Framing the determinants of health: The "Rainbow" model (lecture15)
• Define the components of the "Rainbow Model" and use this framework to identify the determinants of a dis-ease
• Define the difference between "Upstream" and "Downstream" levels of action
How is absolute inequalities measured?
RD= (EGO - CGO)
how is relative inequalities measured?
Define "determinants of health" for individuals
For individuals: "any event, characteristic or other definable entity, that brings about a change for better or worse in health" these are normally multi-factorial.
Give some examples of health determinants
• Water, shelter, sanitation • Income • Employment • Education • Housing and neighbourhoods • Societal characteristics e.g. racism, attitudes to alcohol or violence, value on children • Autonomy and empowerment - social cohesion
Draw and label the rainbow model
there are six recognised levels
What is the determinants of health frame work?
this is a framework to help identify risk factors and consider levels of intervention. It also recognises that determinants operate at different scales e.g, micro (individual) meso (family) etc.
Give some examples of non-modifiable risk factors
age, sex and hereditary factors.
What do the dashed lines between factors represent?
they represent permeability between factors: - No arch operates in isolation from the others - Events at one level may impact on factors at another (higher or lower) level
Define Downstream interventions
These are interventions that operate at the micro (proximo) level, include treatment systems, and disease management.
Define upstream interventions
These are interventions that operate at the macro level, such as government policies and international trade agreements
Why is upstream intervention more helpful?
•identifying upstream determinants provides effective intervention points without victim blaming. •It is potentially more efficient economically and more successful than focusing on individuals