China
Africa
Explore chapters and articles related to this topic
Ageing, disability and family life
Published in Beverley Clough, Jonathan Herring, Disability, Care and Family Law, 2021
In contrast, eligibility for social care and support is the responsibility of local authorities and funded partly through local taxation. Local authorities are also under a legal duty to set the eligibility criteria to access their services in-line with their budgets, rather than in-line with levels of local need. This means there can be huge variations in whether people are eligible for social care support, how much they have to pay to access it, how long they need to wait, what services are available, and whether carers can access support. In fact, an inverse care law seems to operate, whereby the wealthiest local authorities with the lowest levels of need offer the most comprehensive services, and vice versa.
New dawn: Welfare in NHS Mk 2 – A new social compact
Published in Nigel Starey, Health and Social Care in the Digital World, 2020
So this chapter briefly considers how these elements might be assembled to form a coherent system, one which might enjoy the confidence of the community and inspire individuals and communities to describe and design their own careers and future plans in a more positive light. One where albatross chicks feed on oily fish rather than regurgitated plastic; one where the elderly feel valued and respected rather than lonely and isolated; one where the vulnerable are nurtured, protected and supported to live fulfilling lives, are viewed as assets and inverse care law winners because of what they can offer and teach us, and we may become frail and vulnerable ourselves as our lives unfold. At its centre this system needs to redefine the inverse care law [1] to become a care law where the resources applied are directly correlated with needs and used to maximise the potential locked up in every member of the community.
Young people who use and misuse substances while they are pregnant
Published in Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros, Substance Misuse and Young People, 2019
Laura Brandt, Laura Moser, Gabriele Fischer
A special treatment service in the UK resulted from the appointment of a drug liaison midwife (DLM) in 1995, based at Manchester Drug Service (Macrory and Boyd, 2007). This was a reaction to the inadequacy of maternity services for the special needs of substance-dependent pregnant women and their offspring, and was sought as an additional resource for both service users and providers. The DLM appointment provided a unique opportunity to establish community-based care and a liaison with hospital-based services (Miles et al., 2007). The Manchester Specialist Midwifery Service specialises in providing service for women and their families with problems related to drug and alcohol use, in addition to supporting and coordinating care for HIV-positive women since 2001. The objective of this service is to address the inequities of the inverse care law, i.e. that those who are most in need of health services are the people who are least likely to access them (Tudor Hart, 1971; Macrory and Boyd, 2007).
COVID-19 vaccine equity: a health systems and policy perspective
Published in Expert Review of Vaccines, 2022
Remco Van De Pas, Marc-Alain Widdowson, Raffaella Ravinetto, Prashanth N Srinivas, Theresa J. Ochoa, Thierno Oumar Fofana, Wim Van Damme
Vaccine inequity is a long-standing public health challenge. For instance, inequities between HICs and LICs/LMICs in access to vaccines have been discussed in relation to rabies [25]. Inequity also exists within countries where often the most affected sections of society are also the least vaccinated, especially for adult immunization [26]. This is known as the inverse care law: the availability of good medical care tends to vary inversely with the need of the population served [27]. This was observed for HPV vaccination [28] and also for influenza vaccines in the US where vaccination rates in 2009 for both seasonal and pandemic H1N1 influenza among non-Hispanic White adults were higher than in Black, Hispanic, and other groups [29,30]. These patterns have repeated themselves across US states for COVID-19 vaccination [31].
Do ‘payments for performance’ lead to better or lower quality of services in public service healthcare?
Published in International Journal of Healthcare Management, 2020
Although the QOF systems take a predominantly biomedical and curative approach, a few targets are indeed placed in the ‘Public Health’ domain. An equitable healthcare system requires strong PC and the Department of Health specifically states QOF as being an important tool in tackling inequality [25]. The scheme has evolved over time to now support prevalence-adjusted payment methods, which aims to put more funds in the areas where disease prevalence is greater to tackle such problems. Such an approach to incentives aims to tackle the notion of the ‘Inverse Care Law’, where good medical care is unavailable to the areas that need it most [30]. As such, the impact of QOF on public health can be assessed in part through looking at health inequalities, chronic condition indicators and contraceptive rates (as outlined in QOF).
Involving medical students in the planning and delivery of a vaccination and health screening outreach clinic
Published in Education for Primary Care, 2022
Improving access to healthcare for people experiencing homelessness can be achieved via temporary outreach clinics [1,2]. Involving medical students in homeless healthcare projects has been shown to increase understanding of social determinants of health and leads to positive changes in student perception of this vulnerable patient group [2]. The Tudor-Hart ‘inverse care law’ states that good medical care varies inversely with the need for it in a population [3]. This relates to the ‘inverse training law’ where areas with fewer resources and more stress on health services have less capacity for training, resulting in minimal inclusion health training opportunities for medical students and medical trainees [4]. In the past, medical students have successfully designed and set up a social prescribing service in primary care, helping hone communication skills, get a better understanding of social prescribing and approach healthcare in a more holistic way [5]. As part of the General Medical Council’s Outcomes for Graduates, medical students must be able to fulfill different roles in a team, understand leadership and work effectively in a team with a clear purpose, and new doctors must understand issues of health inequalities and social determinants of health [6]. According to a report funded by the Department of Health, there is limited teaching on inclusion health for health professionals, and most credit their knowledge to learning through work experience rather than formal education [7]. Educational projects involving inclusion health could increase the social accountability of medical schools and have a positive effect on the health of vulnerable groups in the local community [8,9].