1. Quality Education for a Healthier Scotland Module 5 A Community Development Approach

2. Quality Education for a Healthier Scotland Learning outcomes  Describe the difference between the social model of health and medical model of health  Identify the barriers to good health  Explore the idea of equity in health  Define poverty and relative poverty

3. Quality Education for a Healthier Scotland Session outline  What is a ‘health inequality’?  Barriers to good health (medical & social model)  Poverty  Equity in health

4. Quality Education for a Healthier Scotland Activity – in pairs What is a health inequality ?

5. Quality Education for a Healthier Scotland Health Inequalities “Health inequalities can be defined as differences in health status… between different population groups.” (WHO, 2012)

6. Quality Education for a Healthier Scotland NHS set up 1948 Reduce health inequalities  To have free healthcare for anybody who needed it.  To have a fair service available to all groups of people. “The Health Divide” (1987) Margaret Whitehead

7. Quality Education for a Healthier Scotland Inequalities in Oral Health (NDIP) Health inequalities present

8. Quality Education for a Healthier Scotland Barriers to good health Access Lack of facilities Cost Transport Education/ Knowledge Time Motivation Embarrassment Confidentiality Lack of support – family/ friends Fear Age

9. Quality Education for a Healthier Scotland Barriers & Choices Group Activity

10. Quality Education for a Healthier Scotland Discussion Social & medical models of health

11. Quality Education for a Healthier Scotland Medical Model  Concerned with disease & illness  Pays less attention to the patient’s social situation or the wider environment.  Quantitative approach (Bury 2005)

12. Quality Education for a Healthier Scotland Social Model  Our health will be influenced by our social circumstances/ position in society.  Importance of social, economical, environmental & cultural influences.  Qualitative method  Holistic approach  Now widely recognised by health professionals (Willems et al, 2005)

13. Quality Education for a Healthier Scotland Social & Medical Model Zola

14. Quality Education for a Healthier Scotland What is Poverty? What factors lead to poverty?

15. Quality Education for a Healthier Scotland Poverty “Poverty is technically defined as when a person’s household income (adjusted for the size & composition of the household) is less than 60% of the UK median income” (Scottish Government, 2010) Drug/ Alcohol related Age Government Policy Family Employment Status Health Status Ethnicity Lack of education Recession – high cost of living, too many people, not enough jobs (Smith & Middleton, 2007)

16. Quality Education for a Healthier Scotland 2 Different types of poverty  Absolute Poverty  Relative Poverty

17. Quality Education for a Healthier Scotland Oppenheim and Harker for child poverty action group define absolute poverty as follows: “An absolute definition of poverty assumes that it is possible to define a minimum standard of living based on a person’s biological needs for food, water, clothing and shelter” Poverty, the facts (1996)

18. Quality Education for a Healthier Scotland Relative Poverty “individuals can be said to be in poverty when they lack the resources to obtain the types of diet, participates in the activities and have the living conditions and amenities which are customary, or at least widely encouraged or approved, in the societies to which they belong.” Townsend, P (1979); Poverty in the UK

19. Quality Education for a Healthier Scotland Group Activity List of necessities

20. Quality Education for a Healthier Scotland The effects of poverty Depression Very deprived families experience more stress than more middle class families as a result of living in poverty. Low school attendance More likely to be exposed to illness, evictions, poor nutrition, smoking/drinking, breast-feeding rates, poor oral health Social exclusion (Murali & Oyebode 2004)

21. Quality Education for a Healthier Scotland Poverty  Poverty is a barrier - accessing services. (WHO, 2008) (Sienkiewicz 2010)  Childsmile uses data collection to target those who are deprived and in most need to help people overcome this barrier.

22. Quality Education for a Healthier Scotland Equity 1. Oranges 2. Equity Ville

23. Quality Education for a Healthier Scotland Equity “The concept of health equity focuses attention on the distribution of resources and other processes that drive a particular kind of health inequality...” ( Braveman and Gruskin, 2003 )

24. Quality Education for a Healthier Scotland How healthy are we as a nation ? - http://www.scotpho.org.uk/homehttp://www.scotpho.org.uk/home CHEX has launched an online searchable database of community-led health organisations in Scotland. Visit the database here - http://www.chex.org.uk/project-search/http://www.chex.org.uk/project-search/

25. Quality Education for a Healthier Scotland Conclusions Questions Further reading www.scotland.gov.uk www.scotpho.org.uk www.cpag.org.uk/scotland www.growingupinscotland.org.uk