Key informants described the cost of health services, lack of transportation, and health service characteristics as barriers to Māori access to health care. Interventions that address financial and logistical barriers have been found to be effective at increasing access to healthcare.

Māori are half as likely as non-Māori to benefit from private health insurance. Māori experience more hospitalisation due to primary care interventions or lack of intervention.

Māori adults report high rates of most health conditions, particularly diabetes and asthma. Rates of diabetes are high among Pacific adults. Rates of diagnosed mental health conditions are rising. Rates of psychological distress are high among Māori and Pacific adults, and in adults living in the most deprived areas.

In New Zealand, ethnic identity is an important dimension of health inequalities. Maori health status is demonstrably poorer than other New Zealanders; actions to improve Maori health also recognise Treaty of Waitangi obligations of the Crown. Pacific peoples also have poorer health than Pakeha.

Health inequalities arise because of the conditions in which we are born, grow, live, work and age. These conditions influence our opportunities for good health, and how we think, feel and act, and this shapes our mental health, physical health and wellbeing.

Health inequalities go against the principles of social justice because they are avoidable. They do not occur randomly or by chance. They are socially determined by circumstances largely beyond an individual’s control. These circumstances disadvantage people and limit their chance to live longer, healthier lives.

Prevention can help to reduce health inequalities. For this to happen, prevention needs to be at least as effective in groups of the population with the worst health. Cost-effective health improvement: Preventing people taking up smoking (primary prevention) avoids smoking-related illness.

Conditions that lead to marked health disparities are detrimental to all members of society. Some types of health inequalities have obvious spillover effects on the rest of society, for example, the spread of infectious diseases, the consequences of alcohol and drug misuse, or the occurrence of violence and crime.

Reducing inequality requires transformative change. Greater efforts are needed to eradicate extreme poverty and hunger, and invest more in health, education, social protection and decent jobs especially for young people, migrants and other vulnerable communities.

Effects of income inequality, researchers have found, include higher rates of health and social problems, and lower rates of social goods, a lower population-wide satisfaction and happiness and even a lower level of economic growth when human capital is neglected for high-end consumption.

In England, there is a systematic relationship between deprivation and life expectancy, known as the social gradient in health. Males living in the least deprived areas can, at birth, expect to live 9.4 years longer than males in the most deprived areas. For females, this gap is 7.4 years.

nurses

The report describes nine determinants of health that are drivers of health inequities: income and wealth, housing, health systems and services, employment, education, transportation, social environment, public safety, and physical environment.

In the literal sense, disparity merely implies a “difference” or a “lack of parity” of some kind [1]. Inequity, on the other hand, implies “a state of being unfair”[1]. In the context of health care, these two concepts may have distinct implications for practice and policy.

Social determinants of health such as poverty, unequal access to health care, lack of education, stigma, and racism are underlying, contributing factors of health inequities. The Centers for Disease Control and Prevention (CDC) is committed to achieving improvements in people’s lives by reducing health inequities.

Health disparity and health equity or inequity are often used interchangeably because it is challenging to speak of one without the other. Inequity kept the patient in the previous section from obtaining insurance and accessing affordable preventive care, and she ultimately developed a chronic illness.

Health disparities are preventable differences in the burden of disease, injury, violence, or in opportunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, and other population groups, and communities. Health disparities exist in all age groups, including older adults.

The United States has among the largest income-based health disparities in the world: Poor adults are five times as likely as those with incomes above 400 percent of the federal poverty level to report being in poor or fair health.

Multiple socioeconomic factors contribute to health disparities, including income, education, residential segregation, stress, social and physical environment, employment, and many others. Disparities according to income and education have increased for smoking, with low-income persons smoking at higher rates.

Raising public and provider awareness of racial/ethnic disparities in care; Expanding health insurance coverage; Improving the capacity and number of providers in underserved communities; and. Increasing the knowledge base on causes and interventions to reduce disparities.

One of the most powerful things nurses can do to reduce health disparities is to advocate for their patients. This may include advocating for patient rights, appropriate resources, interpreters, distress screening or even cultural-competence training in your workplace.

Healthy People 2020 organizes the social determinants of health around five key domains: (1) Economic Stability, (2) Education, (3) Health and Health Care, (4) Neighborhood and Built Environment, and (5) Social and Community Context.

What are social determinants of health?

• Economic Stability.
• Education Access and Quality.
• Health Care Access and Quality.
• Neighborhood and Built Environment.
• Social and Community Context.

Wider determinants, also known as social determinants, are a diverse range of social, economic and environmental factors which impact on people’s health. Such factors are influenced by the local, national and international distribution of power and resources which shape the conditions of daily life.

The World Health Organization (WHO) describes social determinants as ‘the circumstances in which people grow, live, work, and age, and the systems put in place to deal with illness. The conditions in which people live and die are, in turn, shaped by political, social, and economic forces’ (CSDH 2008).

What can be done at the community level?

1. Partnerships with community groups, public health and local leaders.
2. Using clinical experience and research evidence to advocate for social change.
3. Getting involved in community needs assessment and health planning.
4. Community engagement, empowerment and changing social norms.

The following list provides examples of the social determinants of health, which can influence health equity in positive and negative ways:

• Income and social protection.
• Education.
• Unemployment and job insecurity.
• Working life conditions.
• Food insecurity.
• Housing, basic amenities and the environment.

For Aboriginal and Torres Strait Islander people, the social determinants of health also include factors such as cultural identity, family, participation in cultural activities and access to traditional lands.

Social determinants of health are the conditions that we live, learn, work, and play in. These conditions can influence the health and well-being of you and your community. These factors affect your ability to take part in healthy behaviors, and this affects your health.