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Working with deprived populations

Working with deprived populations. Tackling health inequalities in primary care Dr. Les Goldman, Bradford. Aim. Examine concept of health inequality and how it affects work in general practice. Objectives. Understand concept of health inequality

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Working with deprived populations

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  1. Working with deprived populations Tackling health inequalities in primary care Dr. Les Goldman, Bradford

  2. Aim • Examine concept of health inequality and how it affects work in general practice

  3. Objectives • Understand concept of health inequality • Understand how it applies to a local practice population • Be able to develop initiatives to tackle health inequality at practice level • Community Orientation 

  4. How? • Short presentation • Group exercise - your experience of health inequalities • Group exercise - develop a practice plan • Discussion of our plans • Reflection on what we learned

  5. Definition • Unequal expectation of morbidity or mortality among different social groups • Reflects different exposure to risk due to • Socio economic status • Age • Disability • Ethnicity • Gender

  6. Inequality • Older people are ill more

  7. Inequity

  8. Inequity v inequality • Older people and people with disabilities have poorer access to health services • Higher risk of death by suicide or homicide among men • Ethnic differences in disease incidence • Diabetes • Infant mortality

  9. Determinants of health Acheson Report 1998

  10. Spectrum of health inequalities • Outcome - morbidity, mortality • Access to health care • Homeless • Disabled • Causes of ill health • Smoking, drug addiction • Obesity, poor nutrition

  11. Interventions • Upstream • Reduce income inequalities • Improve pre-school education • Government responsibility  • Downstream • At community or practice level • Access / lifestyle / morbidity • Practice / Commissioning Alliance / PCT 

  12. Task 1 • Your experience of health inequalities? • Has anything upset you? • Have you wanted to change something? • Feed back

  13. Task 2 • Make plan to tackle a problem in practice (access / risk / outcome) • SMART • Specific Measurable Attainable Relevat Time bound • PDSA • Plan Do Study Act • Short repeated cycles of change

  14. What changes are to be made? • Next cycle? • Objective • Questions/predictions • Plan to carry out the cycle (who, what, where, when?) • Plan for data collection • Complete the analysis of the data • Compare data to predictions • Summarise what was learned • Carry out the plan • Document problems and unexpected observations • Begin analysis of • the data PDSA

  15. Factors to consider • Who will be involved • In practice / outside practice • In implementation • Time • Funding

  16. References • London Health Observatory • www.lho.org.uk • Dept of Health • www.dh.gov.uk • Acheson Report - Independent Inquiry into Inequalities in Health 1998 • Tackling Health Inequalities - a Programme for Action Dept of Health Jul 2003

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