M4

go hand in hand

Advocacy involves communicating scientific data to inform awareness about global health issues

Advocates and scientists can work together to come up with implementable strategies and interventions to help eliminate these inequities

Then scientists can test success of interventions

the health inequities that exist between wealthy and impoverished pops

people w lowest income have highest levels of illness and premature mortality

Individuals living in extreme poverty have worse health compared to those who are wealthy

poverty affects health directly and indirectly (indirect includes inability to buy foods, safe housing, stressors)

work environment plays role in perpetuation of gradient

lower education = less likely to get a job and be financially stable

Educated have more access to health-promoting info and resources

Low-income more likely to be exposed to harms of climate change such as floods and droughts

mechanism that explains how individuals who are in poverty are trapped in poverty unless an external force intervenes by providing them w a significant amount of money and resources

actions of poverty become self-reinforcing

the total market value of all final goods and services produced annually in an economy

used as a comparative measure of economy and standard of living between countries

health inequities arise because of inequities in social determinants of health

in 2008, commission on SDHs called on WHO to lead global action towards closing gap

WHO committed to the goal of closing global health gaps in one generation, and they propose 3 ways to do this:

-improve daily living conditions (where people work, play, live): equity from start, healthy places, healthy people, fair employment/healthy work, social protection, UHC

-address inequities in power, money, and resources

measure and understand the problem and assess impact of action

5 areas to address:
-Equity from the start
-Health places, healthy people
-Fair employment and decent work
-Social protection across lifecourse
-Universal healthcare

physical dimension - Physical condition of household should meet all of individual's basic survival needs

social dimension - aspects such as affordability and home ownership, which contribute to person's sense of belonging and control over their home. also domestic environment

spatial dimension - Refers to location of a house in relation to other things in environment (schools, healthcare services, recreational areas, grocery stores). also consider proximity to industrial waste and contaminants

longitudinal study that looked into relationship between ensuring the healthy development of children, both physical and psychosocial, and a child's later development in life

When individuals work in healthy conditions, they gain financial security, social status, personal development, social relations, self-esteem, and protection from physical and psychosocial illness

adverse working conditions tend to be clustered in lower-status occupations. Associated with poor physical and psychosocial health and stress

Unemployment can have profound neg effects on physical and mental health through financial insecurity, material deprivation, a lack of opportunities for personal development, and increased stress

Involves improving larger built-in environment where people live, which has large impact on physical and mental health

Long-term international development initiative that aims to create an environment that supports health and a good quality of life

important driver in reshaping population health problems

leads to crowing, violence & injuries, diseases, pollution, gentrification

incr in urbanization = incr in pop

If vol of stores and access to services does not keep up w increased pop demand, then increased pop must compete for limited daily resources

With limited space, cost of housing increases, which can lead to crowding at family level

With increased urbanization and crowding, there tends to be an incr in disparities in standards of living amongst citizens which may lead to conflict over resources

have higher crime rates

urban centres that experience crowding and urbanization there is incr risk of spread of communicable disease due to large pop living in a close proximity

Impact of climate change is disproportional, with those living in SDI countries which have poor health infrastructure, people living on small islands, and those living in mega cities, mountain ranges, or polar regions being more vulnerable to climate change

low-value neighbourhoods experience an influx if affluent residents and business, transforming the neighbourhoods to high-value areas

consequences:
-incr rent leading to displacement
-changes racial composition
-can no longer afford basics

2 areas:

1. social protection across lifecourse
2. UHC

Key global aspiration is universal healthcare coverage regardless of ability to pay

Early childhood intervention that gave enriched preschool and access to healthcare for disadvantaged children in North Carolina

Followed them for 35 years

report suggested need to develop

4 pillars that systems should be built on to have better outcomes

1. Local action
2. Primary level of care (emphasis on primary level care)
3. Equitable system (not relying on ability to pay)
4. Prevention, health promotion, and intervention

- inadequate nursing stations
- lack medical transport
- lack support allocation and comparable access

telehealth

NOSM: Northern Ontario School of Medicine is mandated to both educate doctors and to contribute to care in Northern Ontario's urban, rural, and remote communities

aligning health policies across a # of government departments to promote health equity

Implies inclusion of several sectors, in addition to health sector, when attempting to design public policies meant to address health outcomes

Crucial because most of decisions that impact health of pop lies outside health sector

-social goods should be governed by public sector
-Legislation should promote gender equality
-Promote political empowerment

When state work to guarantee a complete set of rights for all citizens, and a fairy distribution of resources across society

founded by self-organization of disadvantage groups

Carries out set of complementary actions to combat the practice at grassroots and community level

obstacles that could harm the feasibility of a policy or intervention:
-Civil unrest
-Governmental policies or agendas
-Physical barriers
-Cultural barriers

factors or resources that can be leverages to increase the feasibility or effectiveness of a policy or intervention:
-Willingness of a community to accept a policy or participant in intervention
-Governmental programs that make additional resources available for addressing the health issue