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Pink Pub Quiz . Inequities. Services not targeted according to need this is the key determinant in health inequality Relate to Access to service Availability of responsive service Utilisation of services . Events rate.
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Inequities • Services not targeted according to need this is the key determinant in health inequality • Relate to • Access to service • Availability of responsive service • Utilisation of services
Events rate • Number of people dying in a defined group of people in a given time
Social control role • Societal and political mechanisms or processes that regulate individual and group behaviour with the aim of maintaining social order
Health behaviour • Behaviours that people engage in that affect their health
‘Intention to treat’ analysis • Compare all participants • Reflects actual effect outside in clinical practice
Race • A concept that concentrates on assumed biological/genetic differences between groups of people • Racialisation is the process with creates the conditions for groups to be recognised as races and which makes racism possible
Odds ratio • Number of cases/number of non-cases
Direct racism • Treated less favourably due to ethnicity or religion • Basically – you know you’re doing it
Incidence • The number of new cases arising of a specified disease in a defined population at a given time
Indirect racism • People unaware that their actions are undermining the position of people from ethnic minority groups • You don’t realise you’re doing it
Inverse care law • The availability of good medical care tends to vary inversely with the need for it in the population served
Biopsychosocial model • The biology, psychology and social context of an individual which all play a role in their health
Lay belief • Peoples common sense understanding and knowledge about health and illness • Can be derived from scientific knowledge and/or evidence based practice • Generally rooted in peoples own experiences • Not necessarily different from medical understanding
Confidence interval • The measure of certainty which can be attached to the results e.g. 95%
Disability free life expectancy • The number of years an individual can expect to live with out a limiting chronic illness or disability
Access Inequality • A difference in the level or service provided to different areas or social groups
P-value • The probability that we could have obtained the observed data if the null hypothesis were true • Good p-value = less than 0.05
Ethnicity • A long shared history distinguishing one group from another • Cultural tradition including family, social customs and manners • Often but not necessarily associated with religious observance
Placebo effect • The patients attitude to their illness and indeed the illness itself, may be improved by a feeling that something is being done about it
Crude birth rate • Live births per 1000 population
Sex • Characteristics between males and females that are biologically determined
Culture • Shared experiences, beliefs and values • Members of a particular ethnic group may not share the same cultural experiences, beliefs or values -> need to be sensitive
Need • A claim for services and implies a capacity to benefit from an intervention • 4 main categories • Felt • Expressed • Normative • Comparative
Gender • The social and cultural meanings assigned to being male or female
Institutionalised racism • The collective failure of an organisation to provide an appropriate and professional service to people because of their colour/culture/ethnic origin
Prevalence • The number of people with a specified disease in a defined population at a given time
Social capital • Social networks and norms that facilitate co-ordination and co-operation • 2 types • Bonding – strong ties between individuals of a social network that see themselves as homogenous • Bridging – links across social groups in society who do not necessarily share similar social identities
Standard error SE • A measurement of how far from the ‘true’ value the estimate actually is
4 definitions of health • Health is the absence of illness • Health is functional ability • Health is equilibrium • Health is freedom • WHO definition – complete physical, social and mental well being and not merely the absence of disease or infirmity
Health Inequalities • Systematic differences in health and illness across social groups
Cohort study • Recruit DISEASE FREE individuals • PROSPECTIVE study • And classify according to their exposure status
The Census • A simultaneous recording of demographic date by the government at a particular time pertaining to all persons who live in a particular territory
Clinical trial • Any form of planned experiment that involves patients and is designed to elucidate the most appropriate method of treatment for future patients with the disease in question
Total fertility rate • Average number of live children that a group of women would have if they experienced the age specific fertility rates of the calendar year in question throughout child bearing years
General fertility rate • Live births per 1000 women aged 15-44 (child bearing years)
‘As-treated’ analysis • Only compare those that completed and complied fully with treatment • Compares physiological effects of treatment but loses randomisation
Attributable risk • (Incidence rate exposed – incidence rate non-exposed)/incidence rate exposed • How much risk can we assign to a factor and therefore how much disease/problem would we get rid of if we eliminated that factor
Epidemiology • The study of disease in populations
Confounder • A factor that is associated with the exposure under investigation but independently affects the disease risk
Standardised mortality rate SMR • Number of observed deaths/ number of expected deaths
Null hypothesis • No effect • If they ask it in an exam – you might be asked to write out a possible null hypothesis for a scenario they give – basically there is NO difference between the two groups/treatments/studies – how ever they phrase it
Case-control study • A RETROSPECTIVE study • Recruiting a group of cases based on their disease state • Then identify a group of suitable non-cases
Relative risk • The number of cases in population A relative to the number of cases in population B
Placebo • An inert substance identical in taste, colour, size etc • Packaged and labelled in an identical container to active drug
Clinical equipose • Reasonable uncertainty about which treatment (including non-treatment) is better • Randomisation does therefore not deny any patient the best treatment