Social Determinants of Health Flashcards
(38 cards)
Social Determinants of Health
the economic and social conditions that shape the health of individuals, communities, and jurisdictions as a whole” (Raphael, 3)
- Include material and social environments, and are not always (or usually) directly within our control
- Differ from a traditional focus on individual characteristics and behaviours
- “social determinants of health also determine the extent to which a person possesses the physical, social and personal resources to identify and achieve personal aspirations, satisfy our needs, and cope with our environments (Raphael, 3).
- E.g. Food, housing, employment, education, health systems, pollution, racism, sexism etc.
1845: Friedrich Engels
- Material living conditions, day to day stress and adoption of health-threatening behaviour contribute
- Poor housing, clothing, diet and lack of sanitation leads to infections, diseases and early death among working class English
1885: Rudolph Virchow
- ‘Father of Modern Pathology’
- Health-threatening living conditions as rooted in public policy
1974: New Perspectives on the Health of Canadians
-human biology, lifestyle, and health care organizations as determinants of health
1979: The Political Economy of Health:
- “social determinants of health” coined
- Income, resource distribution stress from unemployment and insecure employment
1992: The Health Divide (UK)
- Lowest employment group shows greater likelihood of various diseases, and premature death from illness or injury; despite universal health care system
- Focus on poverty and the clustering of indicators together
1980: the Black Report (UK)
- Lowest employment group shows greater likelihood of various diseases, and premature death from illness or injury; despite universal health care system
- Focus on poverty and the clustering of indicators together
1986: Canadian Public Health Association Action Statement for Health Promotion in Canada
-Advocating for healthy public policies as the single best strategy to affect the determinants of health
1986: Achieving Health for All a Framework for Health Promotion (Canada)
-Need to reduce inequities between income groups; policies to promote income security, employment, education, housing, business, agriculture, transportation and technology
1998: Taking Action on Population Health: a Position Paper
-Paper for Health Promotion and Programs Branch Staff (Canada)
2000: Canadian Public Health Association Action Plan
-Poverty as having a profound influence on health and needs to be reduced
2003: WHO Social Determinants of Health: the Solid Facts
-Explain how nations differ in overall population health
THE GAP BETWEEN KNOWLEDGE AND POLICY
- Despite knowledge of their importance since the 1800s, social determinants have been obscured by an emphasis on biomedical factors and individual behaviour
- This knowledge has not always translated into practice: Canadian public health policy tends to favour individual, behaviour-based approaches
In the 1970s…
the term “social determinants of health” was conceived, and since then a growing body of research has demonstrated their importance
KEY QUESTIONS FROM THE SDOH PERSPECTIVE
- What are the social factors (e.g. income, education, employment conditions etc.) that shape health and that help explain health inequalities?
- What are the societal forces (e.g. economic, social and political) that shape the quality and distribution of these factors?
- What is it about Canada’s (or global) economic and political systems that make addressing the social determinants of health through public policy so difficult?
World Health Organization (Ottawa Charter for Health Promotion):
-“prerequisites for health” include peace, shelter, education, food, income, stable ecosystem, sustainable resources, social justice and equity
Rainbow Model of Health (1992):
-“living and working conditions arch” includes agriculture and food production, education, work environment, unemployment, water and sanitation, health care services and housing as contributors to health
Health Canada:
- various determinants, some (not all) of which are social determinants:
- income, social status, physical and social environments, biology and genetic endowment, personal health practices and coping skills, healthy child development, health services, gender and culture
CDC:
-Socioeconomic status, transportation, housing, access to services, discrimination by social grouping (e.g. race, gender class and social or environmental stressors
British Working Group:
-social gradient (class), stress, early life, social exclusion, work, unemployment, social support, addiction, food, transport
THE SOCIAL DETERMINANTS OF HEALTH FRAMEWORK
- Indigenous ancestry
- Disability
- Early life
- Education
- Employment and working conditions
- Food security
- Gender
- Geography
- Health care services
- Housing
- Immigrant status
- Income and its distribution
THE SOCIAL DETERMINANTS OF HEALTH FRAMEWORK FROM THE YORK UNIVERSITY CONFERENCE
- Includes social location (gender, race, Indigenous ancestry) as indictors of power, influence, and access to economic and social resources
- Includes social safety net, increasingly recognized as important determinant
Framework of the York University Conference based four criteria:
- All of these social determinants of Health are important to the health of Canadians
- All of these social determinants are understandable to Canadians
- All of these social determinants of health have clear policy relevance to Canadian decision makers and citizens
- All social determinants of health are especially timely and relevant
Key Themes in Social Determinants of Health
- empirical evidence to support SDoH
- mechanisms and pathways by which SDoH’s effect health
- importance of the life course perspective
- role of public policy and policy environments
- politics and political ideology
