Background and Objectives
Question:
Discuss about The Health Funding Authority response to reducing.
Health inequalities are widespread all over the world. This report provides a perfect synthesis of the health inequality audit carried out in Riverlands that was divided into 15 subzones. According to HM Treasury (2002) about the Cross-Cutting Review on Health Inequalities, the obligations of the government were stipulated to minimize inequities in the health sector and recognize that sustainable action on the broader contributing factors of health inequities is necessitated if the generation cycle of poverty and health is to be shattered. National policy and strategy indicate a collection of clarifications and interpretations of the meaning of tackling health inequities (Graham, 2002).
This report discusses four significant determinants of health inequities in Riverlands. These contributing factors are general socioeconomic and environmental conditions, gender, ethnic identity, and geographic place of residence. For instance, general socioeconomic and environmental conditions, that is, the status people have in the society regarding education and incomes can affect the ability of a person to access health services (HFA, 2000).
In this report, health inequity is conveyed in three ways:
- Utilization of health services: – where the rehabilitation, prevention and treatment measures are put into consideration.
- Health outcomes: – where the mortality (life quantity) and morbidity (life quality) are considered.
- Health risks: – where behavioral, biological and environmental factors are considered.
Taking into consideration the failure to minimize inequalities in the health sector, we decided to carry out an audit in Riverlands, primarily to identify what more the local government could ensure to improve the outcome. Our focus was the input the NHS and Department of Health have made in securing health equity. The following were our terms of reference:
- Whether the Government, through the Ministry of Health, has met its public service targets in respect to health inequalities in Riverlands;
- The accomplishment of NHS organizations to co-coordinate activities with local authorities of Riverlands and other relevant organization in handling the issue of disparities;
- The efficiency of the Department of Health in co-coordinating policies and strategies with the local government departments, in an attempt at minimizing health inequalities;
- The quality and distribution of GP services and their impact on health inequalities, and how the outcome and quality structure might be applied to reduce disparities in the health sector;
- The efficiency of public health services in minimizing health inequalities by aiming at the leading causes of disparities such as smoking in local areas; and
- Whether the Government, through the Ministry of Health, has met its public service targets in respect to health inequalities in Riverlands.
Health inequities in Riverlands society are documented in several aspects. Health and other relevant agencies usually collect health statistics, and available in a range of source documentations which we immensely relied on. There are limitations in the available data regarding methods of collections, interpretation, and quality. However, regardless of the restrictions, the information evidently indicates health inequalities across the subzones of Riverlands in the stated measures: gender, socio-economic status, cultural uniqueness, and geographical dwelling place.
Both gender and sex impact the disparities in health outcomes of women and men. Sex is the biological differences recognized between women and men, while gender is the social classification that describes the cultural and social structure of masculinity and femininity in the social order, indicating the difference in allocating supremacy and resources (Ostlin, 2002).
Gender inequalities cause particular morbidity and mortality suggesting that the involvements with the aim of minimizing differential wellbeing amongst men should have a focus distinct from interventions that reduce women health inequalities (Smith et al., n.d.). The gender health inequalities in outcomes are as a result of differential gender risk factors, for instance, differential labor exposure segregation both at home and workplace, and the difference in accessing economic and social resources. The health of both women and men is affected by gender policies and gender roles. Awareness programs need to be established in Riverlands to sensitize the influence of roles which expose gender to health hazards, utilization of available health services and health outcomes.
Averagely in Riverlands, men have shorter life expectancy than women. Differences in gender health are illustrated in figure 3 below.
Contributing Factors to Health Inequalities in Riverlands
The lifestyle factors which impact inequalities in health are also referred to as the ‘proximate’ causes of inequalities in health since they are the direct originators of illnesses as opposed to the ‘broader determinants ‘such as socio-economic factors (Kristenson, 2006). These factors are smoking, nutrition, exercise, alcohol consumption, drug use, and sexual behavior. In Riverlands, the statistic shows that higher percentage of men smoke than women.
indicates the level of smoking among adults in the subzones of Riverlands. Amongst male adults, daily cigarette smoking varies from an estimate of 22% in Subzone 01 to 45% in Subzone 14. Females recorded the lowest and highest percentage in cigarette smoking; 12% in Subzone 01 and 27% in Subzone 14 respectively.
Health and possibilities of untimely deaths are caused by socioeconomic factors prevailing throughout the life and across the generation (Davey-Smith et al., 1997). Therefore, health in the middle or old age is subject to the previous socioeconomic status along with the current situation. In Riverlands, the subzones have registered a group of people with low level of education. This always results in underpaid jobs which are vulnerable and expose them to chemical and physical menaces, and inadequate housing.
There are several reasons behind the social-economic disadvantaged people in these zones to less likely embrace the beneficial health demeanors (Marmot & Bell, 2013). First, the relevant information as a guide on how they should healthily behave is not reaching them. Moreover, they lack the necessary resources that can enable them to live healthily, furthermore, the environment (swampy and infested with mosquitoes) where they live negatively affect their health. It is also apparent that demeanors such as smoking are characterized and more inbuilt in those people with low socio-economic status.
above shows the employment rate in Riverlands. Subzone 10 records the lowest rate of unemployment of 10% among females and 11% among males. Subzone 04 marks the highest percentage of unemployment of 25% among females and 23% among males. This scenario explains the inequalities in health across the subzones which are as a result of unemployment. In every Subzone, females recorded lower percentage compared to males.
Where people live, place of residence plays a significant role in creating health inequalities. It is the physical, local and social environments of the people. The acknowledged characteristics of people’s place of residence that create inequalities in health are (Pearce, Mitchell, & Shortt, 2015):
- The difficulty in accessing the place for the health services to be provided;
- The difficulty in accessing the place for educational facilities, employment and societal activities;
- An unavailability of food choices which are healthy and affordable;
- Lack of safety factors on roads, lack of recreational facilities, and the shortage of public transport systems; and
- Lack of suitability and better quality of the housing stock.
Some zones in Riverlands that are poverty-stricken experience features that make them unhealthier compared to those who live in wealthier zones. Therefore, life expectancy in poverty-stricken subzones is lower compared to the life expectancy of those people in wealthier subzones. Moreover, some subzones in Riverlands are very marshy denying the accessibility of health services. Subzones within Riverlands have negative perceptions and low level of cohesiveness with other subzones making it difficult for health services to be provided equally. Figure 4 indicates that subzone 09 has a longer life expectancy at birth compared to other subzones. Moreover, females generally have a longer life expectancy at birth than males as illustrated in figure 4.
Gender and Health Inequalities
The Australian government should bring into notice national indicators particularly to observe and control the progress of minimizing inequalities in health both nationally and locally. Besides, NHS together with Australian government should assess the geographical spread of primary care services to make sure that the requirements related to higher deprivations levels are sufficiently resourced.
Furthermore, the NHS boards and councils should ascertain things that they jointly employ in reducing inequalities in health sector locally, and work together to make sure that the targeted resources are those resources with the highest demand. The NHS should as well observe and control the usage of hospital services by the diverse group of people, and apply the gotten information to find out whether a particular line of action is necessary to help a specific group of people to access health services.
Conclusion
All the evidence indicated an apparent relationship between deprivation of socio-economic, poverty, and higher levels of morbidity and shorter life expectancy. Health inequities mirror broader inequalities that result from the social divisions in our societies (Jelfs, 2016). There are measures that local authorities of Riverlands can take through benefits schemes to aid in reducing economic disparities which eventually would influence iniquities in health. The existent of health inequalities in Riverlands is indicated by various indicators of the state of wellbeing: morbidity, mortality, and life expectancy
Acronyms and terms used in the report
ABS Australian Bureau of Statistics
GP General Practice
NHS National Health Service
SF36 This is a measure of health status
WHO World Health Organisation
References
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Davey-Smith G, Hart C, Montgomery S. 1997. Lifetime Socioeconomic Position and Mortality.Prospective Observational Epidemiology. British Medical Journal 314: 547–52.
Department of Health (2011). The health and wellbeing of Aboriginal Victorians: Victorian Population Health Survey 2008 Supplementary report, State Government of Victoria, Melbourne.
Graham, H. (2002) ‘Tackling inequalities in health in England: remedying disadvantage, narrowing gaps or reducing gradients?’ Internal discussion paper. Health Development Agency, London.
HFA. (2000). Striking a Better Balance: A Health Funding Authority response to reducing inequalities in health. Wellington: Health Funding Authority.
HM Treasury (2002) The Cross Cutting Review on Health Inequalities. Summary Report. HM Treasury, London.
Jelfs, P. (2016). The Australian Bureau of Statistics’ Aboriginal and Torres Strait Islander enumeration and engagement strategies: challenges and future options. Indigenous Data Sovereignty. doi:10.22459/caepr38.11.2016.15
Kristenson, M. (2006). Socio-economic position and health. Social Inequalities in Health, 127-152. doi:10.1093/acprof:oso/9780198568162.003.0006
Marmot, M., & Bell, R. (2013). Socioeconomically Disadvantaged People. Social Injustice and Public Health, 21-41. doi:10.1093/med/9780199939220.003.0002
Ostlin P. 2002. Gender perspecitive on socioeconomic inequalities in health. In J Mackenbach, M Bakker (eds). Reducing Inequalities in Health: A European perspective. London: Routledge Press.
Pearce, J., Mitchell, R., & Shortt, N. (2015). Place, space, and health inequalities. Health Inequalities, 192-205. doi:10.1093/acprof:oso/9780198703358.003.0014
Public Health Information Development Unit, Medicare Locals Instant Atlas, University of Adelaide
Smith, G. D., Hart, C., Upton, M., Hole, D., Gillis, C., Watt, G., & Hawthorne, V. (n.d.). Height and risk of death among men and women:. Health inequalities, 233-250. doi:10.2307/j.ctt1t8955q.27
VicHealth (2004). The Health Costs of Violence. Measuring the burden of disease caused by intimate partner violence. VicHealth, South Carlton.
Victorian Department of Health (2012). Mornington Peninsula (S) and Frankston (C) 2011. Local Government Area Profiles, Modelling, GIS and Planning Products Unit, Melbourne.
World Health Organization (2017) ‘Gender, equity and human rights’, https://www.who.int/genderequity-rights/understanding/gender-definition/en/
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