How do General Practitioners understand health inequalities and do their professional roles offer scope for mitigation? Constructions derived from the deep end of primary care

Babbel, B., Mackenzie, M. , Hastings, A. , Watt, G. and Mackenzie, M. (2019) How do General Practitioners understand health inequalities and do their professional roles offer scope for mitigation? Constructions derived from the deep end of primary care. Critical Public Health, 29(2), pp. 168-180. (doi:10.1080/09581596.2017.1418499)

Babbel, B., Mackenzie, M. , Hastings, A. , Watt, G. and Mackenzie, M. (2019) How do General Practitioners understand health inequalities and do their professional roles offer scope for mitigation? Constructions derived from the deep end of primary care. Critical Public Health, 29(2), pp. 168-180. (doi:10.1080/09581596.2017.1418499)

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Abstract

Scotland is faced with pernicious health inequalities, which stem from inequalities in living conditions and the societal structures that create them. While action is needed to address the wider structural causes of health inequalities, the role of general practitioners (GPs) merits attention due to health care’s potential to mitigate or exacerbate health inequalities. Minimal research, however, has explored how GPs understand the fundamental causes of health inequalities nor how they conceptualise their role in mitigating these. This paper aims to fill this gap using in-depth qualitative interviews with 24 GPs working in some of Scotland’s most socio-economically disadvantaged, urban areas. Using Raphael’s SDH discourse framework, this paper found clear linkages between GPs’ perceptions of their patients, how they defined the ‘problem’ of health inequalities, and what they thought could be done to tackle them in disadvantaged areas. In general, there was convergence on how interviewees viewed their role in mitigating health inequalities through their work with individual patients. However, greater variation was found when describing the boundaries of their role and how far these extended beyond individual encounters. Specifically, only those GPs fluent in discussing structural causes of health inequalities discussed obligations to change local systems via strengthening community linkages and to influence higher level policies related to the SDH. This suggests that while there is a degree of what Metzl and Hansen deem ‘structural competency’ amongst some GPs working in disadvantaged areas, the scope remains to deepen this competency more broadly.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Hastings, Professor Annette and Watt, Professor Graham and MacKenzie, Professor Mhairi and Babbel, Mrs Breannon
Authors: Babbel, B., Mackenzie, M., Hastings, A., Watt, G., and Mackenzie, M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Social Sciences > School of Social and Political Sciences > Urban Studies
Journal Name:Critical Public Health
Publisher:Taylor and Francis
ISSN:0958-1596
ISSN (Online):1469-3682
Published Online:28 December 2017

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