Social Sciences
The Social Determinants of Health
The social determinants of health refer to the conditions in which people are born, grow, live, work, and age, and how these circumstances influence their health. These determinants include factors such as socioeconomic status, education, neighborhood and physical environment, employment, and social support networks. Understanding and addressing these social factors is crucial for promoting health equity and improving overall well-being.
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12 Key excerpts on "The Social Determinants of Health"
eBook - ePubVital Signs
The Deadly Costs of Health Inequality
- Lee Humber(Author)
- 2019(Publication Date)
- Pluto Press(Publisher)
4The Social Determinants of Health
The Social Determinants of Health are a combination of social, economic and political factors that shape the health of individuals, communities and populations. These influences determine to a great extent people’s state of health or illness. The Social Determinants of Health are overwhelmingly shaped by policy and political ideologies. The WHO says, ‘This unequal distribution of health-damaging experiences is not in any sense a “natural” phenomenon but is the result of a toxic combination of poor social policies, unfair economic arrangements and bad politics.’1With regard to acting upon these determinants, two areas of action in particular were recommended by the WHO Commission on The Social Determinants of Health in their 2008 report, Closing the Gap in a Generation . The first area that needs addressing is daily living conditions, including healthy physical environments, fair employment and decent work, social protection across the lifespan and access to healthcare. The second major area concerns the distribution of power, money and resources, including equity in health programmes, public financing of action on the social determinants and economic inequalities.2Following Closing the Gap , the 2011 World Conference on Social Determinants of Health brought together delegations from 125 member states and resulted in the Rio Political Declaration on Social Determinants of Health. This declaration involved an affirmation that health inequities are unacceptable, and noted that these inequities arise from the societal conditions in which people are born, grow, live, work and age, including early childhood development, education, economic status, employment and decent work, housing environment and effective prevention and treatment of health problems.3Closing the Gap
No longer available |Learn more- (Author)
- 2014(Publication Date)
- Library Press(Publisher)
________________________ WORLD TECHNOLOGIES ________________________ Chapter- 6 Social Determinants of Health Social determinants of health are the economic and social conditions under which people live which determine their health. They are societal risk conditions, rather than individual risk factors that either increase or decrease the risk for a disease, for example for cardiovascular disease and type II diabetes. Health policy was once thought to be about little more than the provision and funding of medical care: The Social Determinants of Health were discussed only among academics. This is now changing. While medical care can prolong survival and improve prognosis after some serious diseases, more important for the health of the population as a whole are the social and economic conditions that make people ill and in need of medical care in the first place. Nevertheless, universal access to medical care is clearly one of The Social Determinants of Health. Raphael (2008) reinforces this concept: Social determinants of health are the economic and social conditions that shape the health of individuals, communities, and jurisdictions as a whole. Social determinants of health are the primary determinants of whether individuals stay healthy or become ill (a narrow definition of health). 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 needs, and cope with the environment (a broader definition of health). Social determinants of health are about the quantity and quality of a variety of resources that a society makes available to its members. Factors Social determinants of health have been recognized by several health organizations such as the Public Health Agency of Canada and the World Health Organization to greatly influence collective and personal well-being.
eBook - PDFVital Signs
The Deadly Costs of Health Inequality
- Lee Humber(Author)
- 2019(Publication Date)
- Pluto Press(Publisher)
39 4 The Social Determinants of Health The Social Determinants of Health are a combination of social, economic and political factors that shape the health of individuals, communities and populations. These influences determine to a great extent people’s state of health or illness. The Social Determinants of Health are over-whelmingly shaped by policy and political ideologies. The WHO says, ‘This unequal distribution of health-damaging experiences is not in any sense a “natural” phenomenon but is the result of a toxic combination of poor social policies, unfair economic arrangements and bad politics.’ 1 With regard to acting upon these determinants, two areas of action in particular were recommended by the WHO Commission on The Social Determinants of Health in their 2008 report, Closing the Gap in a Generation . The first area that needs addressing is daily living conditions, including healthy physical environments, fair employment and decent work, social protection across the lifespan and access to healthcare. The second major area concerns the distribution of power, money and resources, including equity in health programmes, public financing of action on the social determinants and economic inequalities. 2 Following Closing the Gap , the 2011 World Conference on Social Determinants of Health brought together delegations from 125 member states and resulted in the Rio Political Declaration on Social Determi-nants of Health. This declaration involved an affirmation that health inequities are unacceptable, and noted that these inequities arise from the societal conditions in which people are born, grow, live, work and age, including early childhood development, education, economic status, employment and decent work, housing environment and effective prevention and treatment of health problems. 3 Closing the Gap was the most detailed account of the nature and impli-cations of The Social Determinants of Health approach to that point.
- Audrey R. Chapman(Author)
- 2016(Publication Date)
- Cambridge University Press(Publisher)
248 7 The Social Determinants of Health, Health Equity, and Human Rights There is increasing documentation that health status, both on an individual and on the community level, is shaped by a wide range of nonmedical fac- tors. Work in social epidemiology, social medicine, and medical sociology has shown that The Social Determinants of Health, the social and economic conditions in which people grow, live, work, and age, affect their oppor- tunities to lead healthy lives. Research also links economic inequalities and social disparities with health outcomes. Two well-known studies of inequalities in health status in Britain, one by a working group appointed in 1977 (Townsend and Davidson 1982) and a second in 1997 (Marmot 1999), found that inequalities of health status in lower level occupational groups, as compared with those in the higher level groups, persisted at all stages of life despite universal access to health services through the National Health Service. The researchers attributed the continuing dis- parities primarily to social and economic factors such as income, work (or lack of it), environmental conditions, education, housing, transport, and what are now termed “life-style” issues that remained outside the ambit of national health policy. More recently, the landmark report of the World Health Organization’s Commission on The Social Determinants of Health (CSDH), Closing the gap in a generation: Health equity through action on The Social Determinants of Health (CSDH 2008), has provided greater visi- bility for the significant role of The Social Determinants of Health in shaping health outcomes and thereby contributing to existing and growing health inequalities both within and between societies. Studies have also demonstrated correlations between specific social determinants and health outcomes. Research in many parts of the world has documented that income has a striking association with health.
eBook - PDFPublic Health
Local and Global Perspectives
- Pranee Liamputtong(Author)
- 2022(Publication Date)
- Cambridge University Press(Publisher)
Thus, a person’s social context becomes a determinant of their health. The implication of this is that the greatest benefits to population health will occur by improving the health of the communities in which people live. The degree to which people interact with each other, are integrated into society and support each other makes 130 Part 2: Determinants of health the community a healthy place to live. In turn, the health of communities influences the health of individuals living in the community. Today, the concept that health is influenced by social determinants is widely accepted. There is more and more evidence, using increasingly sophisticated measures of socio-economic status, pointing to the importance of The Social Determinants of Health. Societies that support the most disadvantaged and are respectful of their indigenous peoples have better health outcomes. Improving the social context means that contemporary public health has to be cross-disciplinary, encompassing not only medi- cine, but also sociology, psychology, anthropology, ecology, urban planning, architecture, engineering, social work, political science and economics. This chapter introduces the social determinants of public health. It discusses the relative contribution to health of individual behaviours and the factors external to individuals, such as the healthcare sector and structural racism. Then it introduces the concepts of social justice and health equity, which underpin healthy societies. Finally, it introduces a social determinant of health that has been identified by key workers in the field as having a profound influence on health, namely unemployment. Spotlight case studies are provided throughout to give a practical understanding of The Social Determinants of Health. SPOTLIGHT 7.1 Indigenous ways of knowing as a social determinant Aboriginal and Torres Strait Islander people in Australia experience health disparities as a result of colonisation.
eBook - PDFPublic Health
Local and Global Perspectives
- Pranee Liamputtong(Author)
- 2019(Publication Date)
- Cambridge University Press(Publisher)
Social epidemiology has taken this a step further, suggesting that we can apply the distribution of traditional risk factors within populations to social factors such as social cohesion and socio-economic status (Berkman & Kawachi, 2000; see also Chapter 12). Thus, a person’s social context becomes a determinant of their health. The implication of this is that the greatest benefits to population health will occur by improv- ing the health of the communities in which people live. The degree to which people interact with each other, are integrated into society and support each other makes the community a healthy place to live. In turn, the health of communities influences the health of individuals living in the community. Today, the concept that health is influenced by social determinants is widely accepted. There is more and more evidence, using increas- ingly sophisticated measures of socio-economic status, pointing to the importance of The Social Determinants of Health. Societies with low relative poverty – the gap between the richest and the poorest – do well on almost every health index. Societies that support the most disadvantaged have better health outcomes. Societies that have high levels of trust have better health. Improving the social context means that contemporary public health has to be cross-disciplinary, encompassing not only medicine, but also sociology, psych- ology, anthropology, ecology, urban planning, architecture, engineering, social work, political science and economics. It means that the success of public health interventions in real-world settings must also be measured by the active participation of communities in the process of their implementation. This chapter introduces the social determinants of public health. It defines the social determinants and discusses the relative contribution to health of individual behaviours, the healthcare sector and other external factors.
eBook - ePub- John J Macdonald, University of Western Sydney, Australia(Authors)
- 2012(Publication Date)
- Taylor & Francis(Publisher)
social determinants of health give substance to this common-sense view by providing us with empirical evidence of this impact.The work on The Social Determinants of Health has often emerged from considerations about differentials in health status: concerns as to why some people and groups of people have poorer health outcomes than others. At the same time there has been an increase in our collective knowledge of links between the body’s physiology and the working of the mind. Often the brain mediates this link between the body and its environment either directly as the person encounters thoughts, ideas, non-material phenomena and reacts to these; or indirectly, as the mind interprets the physical phenomena it encounters – like cold, heat, smoke, physical deprivation like hunger, etc.The evidence grows of the links between the social context and the individual’s biological and mental condition, their health and well-being:There is a chain that runs from the behaviour of cells and molecules to the health of populations, and back again, a chain in which the past and the present social environments of individuals and their perceptions of those environments constitute a key set of links. No one would pretend that the chain is fully understood, or is likely to be for a considerable period of time to come. But the research evidence currently available no longer permits anyone to deny its existence.Evans et al (1994), p184 Context is more than just a contributory factorIt is under the banner of The Social Determinants of Health that researchers have collected information about these ‘key links’ between social circumstances and the health of populations and, of course, of the individuals making up these populations. When we speak of The Social Determinants of Health, we are looking at the factors in the social context of people’s lives which contribute to and are an essential dimension
- Toni Schofield(Author)
- 2015(Publication Date)
- Cambridge University Press(Publisher)
This unequal distribution of health-damaging experiences is not in any sense a ‘natural’ phenomenon but is the result of a toxic combination of poor social policies and programmes, unfair economic arrangements, and bad politics. Together, the structural determinants and conditions of daily life constitute The Social Determinants of Health and are responsible for a major part of health inequities between and within countries . . . And of course climate change has profound implications for . . . how it affects the way of life and health of individuals and the planet. We need to bring the two agendas of health equity and climate change together. (CSDH 2008: 1) Even a cursory reading suggests that The Social Determinants of Health are com- plex. The phrase, ‘the social gradient in health’ and the sentence, ‘structural determinants and conditions of daily life constitute The Social Determinants of Health’, for instance, are unlikely to feature regularly, if at all, in most people’s reading material and communications. Clarifying what the CSDH means by ‘health’ is a good start because it is central to the whole story, but there is no explicit definition or statement of what health is in the Closing the Gap report. CHAPTER 1: The Social Determinants of Health APPROACH 7 Yet, it is possible to identify what the report means by ‘health’ by analysing how it writes about – or represents – the topic. ‘Health’ and the WHO The WHO has an official definition of health that was formulated in 1946 and has remained unamended since 1948. It proclaims that ‘health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO 1948). A problem with this definition is that it represents health as a kind of transcendental experience, like heaven or nirva- na. Not surprisingly, some have criticised it as unrealistic and utopian (Dubos 1960) – more like a definition of a spiritual state.
eBook - PDFPublic Health
Local and Global Perspectives
- Pranee Liamputtong(Author)
- 2016(Publication Date)
- Cambridge University Press(Publisher)
Part 2 Determinants of health 5 Social determinants of public health John Oldroyd Learning objectives After studying this chapter, you will be able to: • describe the relative contribution of the healthcare sector, individual behaviours and structural factors to the generation of health • describe the differences between health inequalities and health inequities • understand the concept of social justice • explain the social gradient in health • expound key social determinants of health from The Solid Facts. The Social Determinants of Health at work – Struggle Street, SBS, 2015 Struggle Street (SBS on Demand, 2015) was a ‘fly on the wall’ Australian documentary series, broadcast on SBS television in 2015, which poignantly illustrated how individu- als are only as healthy as the communities in which they live. What emerged from this series is that measures of disadvantage (unemployment, poverty, addiction, domestic vio- lence, obesity, smoking, depression, disability, childhood illnesses) appear to cluster and that deprivation is a vicious circle that tends to be passed on through generations. The unemployed are more likely to have poor housing and have limited social support, 94 Part 2 Determinants of health thus experiencing stress, anxiety and depression, and are more likely have poor diets, be inactive and to smoke. Children who experience poor parenting are more likely to not know how to parent when they grow up. These complex, underlying factors are called The Social Determinants of Health . They include employment (whether or not a person works, where they work, the type of work they do, workplace stress), early life exposures (maternal health, breastfeeding, parental attachment) and social exclusion (the lack of social supports). Addressing them involves securing employment, developing strong social networks, advocating respectful relation- ships, developing healthy communities and working to reduce health inequalities.
eBook - ePubShaping Nursing Healthcare Policy
A View from the Inside
- Diane Seibert, Beverly Malone, Patrick DeLeon(Authors)
- 2022(Publication Date)
- Academic Press(Publisher)
Dahlgren & Whitehead, 2021 ).The WHO conceptual social determinant of health framework
The WHO SDOH Framework depicts how social, economic, and political factors such as income, education, occupation, gender, race, and ethnicity impact a person's socioeconomic position which then plays a role in determining health outcomes (Solar & Irwin, 2010 ). These factors can influence a person's ability to lead a healthy life, impacting things such as quality of housing, opportunities in the built environment that encourage physical activity, and access to healthcare services (National Academies of Sciences, Engineering, and Medicine, 2021 ; Solar & Irwin, 2010 ). In this framework, SDH are categorized into two broad types that work together to impact health and well-being. These determinants are structural determinants, which include socioeconomic and political contexts, class, gender, ethnicity and racism, and intermediary determinants, which include the living and working conditions of people (Solar & Irwin, 2010 ).The Social Determinants of Health and social needs model of Castrucci and Auerbach
The Social Determinants of Health and Social Needs Model of Castrucci and Auerbach (2019) elucidates upstream, midstream and downstream strategies to address SDH (Castrucci & Auerbach, 2019 ). The downstream strategies are individual-level interventions that include disease treatent and chronic disease management. The midstream strategies address social needs including housing conditions, employment, and food security (Castrucci & Auerbach, 2019 ). While downstream and midstream strategies impact individuals, upstream stretegies impact communities (Castrucci & Auerbach, 2019 ; National Academies of Sciences, Engineering, and Medicine, 2021 ). Upstream interventions influence root causes or sociostructural factors such as policies, economics, discrimination, and racism (Castrucci & Auerbach, 2019 ; National Academies of Sciences, Engineering, and Medicine, 2021
- Paula Stamps Duston(Author)
- 2015(Publication Date)
- CRC Press(Publisher)
This includes the circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness (WHO, 2008). As shown in Figure 2.1, there is broad agreement that three categories are very clearly social determinants of health: physical environment, socio-psychocultural factors, and social and health policy. Strong public health model Weak public health model Genetic background Age Gender Personal health behavior Personal health behavior Race/ethnicity Genetic background Age Gender Use of health services Social status (education/income) Physical environment Sociopsychocultural factors Physical environment Sociopsychocultural factors Use of health services Social/health policy Race/ethnicity Social status (education/income) Social/health policy Individual health determinants of health determinants of Social Figure 2.1 Impact of health determinants: strong versus weak public health model. 20 ◾ Analyzing Form, Function, and Financing of the U.S. Health Care System The physical environment includes not only safe drinking water, clean air, and safe houses, but also food safety, as well as control of toxic chemi-cals, including radiation and other hazards. Healthy workplaces and safe roads are also included here, as are habitat alterations, such as the increase in urbanization and decrease in green and outdoor spaces. This set of vari-ables has long been a mainstay of the public health efforts to improve health of both individuals and communities. The current definition of the physical environment has recently been expanded to include the notion of the impact of climate change on health (Frumkin et al., 2008). Sociopsychocultural factors is a very large set of factors encompassing a range of variables. These include the presence of social support networks, individual psychological perceptions, and cultural beliefs and traditions.
eBook - ePubHealth Impact Assessment
Principles and Practice
- Martin Birley(Author)
- 2013(Publication Date)
- Routledge(Publisher)
In England, evidence-based checklists and mental well-being impact assessment tools have been developed to assist with commissioning, delivering or developing proposals (National Mental Health Development Unit, 2010). This sub-field of HIA is very active.2.4 DETERMINANTS OF HEALTHHealth determinants are factors that influence our state of health. The factors are personal, social, cultural, economic and environmental. They include our physical environment, income, employment, education, social support and housing. They act in unison and are synergistic. The italicized words in the box are examples of health determinants.Examples of health determinantsWe get malaria because our immunity is low, we do not have access to or are not taking the right drug, there is an infected mosquito, and the mosquito bites us. The infected mosquito is necessary but not sufficient.Asthmatic attacks do not only depend on the presence of a pollutant but also on the age and immune status of the individual and the medical care provided.There are a number of different models and diagrams that are used to illustrate this concept. One of the most well-known is the lifeworld diagram of Dahlgren and Whitehead (1991), or its alternative representation (Barton et al, 2003). These diagrams envisage five successive spheres of influence starting with the individual and then ranging through social and community influences, living and working conditions, and general socio-economic cultural and environmental conditions.In this book, three principal categories of health determinants are used: 1 individual/family determinants such as education, immune status and age; 2 physical and social environment determinants such as exposure to pollutants and employment opportunities; 3 institutional determinants such as medical care and clean water provision.Within each category, there are a number of subcategories, illustrated in Table 2.6
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