P11#2
TaniAlexis
P112.docxDesry Hyacinth
RE: Discussion - Week 11
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Week 11; initial post
The concept of health equity has been described as differences in health care that are unnecessary, unfair, and unjust and avoidable. The term health equity and health inequality are not synonymous, though they are often used interchangeably. Health inequality on the other hand designates differences, variations and disparities in health achievements of individuals and groups. Health equality does not imply moral judgement. The crux of the distinction between equality and equity is that the identification of health inequities entails normative judgement premised upon one's theories of justice, society and reasoning underlying the genesis of health inequalities. Inequalities in health between population groups exist in all countries. These differences occur along several axes of social stratification including socioeconomic, political, ethnic, cultural and as discussed in this issue by Buyana, gender. The causes of inequalities in developed may be different from those in developing countries. There is not a great deal of mystery as to why poor people in low income countries suffer from high rates of illness particularly infectious diseases and malnutrition: little food, unclean water, low level of sanitation and shelter, failure to deal with the environments that lead to high exposure to infectious agents and lack of appropriate medical care. Similarly there is a great deal of knowledge of the causes of non-communicable diseases that represent the major burden of disease for people at the lower end of the social gradient in middle income and high income countries. The World Health Organization global burden of disease study identified underweight, overweight, smoking, alcohol, hypertension, and sexual behavior as major causes of morbidity and mortality. Addressing social determinants of health will yield greater and sustainable returns to existing efforts to improving global health. There is need for empowerment of individuals, communities and countries. Empowerment can be seen to operate at three interconnected levels/dimensions- materials, psychosocial and political. People need the basic material requisites for a decent living, they need to have control over their lives and they need a political voice and participation in decision making processes (African Health Science 2009).
Hygiene refers to acts that can lead to good health and cleanliness, such as frequent handwashing, face washing, and bathing with soap and water. Keeping hands clean is one of the most important ways to prevent the spread of infection and illness. However, in many areas of the world, practicing personal hygiene is difficult due to lack of resources such as clean water and soap. Many diseases (including diarrheal diseases) can be spread when hands, face, and body are not washed appropriately at the key times (Center for Disease and Control 2016).
Education is critical to social and economic development and has a profound impact on population health. We review evidence for the health benefits associated with education in the context of a socioecological model of health. The health benefits of education accrue at the individual level (e.g., skill development and access to resources); the community level (e.g., the health-related characteristics of the environments in which people live); and the larger social/ cultural context (e.g., social policies, residential segregation, and unequal access to educational resources). All of these upstream factors may contribute to health outcomes, while factors such as ability to navigate the health care system, educational disparities in personal health behaviors, and exposure to chronic stress act as more proximate factors (Zimmerman, Woolf, Haley 2015).
People in poor countries tend to have less access to health services than those in better‐off countries, and within countries, the poor have less access to health services. Many different approaches are shown to improve access to the poor, using targeted or universal approaches, engaging government, nongovernmental, or commercial organizations, and pursuing a wide variety of strategies to finance and organize services. Key ingredients of success include concerted efforts to reach the poor, engaging communities and disadvantaged people, encouraging local adaptation, and careful monitoring of effects on the poor. Yet governments in low‐ and middle‐income countries (LMICs) rarely focus on the poor in their policies or the implementation or monitoring of health service strategies (Peters, Gag, Bloom, Walker, Brieger, Rahman 2008).
Global health issues (GHIs) require global cooperation in response, planning, prevention, preparedness, and care that reflects health equity issues among nations. These issues require complex inter-professional and interagency cooperation and solutions that involve governments, non-profits, and many times include private companies and foundations. The widening gap between supply and demand of healthcare workers indicates the need for an urgent response. Closing the gap to improve access to care is not as simple as producing more healthcare workers. Many factors impact the balance of demand and the supply of timely, appropriate care. The number of healthcare workers is only one of many factors impacting access to care on a global scale. Healthcare workers are not easily attracted to many rural areas where there are limited options to work. They may perceive negative lifestyle differences when compared to urban and suburban options. Salaries for health workers tend to be lower in rural areas, but these individuals may work longer hours due to the limited number of providers. Volunteer work; nurses can assist by volunteering.
References:
Health equity: challenges in low income countries. (2009). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2877288/
Hygiene in Lower Income Countries. (2016).
Population Health: Behavioral and Social Science Insights. (2015). Retrieved from https://www.ahrq.gov/professionals/education/curriculum-tools/population-health/zimmerman.html
Poverty and Access to Health Care in Developing Countries. (2008). Retrieved from https://nyaspubs.onlinelibrary.wiley.com/doi/full/10.1196/annals.1425.011
Emerging Global Health Issues: A Nurse’s Role. (2017). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-22-2017/No1-Jan-2017/Emerging-Global-Health-Issues.html
