Positive discrimination in the allocation of health care resources is the only way to reduce persisting geographical inequalities in health in the UK-discuss . Help Please !

[fakeblondie]

I have to write the above as part of an application and would appreciate any interpretations/ thoughts on what they are looking for.
many thanks

What is the application for? Who are you applying to?

This looks like it is referring to evidence that where you live in the UK influences your health. For example, people in some parts of the UK have shorter life expectancies, higher incidence of heart disease, etc. Is positive discrimination the ONLY way to reduce inequality? Possibly not, as poor health is influenced by many factors, such as lifestyle, which may have social causes that would be better addressed by investment in education, jobs and regeneration of the area, or in raising individual expectations of health. For example, it is easy to understand how a person with no job or qualifications or hope for the future may turn to drink/drugs or comfort eating/smoking etc, with the knock on effects on their long term health. So arguably, positive discrimination in terms of public spending may be the only way to reduce inequality, but this would need to take a wider view than just the allocation of health resources.

Some initial thoughts - ask yourself these questions:

1. what are geographical inequalities in health?
2. What are considered the root causes of health inequalities? - arguable they will include economic, social, behavioural and cultural factors
3. Which health care resources? more community health services? More hospitals? More research into long term conditions? etc
4. If it is decided that health care resources should be reallocated, who makes that decision? What is the decision based on?
5. Ethics - is positive discrimination ever right? Will it cause other problems?
6. How will the effect of positive discrimination be measured?

I've said more or less the same thing as skivingagain

read the black report
identify key health issues that are affected by where you live, thinking specifically smoking, maternity services and breastfeeding but there will be more
What are other ways to reduce health inequalities - universal services would be obv one, advantages & disadvantages
Does 'discrimination' in this case have to refer to sex, age, disability etc, or could +ve discrimination include geography?

another way would be uiniversal prevention, new legislation & policies

oh and marmot report if you havent already

marmot indicators may provide specific examples

Wow thanks everyone.
It for a health visiting degree (am already post grad midwife ).

Skivingagain-youve rounded it up[beautifully. I def wasnt tinking laterally enough having been too long since ive written anything remotely academic !
Crystalglasses-thats the first thing i`ve done-huge spidergram with most of those questions on it somewhere.

Stealthpolar - interesting thoughts thanks- never really thought about particularly picking out womens services but considering the application form is for health visiting and i`m hoping to bring to the service my interest and expertise in womens health ( esp breastfeeding ) maybe i could focus on that -???

i assume you're aware of marmot & the black report
Good luck!

levels of deprivation and morbidity/mortality in a particular region DOES affect the amount of heatlhcare resources provided..but it's not just down to healthcare but lifestyle/employmnet/education level/access etc, several other factors

Well it's healthcare based on need - which is as it should be IMO

But still not clear what they mean by "discrimination" in this case, odd word to use unless they mean it - "targetted resources" would make a lot more sense to me

Yes but who defines need and decides how it shoul be met. How much is it driven by economics and political ideology and other vested interests?

At the moment the need is assessed through local JSNA which should take into account people who run services and service users.And in theory the "problem areas" should be defined by research. However I take your point and that's not something i know anything about but would like to if you have time - in fact shall I strat a "Health Inequalities" thread?
I suppose...in our area there has been a free school meals for all pilot. It is a huge success by all accounts. But it is being cut by the end of the year through lack of fundingUnderstandable, but wonder how much of that is evidence based

ooh what a great topic! Suggest you google 'postcode' lottery too and look at scholarly articles that come up.
I did my dissertation on similar lines but was about social care not health care.
Health visitors have huge role to play, but of course they do need the govt funding.
Let us know how you get on!

Very shortly there's going to be a huge recruitment of HV so look at the background papers to this.

Does this really mean " means testing in the NHS- a good idea?"

Personally I think it would be but that's quite a radical idea.