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Type 2 Diabetes Health Equity Audit in the
Basque
Public Healthcare Service (Spain)
Amaia Bacigalupe. Department of Sociol...
Introduction
• The main determinants of health and health inequalities are
outside the healthcare services (Dahlgren and W...
Results
• Great socioeconomic inequalities exist in DM2, as well as in its
main risk factors
Obesity Hypertension Smoking
Results
• Health Services act more intensively on the diabetic population of
lower socioeconomic groups or, at least, no i...
Results
• Despite an adequate management by healthcare services,
significant inequalities in DM2 related results persist
P...
Conclusion
Even if public funded and universally accessible health
services, such as the Basque Health Service, can
delive...
Introduction
• The main determinants of health and health inequalities are
outside the healthcare services (Dahlgren and W...
Results: can be summarized in three main
messages
• Great socioeconomic inequalities exist in DM2, as well as
in its main ...
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Type 2 Diabetes Health Equity Audit in the Basque Public Healthcare Service

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Type 2 Diabetes Health Equity Audit in the Basque
Public Healthcare Service

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Type 2 Diabetes Health Equity Audit in the Basque Public Healthcare Service

  1. 1. Type 2 Diabetes Health Equity Audit in the Basque Public Healthcare Service (Spain) Amaia Bacigalupe. Department of Sociology 2. University of the Basque Country. Spain Santiago Esnaola. Department of Health. Basque Government. Spain amaia.bacigalupe@ehu.eus
  2. 2. Introduction • The main determinants of health and health inequalities are outside the healthcare services (Dahlgren and Whitehead, WHO, 2011) • Some studies have also stressed that the health services can play an important role in reducing or increasing health inequalities • That´s exactly what we wanted to study, using a pathology, such as type 2 diabetes, where great inequalities have been described in terms of prevalence and incidence at least in most Western societies. Research question Can health services reduce social inequalities in type 2 diabetes, regarding its main results (good metabolic control and complications associated with the disease)?
  3. 3. Results • Great socioeconomic inequalities exist in DM2, as well as in its main risk factors Obesity Hypertension Smoking
  4. 4. Results • Health Services act more intensively on the diabetic population of lower socioeconomic groups or, at least, no inequalities are produced Lack of test of glycated hemoglobine Referrals to specialists
  5. 5. Results • Despite an adequate management by healthcare services, significant inequalities in DM2 related results persist Poor metabolic control Complications
  6. 6. Conclusion Even if public funded and universally accessible health services, such as the Basque Health Service, can deliver a “pro poor” healthcare, inequalities in health will remain or even worsen, unless other determinants of health, outside the health system, are seriously tackled. Thanks! amaia.bacigalupe@ehu.es
  7. 7. Introduction • The main determinants of health and health inequalities are outside the healthcare services (Dahlgren and Whitehead, WHO, 2011) • Some studies have also stressed that the health services can play an important role in reducing or increasing health inequalities. • That´s exactly what we wanted to study, using a pathology, such as type 2 diabetes, where great inequalities have been described in terms of prevalence and incidence at least in all Western societies. Research question Can health services reduce social inequalities in diabetes, regarding its main results (good metabolic control and lack of complications associated with the disease)?
  8. 8. Results: can be summarized in three main messages • Great socioeconomic inequalities exist in DM2, as well as in its main risk factors (obesity, hypertension and smoking) • Health Services act more intensively on the diabetic population of lower socioeconomic groups, doing more glycated hemoglobine tests) or at least no inequalities are seen among groups (as in referrals to specialists) • Despite an adequate management by health services, significant socioeconomic inequalities in DM2 related results persist (mainly, complications and poor metabolic control) • Conclusion: Even if public funded and universally accessible health services, such as the Basque Health Service, can deliver a “pro poor” healthcare, inequalities in health will remain or even worsen, unless other determinants of health, outside the health system, are seriously tackled.

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