M3s4 Income, Education And Employment Flashcards
Income association to SDOH
-people living in Canada’s highest income urban neighbourhoods live an average of 3 years longer than those in lower income neighbourhoods
-poorest 20% of Canada’s population have more than double the chance of having 2 or more chronic conditions, including heart disease and diabetes, than the richest 2%
Higher income associated with
-higher educational achievement
-better housing
-improved access to clean water, sanitation and hygiene
-improved access to health services
-safer work environments
Material deprivation (Ontario Index)
-way to measure material and financial resources available to a person
-helps build an understanding of the level of deprivation or hardship an individual or family is facing
How can it be argued that postal code matter more than genetic code for how long you’ll live
-areas, communities, neighbourhoods that people live in can seriously impact their health
-cause of opportunities
-healthy food options like farmers markets, clean air, safe clean parks, good public schools, emergency healthcare
Leads to chronic stress and can strive health problems and lead to less life expectancy
Racial and economic discrimination effects
Greatest income in equality leads to lowest life expectancy
USA life expectancy very low cause of mainly inequality
Ex. More likely to die if live in south city neighbourhoods in Toronto
Education as key social determinant of health
-measures the capture of knowledge and linked to an individuals literacy, capacities and potential assests
-often considered when measuring SES but also important health determining factor on its own
-higher level of educational achievement are associated with improved health outcomes across the globe and this has inter generational effects
-intergenerational effects refer to how a parents education affects children’s health
-can sometimes refer to individuals parents (their levels of education and their resources, choices, and constraints) and other times the educational attainment (and related opportunities, experiences and potential for employment, wealth, income) of the individual themselves
-good indicator in many populations because less memory bias than other indicators, not affected by current health status relatively easy to define, remember and accurately recall
Health literacy
Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others
Education is positively associated with health
Health literacy and health behaviours like taking up vaccinations for children by parents are directly associates with educational attachment levels
-in 5 countries studied, household heads without formal education verses those with education beyond primary school are markedly different in rates of measles immunization uptake
Health literacy as a key social determinant
Related to SES, income, educational attainment but also a distinct factor on its own
-key to achieving healthy people
-people being able to find, use, and serve health information services
5 things to know
1. Organizations and professionals can improve their health literacy by using proven strategies, like answering questions in simple, non-medical language and developing and testing written materials with the audience they want to reach
2. Universal health literacy approaches benefit everyone. Vulnerable people, like older adults people who have difficulty reading and using numbers, or people who are not fluent in English face biggest challenges. If we act as though everyone is at risk of misunderstanding information, everyone is better off
3. Providers can use health literacy strategies to encourage people to take part in decisions about testing, treatment and procedures. Let’s people make healthcare decisions that fit values, goals, preferences and circumstances
4. Clear communication between providers and patients improve health literacy, particularly if providers take time to listen with respect and make information easy to understand. Checking to make sure patients understand information
5. Being health literate will help people make informed decisions and take actions to improve their health. Can help people achieve goals
Occupation as key social determinant
-collecting information about an individuals occupation may capture many aspects of their life including class (and the opportunities and resources it affords), labour exposures, experince of employment, stress levels, levels of social value, etc.
-but if one takes a critical scholar’s perspective, does have some weakness with being an indicator:
-there are gender patterns in many jobs and gender and occupation influences can often act synergistically (and difficult to tease out from each other)
-don’t always capture unemployed or retired persons, persons in transient jobs or students
-may differ between societies and may be quite a bit variation within any one occupational (ex. Different types of teachers and police officers have different experiences and health influences)
The Whitehall studies
-some of the most famous studies of occupation and health
-Whitehall England
-Whitehall study 1 and 2 enrolled thousands of civil servants of different varieties and followed them over many years to study their health outcomes, time, and cause of death
Findings:
-strong associations between grade level of civil servant employment and mortality rates from range of causes
Ex. Lower grade occupation (messengers, doorkeepers) were assocIAted with all cause premature mortality rate three times higher than that of men in higher grade (administrators). Effect named as “status syndrome”
Economic inequality
The unequal or uneven distribution of opportunities and income between the different groups in society
Examples of how poorer populations experince worse health than richer populations
Life expectancy
-on average, 18 year difference in life expectancy between people who live in high-versus low-income countries
Premature death
-the majority of 15 million annual premature deaths due to non-communicable dieases (NCDs) occur in low- and middle-income countries
Disease
-relative gaps within countries between pooper and richer subgroups for diseases like cancer have increased in all regions across world
Under-5 mortality rate
-8 times higher on African continent than European region
Life expectancy and healthy life expectancy have increased overall but persistent widening inequalities in social exposures and health outcomes across populations
5 things that cause health inequalities
Levels of power and resources
-different groups in society have different access to resources, power, and influence which in turn, affect their degree of personal control over their life circumstances and health outcomes
Levels of exposure to health hazards
-some people are greater risk of experiencing or being exposed to factors that negatively affect their health, like poor housing or working conditions that are unsafe
Impacts of health hazards
-even when everyone exposed to same health risks, their health may not be affected same way
Impacts of being sick
-illness and chronic disease can have more serious impact for some groups in society compared with others
Experinces in early childhood
-disadvantage early in a person’s life can accumulate and lead to poor health in adulthood and old age
Health inequalities and the social staircase
-connected to individuals position or place in society
Bottom:
-lower quality of food, less education, insufficient housing, little power over their circumstances
-double chance of dying prematurely or having serious illness than those in highest step
Middle
-sufficient resources and power over their circumstances
-more likely to have shorter life span and be less healthy compared to those on top
Top
-higher quality of food, greater access to education, good housing, and power over their circumstances
-generally healthier than everyone else and live longer life
Effects of income inequalities on health
-underinvestment in social goods like public education and health care
-disruption of social cohesion and the erosion of social supports at the national and community levels
-harmful psychosocial effects of individual social comparison
