Health inequity among the Health inequity among the Stavropol residents Stavropol residents

K.K. Amlaev, Amlaev, Stavropol medical academy, HCP Stavropol medical academy, HCP

coordinatorcoordinator

What we have to do with inequity practically?

We have to implement some stages of health inequity principle in all local policies:

Study of experience on health inequity problem solution Health inequity problem awareness and paying increasing

attention to it Implementation of health projects and programs related to

different groups such as elderly people, invalids, low-income people and other vulnerable groups

Systematic analysis of all sectors’ plans of activities, priorities determination and setting definite goals in this activity

Design and implementation of health inequity related programs

Working out the plan on health inequity reduction Putting health inequity problem into agenda for all key

sectors

The first stage of work on inequity in our city became a survey on life quality and health inequity

issues among the Stavropol residents 529 people participated in the survey. The questionnaire was made up of

several blocks. Own health assessment Respondents’ lifestyle Respondents’ social activity Trust to authorities and social services Satisfaction with a district and conditions

of living Respondents’ socio-demographic features

How would you assess your own health? Distribution of answers due to marital status,

income level and district of living

Excellent or very bad

19,5

0

21,1

03

26

4,410,2 7,1

25

14,78,1

05

1015202530

single widow/widower people whospend lessthan half of

their income onfood

people whospend morethan half of

their income onfood

South-Westerndistrict

Demino

excellent very bad

Do you smoke?Distribution of answers in accordance with

education

20

66,5

0

10

20

30

40

50

60

70

No, I don't smoke

people with primaryeducation

people with highereducation

How often are you in drink (including light drink)?

Distribution of answers in accordance with education level

16,7

50

70,2

0

20

40

60

80

people with primary education

People with incomplete secondary education

people with higher educatin

Never or nearly never

Do you get a support and assistance in case you fall ill?

Distribution of answers in accordance with employment level

4,9

41,5 40

0

5

10

15

20

25

30

3540

45

people havingregular jobs

People havingoccasional jobs

people in care

No, I don't rely on support

Do you take part in elections?Distribution of answers in accordance with the

respondents groups

No, I don't

80

37,925

14,219,4

0102030405060708090

Migrants People fromextended families

War veterans Working people Pensioners

Distribution of answers in accordance with income level and district of living

No, I don't take part in...

12,3

25,8 22,7

46,740,9

05

101520253035404550

People who spendless than a half ofincome on food

People who spendmore than a half of

income on food

Centre of the city Mamaika Botanika

To what extent do you trust different social institutions?

27,835,6

23,221,123

0

5

10

15

20

25

30

35

40

Insurance companies Prosecutor's office Legislative bodies Head of cityadministration

Mass media

absolute trust

Assessing your present situation can you say that…

Distribution of answers in accordance with district of living

Completely agree

49,1 53,335,3 22,7 25

54,8 40

17,60

25

43,820

11,813,6 0

60

53,3

16,713,6 0

0

50

100

150

200

250

Dow ntow n Botanika Biofabrika Mamaika Demino

Public transport work in district is goodEnough opportunities for active spare time spendingEnough opportunities for cultural lifeLevel of personal services

Level of personal services at shops, post offices, public service institutions is high

16,1 12,519,535,7

50600

306090

Migrants Disabled persons Working people Pensioners Vfeterans of

work

Veterans of the

Great Patriotic

war

disagree

Conclusions 1. Our survey revealed that more than 39 % of the

respondents spend more than a half of their income on food. It coincides with the percentage of people (32.7 %) who lack money for the most necessary things.

2. It was revealed that health self-assessment depends on marital status, income level and a district of living. Widowers’, low-income groups’ and “depressed” districts residents’ health assessment is lower than other groups’.

3. The unemployed and migrants pay no attention to

physical activity. A low education level is an independent risk factor of alcohol and tobacco abuse. This group is characterized by the highest level of alcohol use.

4. People who have no steady job, people in ward and migrants rely on smb’s help less than other groups.

•

5. Income level and duration of living in the city have influence on Stavropol city residents’ electoral activity. Low-income people and migrants seldom take part in the elections. A district of living is another factor of reducing electoral activity (Mamaikaand Biofabrika residents take part in the election campaign occasionally). 6. A level of trust in the head of the city is 27.8 %. It is higher than a level of trust in the legislative bodies, Prosecutor’s office, court and insurance companies. People in ward, migrants, Mamaika residents trust different structures least of all.

7. In the respondents’ opinion people with a low education level and those living in communal housing are subjected to different forms of discrimination.

8. People who are in ward give the lowest assessment to the district of their living. It is due to a low access to social objects for this group.

Recommendations for local authority and community

So we can determine the following vectors for health inequalities reduction:

Alignment of development levels of Demino, Mamaika and Biofabrika districts with more successful ones (Centre of the city, Botanika);

improvement of medical and psychological support of people who are in ward and invalids;

increase of accessibility (territorial, pricing and mobile) to socio-cultural objects for people who are in ward ;

working out social support special programs for low-income group;

increase of the administrative structures’ and governmental bodies’ accessibility and transparency as well as their bureaucratization reduction;

migrants adaptation programs working out;

creation of the city consulting centers for vulnerable groups for rendering legal and psychological support free of charge;

adoption of the city and sectoral plans on health inequalities reduction, increase of services quality and accessibility for vulnerable groups;

introduction of appropriate changes in the city administration staff duties; it is necessary to appoint the administration employee responsible for health inequalities issues solution for vulnerable groups.

Remember the face of the poorest and helpless person whom you sometime saw, and wonder, what advantage of that step which you now consider. Whether it will help him to dispose again of his life, of his destiny?

Mahatma Gandi

We will manage it together!

Thank you for your attention!