Health InequalityIs there an app for that?

MobiMooc12Week 3 mHealthMalcolm Lewis

http://about.me/malcolm_lewis

My view point

• Health Promotion Officer with a population health focus.

• My viewpoint biases:– Making and keeping

healthy people healthier, – rather than prevention of

sick people getting a sicker,

– or healing the sick.

Health Inequality

Social distribution of health risks and health outcomes: preliminary analysis of the National Health Survey 2007-08 (28 Aug 2012) Australian Institute of health and Welfare

• The places we live, work, learn and play create health or illness.

• People’s opportunities to engage in health promotion behaviours that lead to good health are not spread equally.

• Generally worse health outcomes for people with low social economic conditions.

Individuals do not choose the key factors that determine their health outcomes.

Key enablers and barriers result from social and political choices, that individual only have limited individual over.

World Health Organization states:“This unequal distribution of health

damaging experiences is not in any sense a ‘natural’ phenomenon but is the result of a toxic combination of poor social policies and programmes, unfair economic arrangements, and bad politics.”

I would add bad apps.

Source: World Health Organization. (2008). Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants Of Health. Geneva: World Health Organization.

Two versions of Health Promotion

• Health promotion is the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions (WHO, 2012).

• Health Promotion is the art and science of helping people discover the synergies between their core passions and optimal health, enhancing their motivation to strive for optimal health, and supporting them in changing their lifestyle to move toward a state of optimal health. (O'Donnell (2009)

Most apps have an individual focus rather than

collective focus.

Health Authorities advise you to buy low fat meats.

Increase health inequalities

• A focus on individual behaviours without changing the contextual factors that constrain and enable health promoting behaviours can increase health inequalities and generally focus scarce health promoting resources in a wasteful way.

Mobile tools are social tools

• Health and illness are produced by social processes.

• How can mhealth use social to improve health?

Apps and tools like crowdmap can let seniors take pictures and comment and map what they find age friendly and age unfriendly.

Or parent or child friendly or disability friendly.

Discrimination as a social determinant of health

Racism as a determinant of social and emotional wellbeing for Aboriginal Australian youthMJA http://bit.ly/P4KYTM

Map and share good local walks or jogs.

How can mhealth apps change the social determinants of health?

• Think about the features and sensors of smart phones and the services they can be connected to.

• What about them could be used to help people change or even ameliorate the social determinants that constrain and enable health outcomes?

Examples: Economic inequality, Racism, human rights, housing quality, social capital, working conditions, spatial planning, building codes, education.

• Read more on from WHO on the Social Determinants:

http://bit.ly/P4MvJI

Ten Rules for Good Health

1. Don't be poor. If you can, stop. If you can't, try not to be poor for long.

2. Don't have poor parents. 3. Own a car. [Or live in a community that provides

excellent, affordable, public transportation.] 4. Don't work in a stressful, low paid manual job. 5. Don't live in damp, low quality housing. 6. Be able to afford to go on a foreign holiday and

sunbathe. 7. Practice not losing your job and don't become

unemployed. 8. Take up all benefits you are entitled to, if you are

unemployed, retired or sick or disabled [and hope the eligibility criteria aren't designed to prevent 60% of applicants getting the benefits they paid for].

9. Don't live next to a busy major road or near a polluting factory.

10. Learn how to fill in the complex housing benefit/asylum application forms before you become homeless and destitute.