Health Systems - Paediatrics

Health Systems

·        Determinants of child health:

o   Biology: genetic, development in utero

o   Socio-economic:

§  Housing

§  Income

§  Education (especially maternal – key issue in 3^rd world)

o   Environment:

§  Social

§  Physical

o   Health Behaviours

o   Health Services

·        Impact of determinants:

o   Perinatal complications and family adversity have an independent impact on cognitive ability

o   Social adversity is a bigger factor in mild mental retardation than biological factors

o   Variations in family social background is a:

§  Weak determinant of specific problems

§  Pervasive determinant on generalised vulnerability to a wide range of problems 

o   Large differences in absolute income have little or no effect on mortality. Small increases in income equality have a large effect

·        Improving health equality through health services:

o   Population based measures:

§  Resource allocation

§  Intersectorial collaboration

§  Community development

§  Data collection on deprivation

§  Salaried GP services for deprived areas

o   Individual health services:

§  Site and mode of provision of services 

§  ­Communication with consumers

§  Targeting of preventative services