This document outlines a lecture on health discrepancies and their causes. It introduces the lecturer, Precious Bembridge, who has 9 years of experience in higher education. The lecture will discuss early developments in healthcare like sanitation, principles of health promotion, and socioeconomic influences on health globally and nationally. Students will learn about using statistics to monitor health in England and how housing and homelessness impact health.

1. Background to subject – looking at discrepancies
in health and their causes
P.BEMBRIDGE

2.  My name is Precious Bembridge
 I have 9 years experience of Lecturing and
Managing in Higher Education settings
 My Educational Strengths expand from
Medicine, Science and Social Sciences.
 CEO Winmas Personnel(UK)
 url:www.winmascareservices.co.uk
 Email:pbembridge@arden.ac.uk
 Please introduce yourself
 Set your ground rules.

3.  Do you believe in the following Philosophical
arguments:
 “You eat to live or “Live to eat” True or False
 “You are what you eat” True or False

4.  By the end of the session the student will be
able to :
 Recognise early developments in healthcare,
such as sanitation in cities
 Understand basic principles leading to health
promotion
 Compare developments in different spheres

5.  By the end of the session the student will be
able to :
 Discuss the socio-economic influences on
health globally and Nationally
 Discuss the use of statistics to monitor health
in England
 Discuss the impact housing and
homelessness has on health

6.  Health promotion as defined by Ottawa
Charter in 1986 is the process of enabling
people to increase control over, and to
improve, their health (Ottawa Charter, 1986).
 To reach a state of complete physical mental
and social wellbeing, an individual or group
must be able to identify and to realize
aspirations, to satisfy needs, and to change
or cope with the environment.
 Health is, therefore, seen as a resource for
everyday life, not the objective of living.

7.  Watch these videos and take notes:
 https://www.youtube.com/watch?v=Qxx14R
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 https://www.youtube.com/watch?v=0ZHm3v
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 https://www.youtube.com/watch?v=TLpzHHb
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 https://www.youtube.com/watch?v=9NVT6iZ
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8.  GLOBAL/INTERNATIONAL- Diabetes is a serious,
chronic disease with a global interest(Global Burden
of Disease) (WHO, 2016); Cancer; Drugs; A global
brief on Hypertension - World Health Day 2013
 GOVERNMENT/POLICY-Report of the Global
Commission on Drug Policy 2011
 COMMUNITY-Community Action for health refers to
the joint effort by the communities that directed to
increasing community control over determinants of
health and thereby improving health
 INDIVIDUAL – Effort by the individual to increase
control over determinants of health and improving
health.

9.  The social determinants of health are the
circumstances in which people are born, grow
up, live, work and age, and the systems put in
place to deal with illness.
 These circumstances are in turn shaped by a
wider set of forces: economics, social
policies, and politics (WHO, 2013).

11. 
 Health inequality is the generic term used to
designate differences, variations, and disparities
in the health achievements of individuals and
groups.
 Health inequalities or inequity refers to those
inequalities in health that are deemed to be
socially produce (modifiable) unfair or stemming
from some form of injustice.
 Identifying health inequalities is concerned with
social justice

12.  Wealth of a nation –
 High income countries (UK, USA, Germany)
spend a greater proportion of GNP on Health
 Low income countries (Georgia, Nigeria)
spend much less

13. Includes factors such as:
 Poverty
 Illiteracy
 Malnutrition
 Early death
 Poor health care
 Poor access to safe water (Waterson 2003)

14.  Between 1985 and 1995 Germany, France and
the UK population had 100% access to safe
water but
 Ethiopia in 1982 only 4% of population had
access to safe water increasing to only 26% in
1995
 (World Bank 2000)

15.  Conflict can be a major reason for poor
health in a country.
 It undermines public health policies such as
immunisations
 E.g WHO target to eradicate polio by 2002
 India – virtually achieved
 Afghanistan, Somalia, Sudan – conflict has
stopped immunisation and prevented goal
being achieved

16.  Even wealthy countries are not immune to
recession affecting health of its population
 As unemployment increases the chance of
poverty, poor housing, homelessness and
poor diet can lead to Health issues in
population
 As National debts increase the country will
decrease spending on healthcare and
especially primary healthcare and public
health issues

17. Economic Well - being
Reduction by 50% in the proportion of people living in extreme poverty
by 2015
Social and human development
Universal primary education in all countries by 2015
Gender equality in access to primary and secondary education by 2005
66% reduction in mortality rates of under 5’s by 2015
Reduction in Maternal mortality by 75% by 2015
Access to reproductive health services by 2015
Environmental sustainabilty and regeneration
Implementation of national strategies for sustainable development in all
countries by 2005 to ensure reverse in loss of environmental resources

18.  Health profiles provided by the government
on a regular basis.
 Gateshead – General Health worse than
national average, deprivation higher than
national average, 8,700/ population of
192,000 children live in poverty (4.53%), life
expectancy lower than national average

19.  West Oxfordshire General health better than
national average, Deprivation lower than
national average, 1,700/ population of
104,000 children live in poverty (1.63%), Life
expectancy higher than national average.
 (www.statistics.gov.uk)
 TASK 15 mins
 Discuss what is the difference between these
2 areas of the UK that are only a few hundred
miles apart?

20.  Primary - Immunisations, Healthy eating etc
that prevent onset of illness
 Secondary – Cervical screening, wearing cycle
helmets, monitoring blood pressure etc that
lead to early detection and treatment of
disease or risk factors to prevent morbidity
and mortality
 Tertiary – Medication to reduce BP,
rehabilitation to increase mobility etc to
minimise disability and morbidity (Scambler
2008)

21.  The government in the 1990’s gave GPs a lot
of money to set up clinics such as
 Well man/ well woman clinics
 Asthma clinics
 Diabetes clinics
 Recently some of this money has stopped
 Question – do only the ‘worried well’ attend,
how do we get those who really need to
attend to do so? Discuss

22.  ‘Housing, health and well-being have always
been inextricably linked’
 ‘Shelter is a basic life necessity and adequate,
affordable housing in a secure
neighbourhood is commonly taken to be a
fundamental prerequisite for healthy and
happy living’ (Watterson 2003 pg 158)
 So how has the housing sector in the UK
changed in the 20th C and has this affected
Health?

23.  Beginning of 20th Century 90% 0f housing was
privately rented
 However poor housing conditions associated
with rapid urbanisation and industrialisation
led to state intervention- driven by concerns
about public health
 Central government saw the local authorities
as those who should provide state subsidised
housing

24.  State owned rented housing (council housing)
reached a peak in the 1970’s with only 10% of
rented housing being provided by private
landlords
 From the 1980’s with a change of government
the ‘right to buy’ council houses meant rented
council housing stock reduced and many councils
passed their stock over to housing associations
 From 1979 – 1997 the Conservative government
sought to reduce state intervention and public
expenditure and looked at expanding home
ownership

25.  Homlessness doubled during the 1980’s due
to market failures, cuts in social security
benefits, negative equity and repossessions
of owner occupied housing.
 The same has been happening in the last 4
years since the start of the current recession.

26.  There are well established links between
housing, deprivation and ill health so our job
as Health and social care practitioners is
really important if we are going to be able to
promote health in our clients.

27.  This is an enduring issue in the UK even
though we are a wealthy nation
 Signs of ill health in the homeless such as
reoccurrence of TB
 Homelessness also leads to other social
issues such as youth offending, poor
educational attainment, unemployment and
alcohol/drug abuse.

28.  Many homeless people are not registered with
GP’s so miss out on initiatives to promote
health – primary and secondary health
promotion initiatives.
 Many homeless people develop Mental health
problems
 How can we provide these services to
deprived populations who do not register
with G.P’s?

29.  Imagine you have been employed by an inner
London borough to work alongside homeless
people to improve their health outlook with
regards to health promotion.
 Who would you need to work with?
 How would you access the homeless?
 As well as health issues what other issues
might you try and tackle?

30.  Collaborative practice between health, social
services and other relevant agencies
 Healthcare taken to homeless people
 Appropriate support for people with
disabilities and mental health problems
 Minimise the use of temporary
accommodation for those that become
homeless.
 If accommodation is temporary it should be
appropriate i.e. Not bed and breakfast
accommodation for those with children

31.  By the end of the session the student will be
able to :
 Discuss the socio-economic influences on
health globally and Nationally
 Discuss the use of statistics to monitor health
in England
 Discuss the impact housing and
homelessness has on health

32.  Look at government homelessness statistics document on the
Unit site:
 Using the document there look at the causes of homelessness,
the people it is affecting and what is happening to help. Produce
a short powerpoint presentation 5- 6 slides that summarises the
findings of the paper.
 Look at the Dept of Health document on the unit site. What are
the Public Health promotion targets in the U.K for the
government? How are they going to ensure they are carried out? .
Produce a short powerpoint presentation 5- 6 slides that
summarises the findings of the paper.
Come back to class at 3.30 ready to discuss with to rest of class

33.  Scambler, G. (ed) (2008)Sociology as applied
to Medicine. Elsevier
 Waterson, A (ed) 2003 Public Health in
Practice, Palgrave
 World Bank (2000) Entering the 21st C world
development report 1999/2000. World Bank,
Washington, DC
 www.statistics.gov.uk