Week 5: Health Inequities case study + Policy Analysis

Question 1

Health inequities are a health and societal concern because:

Answer 1

-They are inconsistent with canadian values
-They are unfair
-They cause preventable suffering
-They threaten the cohesiveness of community and society
-They challenge the sustainability of the health system
-They have an impact on the economy

Question 2

What are health inequities

Answer 2

-Disparities we see between diff populations when it comes to health
-Differences between people, more specifically groups
-Differences [in health] which are unnecessary and avoidable but, in addition, are considered unfair and unjust

Question 3

An example of a health inequity

Answer 3

Access to clean water ? Indigenous people vs Canadians

Question 4

Free standing approach to defining health inequities

Answer 4

any and all health inequalities are unjust (not very popular view but some people do hold it)

Question 5

Derivative approach to defining health inequities

Answer 5

health inequalities are unjust if and only if they are caused by unjust socially controllable causes

Question 6

True or False: According to WHO, the more unjust our social conditions are the more unnecessary avoidable deaths we see

Answer 6

true

Question 7

When are there inequities in the social determinants of health

Answer 7

unjust if social determinants are affecting health negatively

Question 8

True or False: Whether a difference is unjust has many different opinions

Answer 8

True

Question 9

What is the TB incidence rates for indigenous identity and what is it a result of

Answer 9

-0.7 per 100 000 non Canadian’s, and much higher for all different indigenous identities and extremely high for inuit in the north
-result of several other social injustices in society

Question 10

What are inequities in health influenced by

Answer 10

inequities in the social determinants of health

Question 11

True or False: the social determinants of health are addressed via policies in non-health sectors

Answer 11

true

Question 12

What is the reduction of health inequities dependent on

Answer 12

interventions in non-health sectors

Question 13

Almost all respondents __% felt that everyone in Ontario should have the same opportunity for a long and healthy life. Less than half __% felt that everyone does have the same opportunity to live a long and healthy life. Yet, only __ %felt that Ontario society needs major changes to make things more equitable.”

Answer 13

98%, 47%, 58%

Question 14

Brian Sinclair

Answer 14

Died after waiting 34 hours for treatment in Winnipeg emergency room
-Entered for bladder infection, might have sat there dead for 7 hours
-Aboriginal man, double amputee, whether racism placed a role
-Worker assumed man was “intoxicated” and was “sleeping it off”
-Security guard who found him dead told staff and they thought he was joking
-Underlying assumptions are racist.
-Changes have been made in ER, family lawyer says more disturbing info will be revealed.
-Not uncommon in canadian healthcare system

Question 14

True or false if we think its unjust we think its unnecessary

Answer 14

TRUE

Question 14

Mortality rate among those aged 20-24

Answer 14

0.6 per 1,000 (1,588 in 2021 in Canada)

Question 15

Mortality rate among those aged 90+

Answer 15

186 per 1,000 (64, 451 in 2021 in Canada)

Question 16

Universalism

Answer 16

a policy approach where eligibility and access to intended benefits are based simply on being part of a defined population without any further qualifiers such as income, education, class, race, place of origin, or employment status.
-2020-2021 vaccine roll out had diff priority groups created barriers

Question 17

Canada Health Act and healthcare is an example of..

Answer 17

Universalism

Question 18

Target Approach

Answer 18

a policy approach where eligibility and access to intended benefits are determined by selection criteria, such as income, health status, employment status, or neighbourhood.
-example mobile health clinic that goes to the citys most vulnerable areads

Question 19

Proportionate universalism approach

Answer 19

a policy approach that “encompasses both targeted and universal approaches to ensure the population as a whole is proportionately allocated benefits and services.”
-Make sure it’s available to everyone but proportionally rolled out to certain groups

Question 20

Ontarios healthy baby healthy children policy (example of proportionate universalism approach)

Answer 20

no cost home visits to new mothers or new family. From pregnancy till school entry, get infant related needs. No one is negligible, baseline everyone gets something and low income and other metrics can be eligible for extra support, and will be funded. Universalism that’s also proportionate to needs.

Question 21

Policy Analysis

Answer 21

“… a process of multidisciplinary inquiry aiming at the creation, critical assessment, and communication of policy-relevant information.”
Require evidence or information from many different backgrounds and perspectives (health activists, economists, etc)
Can aim to create policy, but also to assess policy, also we might want to analyze that policy further to make it more effective or to reach other population.
“… a technique used in public administration to enable civil servants, activists, and others to examine and evaluate the available options to implement the goals of laws and elected officials.”

Question 22

Retrospective policy analysis

Answer 22

Analysis of policy (whether it exists or not)
Look backwards (that’s what retrospect means), see if it exists
Descriptive; explanatory; often conducted by researchers
What was the nature of the policy?
Why did a policy make its way onto the agenda?
Did a policy successfully achieve its objectives
Which policy instruments were used?
Who were the major actors who influenced the development of the policy and the policy process

Question 23

A policy has to be written down

Answer 23

false

Question 24

Prospective Policy Analysis

Answer 24

Analysis for policy
Ahead into the future, what we SHOULD do
Prescriptive; typically requested by decision-makers considering whether to develop and introduce a policy; often conducted by government policy analysts
What are the policy options available to address the issue under consideration?
How should a given policy be formulated?
How should a given policy be implemented
How might a given policy fare if introduced now?

Question 25

True or false: Policy brief consists of retrospective policy analysis

Answer 25

False: consists of prospective

Question 26

Why conduct a policy analysis?

Answer 26

-To systematically examine and evaluate the options available to pursue/implement the goals of laws to decision-makers
-To better ensure informed decision-making
-To better minimize bias
-To understand what has worked, what hasn’t worked and why
-To better understand the process of policy making

Question 27

Policy analysis triangle

Answer 27

Content, Context, Process, Actors

Question 28

Content

Answer 28

What makes up the policy itself
What is the policy statement
What is/are the policy objective(s)
What are the means through which policy objectives will be pursued (i.e., policy instruments)
What is the relationship between the response to the above questions
What reasons/ evidence are supplied (explicit or implicit) to justify responses to the above questions

Question 29

Actors

Answer 29

Individuals
communities/ populations
Interest groups
organizations/ corporations
Government bodies
** see stakeholder analysis

Question 30

Context

Answer 30

Situational factors: E.g., focusing events: wars, droughts, outbreaks
Structural factors: e.g., the political system (democracy vs dictatorship, etc), demographics, economy
Cultural factors: e.g., linguistic differences, ethnic minorities religious commitments
Exogenous factors: e.g., international treaties/ partnerships

Question 31

Process

Answer 31

Agenda setting, policy formation, decision-making, policy implementation, policy evaluation

Question 32

Stages

Answer 32

stages of the policy process

Question 33

Heuristic

Answer 33

an approach to analysis

Question 34

Stage Hueristic

Answer 34

an approach to policy analysis that breaks down the policy process info stages and analyzes each stage
-focuses on the process by which policies are initiated, formulated, implemented, evaluated

Question 35

Problem Identification and issue recognition

Answer 35

Why did the policy get on the agenda?

Question 36

Policy formulation

Answer 36

Who was involved in formulating the policy?
How was the policy arrived at and agreed upon?

Question 37

Policy implementation

Answer 37

How were the policy’s objectives pursued?
How was the policy put into action/ practice?

Question 38

Policy evaluation

Answer 38

Did the policy achieve its objectives?
What were the unintended consequences of the policy?

Question 39

Stakeholder (Actor)

Answer 39

“an individual or group with a substantive interest in an issue, including those with some role in making a decision or its execution.”

Question 40

Stakeholder analysis

Answer 40

“process through which those making policy or affected by it are identified and their likely position and levels of interest and influence are assessed.”

-identify the policy actors, asses actors political resources (power, influence), asses actors’ political resources (power, influence)

Question 41

Policy actors

Answer 41

rs
Consumer organizations (e.g., patient groups)
Producer groups (e.g., nurses, doctors, pharmaceutical companies)
Economic groups (e.g., workers who may be affected, industries, companies with health insurance schemes) (tobacco workers, farmers, corner store or variety stores have revenue from selling tobacco)
Ideological groups (e.g., single issue campaign organizations, political parties, researchers) (abortion great example)

Question 42

Assess actors political resources

Answer 42

Assess the power of each actor to influence the policy decision, through e.g.,:
Voting
Material resources (e.g., money)
Organizing people
Etc.

Question 43

Understand Policy actors positions and interests

Answer 43

stand policy actors’ positions and interests
Interests: e.g., expected economic effect on their interests; what do they have to gain or lose?
Position: e.g., supportive, neutral, opposed
Level of commitment: e.g., how much of their resources/ influence are they willing to devote to pursuing their interests in the policy (i.e., to support or oppose it)?