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Equity in Health Care Prof Sara Willems, MA, PhD Dep. of Family - PowerPoint PPT Presentation

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Equity in Health Care Prof Sara Willems, MA, PhD Dep. of Family Medicine and Primary Health Care Ghent University, Belgium Life expectancy in Belgium increases 2012 2012 total population: 79.65 years male: 76.49 years female: 82.95 years

  1. Equity in Health Care Prof Sara Willems, MA, PhD Dep. of Family Medicine and Primary Health Care Ghent University, Belgium

  2. Life expectancy in Belgium increases … 2012 2012 total population: 79.65 years male: 76.49 years female: 82.95 years Europe: 75.3 years for men and 81.7 years for women = + 2.7 and +2.3 years from 1998-2010

  3. … but not for all to the same extent Life expectancy for men aged 25 according to educational level 56 54 52 50 Number of additional years to live at the age 48 of 25 46 44 42 Higher Higher Lower Primary No degree education secondary secondary school education education degree Educational level Source: Van Oyen et al, 2010

  4. … but not for all to the same extent Life expectancy for men aged 25 according to educational level 56 54 Social gradient Social gradient 52 50 Number of additional years to live at the age 48 of 25 46 44 42 Higher Higher Lower Primary No degree education secondary secondary school education education degree Educational level Source: Van Oyen et al, 2010

  6. Not all differences in health are inequities in health ! inequalities Source:

  7. Not all differences in health are inequities in health Event Cause Inequity ? Source:

  8. Not all differences in health are inequities in health Event Cause Inequity ? Severe traffic injury Severe traffic injury Not wearing seat Not wearing seat No health inequity No health inequity belt (individual behaviour) Source:

  9. Not all differences in health are inequities in health Event Cause Inequity ? Severe traffic injury Severe traffic injury Not wearing seat Not wearing seat No health inequity No health inequity belt (individual behaviour) Higher rates of sickle cell Biological No health inequity anemia among blacks (genetics) Source:

  10. Not all differences in health are inequities in health Event Cause Inequity ? Severe traffic injury Severe traffic injury Not wearing seat Not wearing seat No health inequity No health inequity belt (individual behaviour) Higher rates of sickle cell Biological No health inequity anemia among blacks (genetics) Higher rates of arthritis among Biological (ageing) No health inequity elderly compared to children Source:

  11. Not all differences in health are inequities in health Event Cause Inequity ? Severe traffic injury Severe traffic injury Not wearing seat Not wearing seat No health inequity No health inequity belt (individual behaviour) Higher rates of sickle cell Biological No health inequity anemia among blacks (genetics) Higher rates of arthritis among Biological (ageing) No health inequity elderly compared to children Black women having babies with Reduced access to Health inequity Source: lower birth weight compared to medical care white women

  12. Health inequalities: differences in health status or in the distribution of health (determinants) between different population groups e.g. differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes

  13. Health inequalities: differences in health status or in the distribution of health (determinants ) between different population groups e.g. differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes

  14. Not all differences in health are inequities in health Event Cause Inequity ? Severe traffic injury Severe traffic injury Not wearing seat Not wearing seat No health inequity No health inequity belt (individual behaviour) Higher rates of sickle cell Biological No health inequity anemia among blacks (genetics) Higher rates of arthritis among Biological (ageing) No health inequity elderly compared to children Black women having babies with Reduced access to Health inequity Source: lower birth weight compared to medical care white women

  15. Health inequalities: differences in health status or in the distribution of health (determinants) between different population groups e.g. differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes Sometimes attributable to biological variations or free choice. Ethically or ideologically unacceptable to change/impossible to change SO unavoidable

  16. Not all differences in health are inequities in health Event Cause Inequity ? Severe traffic injury Severe traffic injury Not wearing seat Not wearing seat No health inequity No health inequity belt (individual behaviour) Higher rates of sickle cell Biological No health inequity anemia among blacks (genetics) Higher rates of arthritis among Biological (ageing) No health inequity elderly compared to children Black women having babies with Reduced access to Health inequity Source: lower birth weight compared to medical care white women

  17. Health inequalities: differences in health status or in the distribution of health (determinants) between different population groups e.g. differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes Sometimes attributable to biological variations or free choice. Ethically or ideologically unacceptable to change/impossible to change SO unavoidable

  18. Health inequalities: differences in health status or in the distribution of health (determinants) between different population groups e.g. differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes Sometimes attributable to biological variations or free choice. Ethically or ideologically unacceptable to change/impossible to change SO unavoidable Others attributable to external environment and conditions outside the control of the individuals concerned Uneven distribution is unnecessary and avoidable, unjust and unfair

  19. Not all differences in health are inequities in health Event Cause Inequity ? Severe traffic injury Severe traffic injury Not wearing seat Not wearing seat No health inequity No health inequity belt (individual behaviour) Higher rates of sickle cell Biological No health inequity anemia among blacks (genetics) Higher rates of arthritis among Biological (ageing) No health inequity elderly compared to children Black women having babies with Reduced access to Health inequity Source: lower birth weight compared to medical care white women

  20. Health inequalities: differences in health status or in the distribution of health (determinants) between different population groups e.g. differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes Sometimes attributable to biological variations or free choice. Ethically or ideologically unacceptable to change/impossible to change SO unavoidable Others attributable to external environment and conditions outside the control of the individuals concerned Uneven distribution is unnecessary and avoidable, unjust and unfair

  21. Health inequalities: differences in health status or in the distribution of health (determinants) between different population groups e.g. differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes Sometimes attributable to biological variations or free choice. Ethically or ideologically unacceptable to change/impossible to change SO unavoidable Others attributable to external environment and conditions outside the control of the individuals concerned Uneven distribution is unnecessary and avoidable, unjust and unfair Health inequities

  22. Can the healthcare system tackle / contribute to inequity in health?

  23. Source: B. Starfield, Why health care is important, presentation at Qatar-EMRO Primary Health Care Conference, Doha, Qatar, november 2008

  24. Source: B. Starfield, Why health care is important, presentation at Qatar-EMRO Primary Health Care Conference, Doha, Qatar, november 2008

  25. Can the healthcare system tackle / contribute to inequity in health? How can the healthcare system tackle / contribute to inequity in health?

  26. In order to contribute to health equity, health care should also be equitable

  27. In order to contribute to health equity, health care should also be equitable ?

  28. In order to contribute to health equity, health care should also be equitable Equal care for everyone?

  29. In order to contribute to health equity, health care should also be equitable Equal care for everyone? E.g. checking blood pressure

  30. In order to contribute to health equity, health care should also be equitable Equal care for everyone? E.g. checking blood pressure Equal care for people in equal need

  31. Equal care equal access equal treatments equal outcomes for people in equal need

  32. Variations in care access/treatment/outcomes because of social mechanisms, structures, processes ~ Inequity in health care

  33. Equity in health care? The case of Belgium

  34. Equal health care equal access equal treatments equal outcomes for people in equal need

  35. Financial barriers in access to health care?

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