Variations in Health and Access to Health Care Key Questions 1. What is primary healthcare? 2. In your local area how do age, gender and wealth affect access to exercise facilities, health care and good nutrition? 3. Local case study: what are the implications of the above for the provision of health care systems in your area?

BBC NEWS | Health | Cancer deaths 'higher in north‘ What reasons are given for different rates of cancer deaths?

Primary Care Trusts (PCTs) Started 1948 Has been more difficult to manage as time has gone on (costs have risen as people living longer and medical advances increasing) Year 2000 – Government produced NHS Plan Creation of primary care trusts (PCTs) This is the care provided by the people you see when you first have a health problem e.g. doctors, pharmacists, dentists, opticians NHS Direct All of the above are managed by local PCT. Control about 80% of NHS budget

London Health

Why are there such wide variations? Environmental Factors Wealth Education Age Other?

Local Case Study: Islington

What are the main issues for Islington health care? How evenly applied are theses issues across the borough? What possible factors could influence this pattern? What could you do as a local health official to address these issues?

With reference to a local case study, assess the relative importance of factors such as age, gender, and wealth on access to facilities for exercise, health care and nutrition. [15 marks] http://www.westberks.gov.uk/index.aspx?articleid=8406

AGE WEALTH GENDER Nutrition Healthcare Exercise Facilities Less accessible for elderly (less mobile). Facilities cater for those with cars more and more Less accessible for under 16’s – cost, local area may have lack of fields, some gyms have restrictions Different attitudes to nutrition over time? Healthy Schools – Jamie Oliver? Meals on Wheels service AGE West Berkshire = ageing, therefore specific facilities given priority Cervical Cancer? Targets particular age groups Teenage pregnancies Better nutrition the wealthier you are? What supermarkets do we have? Private health care e.g. BUPA Wealthier – can afford gym membership Wealthier – more mobile to access exercise facilities Employed full time = easier access Northcroft (more family orientated), Regency, Canons (Nuffield Health) LA Fitness No waiting lists – arguably better treatment? WEALTH Different attitudes to food and diet Contraceptive clinics Sexually transmitted diseases, teenage pregnancies, breast screening services – aimed at specific gender Men have easier access than women - childcare GENDER

Now comes the tricky bit Health Poverty Index (HPI) visualisation tool: Welcome

Task Choose one other London Borough Use the websites demonstrated today: www.healthprofiles.info Search for the PCT info (use google) Use census details at Neighbourhood Statistics - Home Page Use the HPI tool Write a report answering the exam question based on your chosen local authority. You can use other sources of info if you think it is appropriate. Images, maps and statistics are all valid. Guide word limit: 1000 words