct health services for: first nations, RCMP, military, inmates, refugees, veterans
32
What does the prov/tert gov do with the money
- program and service payments to providers, institutions and health authorities for "med necess" doctor and hospital services - supplementary programs not covered by the CHA (home care, long-term care, drug coverage) - programs for medical and non-medical research and public health
33
What is the Canada Health Transfer
- largest def transfer to provincial - cash payments and tax transfers to support health care - flexibility for prov/tert to allocate payments according to priorities - must adhere to the principles of the CHA to be eligible for full federal transfer payments
34
What is the Canada Health Act Annual Report
- produced by the federal minister of health, health Canada and department of justice - full examination of each prov/tert and their compliance to CHA
35
Benefits of CHA system
- percieved health status
36
Weaknesses of CHA system
- medical dominance - home care - health maintenance/promotion
37
What is home care
maintenance/prevention long term care substitution acute care substitution
38
What is the Romanow Report
focuses on DoH home care palliative care regional and community delivery of health services primary health care reform
39
What has the gov been doing to improve hc recently?
shift away from acute care def gov combine a Population health model with a Health promotion model
40
whats the 10 year pan to strengthen hc
1. reduce wait time and improve access 2. strategic health human resource action plans 3. home care 4. primary care reform 5. access to care in the north 6. national pharmaceuticals strategy 7. prevention, promotion and public health 8. heath innovation 9. accountability and reporting to citizens 10. dispute avoidance and resolution
41
what does health care reform look like in Ontario?
1. local health integration networks 2. patients first: action plan to health care 3. bundled care teams 4. connecting care act -> dissolution of LHIN, creation of Ontario Health and Ontario Health Tems
42
What is primary health care
routine care, care for urgent but minor or common health problems, mental health, maternity & child care, psychological services, liaison w/home care, health promotion, disease prevention, nutrition counselling, end-of-life care
43
What is Universal Health Coverage (UHC)
all people have access to the full range of quality health services they need wheneve/wherev, w/o financial hardships
44
what are prov/tert drug benefit programs
income-based universal programs specific programs for population groups that need more coverage (higher costs) - seniors, social assistance recipients, diseased
45
Absolute Poverty
having less than absolute minimum income level - deprivation of basic needs SURVIVAL
46
Disadvantages to the absolute poverty measure
measured based on the cost of basic needs 1. difficult to select a minimum set of necessities (every region has different) 2. cut-off of what is considered the minimum income level changes over time
47
Relative Poverty
having less than the average standard in a society EXCLUSION
48
Which is the more accurate measure of income in a population
Median income - midpoint level of income
49
Difference between equality and equity
Equality: not fair, not leveraging necessities Equity: fairness, justice, human rights
50
Difference between inequality and inequity
Inequality: the condition of being unequal (may or may not be fair) Inequity: unfairness or bias, occurs when differences relate to factors such as race, gender, sexuality, or intersectionality of factors
51
Why is income important SDoH
Income Shapes - overall living conditions affected physiological and psychological functioning Income Determines - quality of other SDoH such as food security, housing, education, early childhood development
52
Wilkinson Ted Talk
- income inequality is more significant within societies as opposed to between societies (w/in: people in communities) (b/w: 1 community to another community)
53
What is the Social Gradient
variation among individuals and groups due to income - poor people have the worst health - countries lower on social gradient are more unequal
54
Gini Coefficient
metric of income inequality 0 (0%) = perfect equality (everyone has same income) 1 (100%) = perfect inequality (one person has all income)
55
Which are the hardest hit populations
- women and children - older adults (65+) - people experiencing homelessness - radicalized groups
56
Low Income Cutoff After Taxes (LICO-AT)
- level below at which families or individuals spend 20% or more of after tax income than average on food, shelter and clothing - updated regularly
57
Low Income Measure (LIM)
- fixed percentage (50%) of median adjusted household income - considered low income if a family's income is below the LIM for family type and size
58
What is welfare in ontario
benefits to support people w/disabilities and people who can't work
59
What is basic income
government program that provides a certain sum of money to a country's or certain region's citizens - guaranteed income so people can afford basic needs to help them thrive - robust social safety net
60
Why does income influence health
1. underinvestment in human capital - skills, knowledge, and experience possessed by an individual 2. underinvestment in social capitol - community solidarity/cohesion 3. psychosocially mediated effects - frustration and biological processes that are harmful
61
Whais welfare state
how society views what it owes members by virtue of citizenship or residence - electoral system a barrier
62
Policy Implications of income and health
- increase minimum wage to living wage and boost social assistance levels for most disadvantaged - reduce inequalities with progressive taxation using revenues to provide universal programs and services - more unionization in workplaces - progressive taxation
63
What is a social safety net
range of benefit programs & supports that protect citizens during life changes
64
what is scarcity mentality
people act differently when they believe things to be scarce
65
What do bigger income gaps result in
deteriorations in social relations, health and human capital

SDoH (2 decks)

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