2. World Health Organisation Definition
Health is not only the absence
of infirmity and disease but also
a state of physical, mental and
social well-being
3. Source: Dahlgren G and Whitehead M (1991) Policies and strategies to
promote social equity in health. Stockholm, Institute for Futures Studies
4. Health Inequalities
Inequality in access to health care
(Inverse care law)
Inequalities in health outcomes
Inequalities in the determinants of
health (for example, in education,
employment or housing)
6. What is deprivation?
Poverty?- economic/ social/ political
Absolute- lack of basic needs- food,
shelter, clean water
Relative- wealth gap/ social
exclusion
Social- lack of access to
information, education, health care,
political power
A commodity, a particular ideal state, a variable state which enables a person to function normally, a reserve of strength, ability to adapt to changing circumstances, a resilent spirit
A positive and universal human right
Broadly speakig there are 3 types of inequality in health (refugees have difficulty in obtaining primary health care) (refugees have difficulty in obtaining primary health care) Outcomes eg. North-south divide in life expectancy. Manchester has the lowest life expectancy for men in England (5 yrs under the national average)
The Index of Multiple Deprivation 2004 measures deprivation in these 7 domains and produces a aggregated score for each super output area in England
If we look at the most deprived 20% of SOAs- the region with the most of these is the North East (38%) followed by the North West (33%). And we can see a massive north-south divide in the distribution of deprivation Income deprivation: this includes income support households, job seekers allowance, working families tax credit, disabled person’s tax credit, supported asylum seekers Employment deprivation: unemployment claimants, incapacity benefit claimants, severe disability allowance claimants of working age Health and Disability: identifies areas with relatively high rates of people who die prematurely or whose quality of life is impaired by poor health or who are disabled (years of potential life lost, comparative illness and disability ratio, emergency admissions, mood and anxiety disorders) Education and Skills Education for children and young people, and lack of skills and qualifications among the working age popualtion Housing and services: overcrowding, affordability to owner occupier, distance to GP, supermarket, primary school, post office
Lower level super output areas (LSOAs) are areas with a minimum of 1000 residents and 400 households. In total Greater Manchester has 259 LSOAs