Download Professor Don Matheson - Central Cancer Network

Turning on the H.E.A.T
Introducing the….
Health Equity Assessment Tool
Acknowledgement: Fiona Cram PhD Katoa Ltd
www.katoa.net.nz
Overview
•
•
•
•
•
What is equity?
What does inequity look like?
What Tools are available to help us?
What is H.E.A.T?
What next?
CCN next steps…….
Equity
‘….Absence of systematic disparities in
health (or in the major determinants of
health) between groups with different
levels of underlying social
advantage/disadvantage’
(Braveman & Gruskin, 2003, p.254)
In Fiona Cram PhD Katoa Ltd ‘Turning up the H.E.A.T’
Health equity is the difference between
populations that are unfair and unjust.
“Those differences don’t have to be there,
we as a society have made choices that
allowed those differences to be there and
we can decide that they go away.”
Professor Don Matheson
Centre for Public Health Research, Massey University, New Zealand
Opening Address Healthcare Aotearoa Hui November 2011
Inequity
What does it look like?
Ischaemic Heart Disease
Mortality 1996-99 and Interventions 1990-99
Male standardised rates per 100,000
250
60
200
50
150
40
100
30
50
20
0
10
Mortality
Mäori
Pacific
Ajwani et al 2003
0
Other
CABG
Angioplasty
Tukuitonga &
Bindman 2002
Inequalities in Cancer Outcomes
All Cancers combined
Blakely et al. Tracking Disparities: Trends in ethnic and socioeconomic inequalities in mortality,
1981-2004. Ministry of Health 2007. New Zealand Census Mortality Study.
Inequities in Cancer…………
a brief summary
• Māori 18% more likely to be diagnosed with
cancer but nearly twice as likely to die from it.
• Cancer specific survival is lower for Māori than
non-Māori for most cancers.
• There is good evidence that at least some of
this difference in survival is due to health
service factors.
Dr Diana Sarfati Director, Cancer Control and screening Research Group Department of Public
Health and Jason Gurney, University of Otago, Wellington
Presentation to the Hei Āhuru Mowai; National Maori Cancer Leadership Group Inaugural Hui, May
2012.
Ka whawhai tonu matou
Equity is achievable
Equity
“equity is about advocacy
and perseverance”
Professor Don Matheson
Opening Address Healthcare Aotearoa Hui November 2011
Celebrate and learn from Successes….
Views from different Mountain tops….
What Tools are useful ?
• Health Impact Assessment and Whānau
Ora Health Impact Assessment
• Ministry of Health (2002) Intervention
Framework
• H.E.A.T. - Health Equity Assessment Tool
What is the H.E.A.T
• Planning tool for the promotion of health
equity (i.e., removal of inequalities)
• Enables assessment of health
initiatives: policies, programmes,
services
• 10 questions to spark consideration of
health inequalities and equity
• Intended to improve mainstream health
delivery
Who uses it?
• People making funding and planning
and policy decisions
• Been used/may also be used by:
– Non-governmental agencies
– Community groups
– Other sectors
– Local government
What about evidence?
• Qualitative and quantitative information
about:
• – Inequalities
• – Effective interventions
• – Evaluation
Include: existing data, community input,
new research
Inequalities has a Whakapapa
This is ‘OUR’ Whakapapa – Reducing inequalities is our
past, our present and our future……………………
Be Aware that……
• The process is important
• Be prepared to challenge assumptions
• Some questions will be more relevant
than others
• Involvement of stakeholders
• Keep records for transparency &
accountability
• Share your record and your analysis
“Worldwide there is a growing feeling
that the systems are getting less
fair. Some are doing well and other
aren’t. Giving communities the voice
for that is important.”
Professor Don Matheson
Opening Address Healthcare Aotearoa Hui November 2011
Member of Asia Pacific HealthGAEN Global Action for Health Equity Regional
Steering Group http://aphealthgaen.org
CCN Next Steps…..
Mid Central Cancer and Palliative Care
Network Group: Inequalities Project
Honouring Te Whare Tapa Wha
Goals:
• To encourage health care professionals to view Māori patients and whanau
from a holistic lens (this is especially important when considering Whanau
Ora).
• To ensure culturally appropriate care is being considered and provided to
Māori cancer clients and their whanau.
• To improve relationships with Māori patients and therefore, their clinical
results.
CCN Next Steps…..
Turning ‘UP’ the H.E.A.T:
Reducing Inequalities Workshops
Using the H.E.A.T and other tools
to reduce inequalities.
Central Region 2012
H.E.A.T from 1840’s to 2012
Health Equity IS an achievable
goal for us!
It is achievable in a generation.
We don’t lack the resources – lets make
sure we don’t lack the will and the
generosity of spirit, and the recognition
of the role all of society can play in
attaining it.
Professor Don Matheson