Fundamentals of Health Promotion for Nurses
Second Edition
Edited by Jane Wills
Short Answer Questions
Chapter 2: The patient in their social context
1. What is meant by health inequalities?
A health inequality is a term that describes an unjust disparity in health outcomes between individuals or groups.
2. What are the social determinants of health?
The social determinants of health are the collective set of conditions in which people are born, grow up, live and work, and that influence their health.
3. What is meant by a social gradient in health?
There is a social gradient in health whereby the poorest have the worst health, measured by early mortality or extent of disease. Across all countries, in general the lower an individual's socio-economic position, the worse their health and a social gradient in health runs from top to bottom of the socio-economic spectrum.
4. What is the name of the latest review of health inequalities in England?
It is called 'Fair Society, Healthy Lives' and sometimes is referred to as the Marmot Review after its chair, Sir Michael Marmot.
5. The Marmot Review recommended investment in early years, how might this improve health inequalities?
The framework proposed by this review shows that influences accumulate across our lives. Some may be protective, e.g., breastfeeding to improve a baby's immune system or a supportive environment in early childhood to increase self-esteem and resilience. Some, on the other hand, may present a risk, e.g., low educational attainment limiting our ability to earn a living wage or smoking. The review stresses the importance of good parenting and educational opportunities.
6. Which groups in England are disproportionately likely to experience ill health?
Those on low income, those living in remote parts of the country, Black and ethnic minority groups, older people.
7. Has the health gap between the richer and poorer groups in society narrowed or widened in the past 30 years?
The health gap between rich and poor has widened despite increased life expectancy.
8. What is meant by social exclusion?
Typically, as a result of poverty, people may be excluded from normal participation in society.