Health Systems
·
Determinants of child health:
o Biology: genetic, development in utero
o Socio-economic:
§ Housing
§ Income
§ Education (especially maternal – key issue in 3rd 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
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