10: social determinants of health

Question 1

what is social determinants of health?

Answer 1

set of fators that influence health & comm (17 in total)

Question 2

social gradient in health
- [xxxx]: live ____ life, les ____
- on the flip side, more ___ , ____, ___ ___, __ ___

Answer 2

• better income, better health: live longer lifes, less suicide
• CVD/ DM/ respiratory disease / infant mortality

Question 3

individual preventative action is much easier to do if…….

Answer 3

have less 1 SDOH while tryna fight health hazard

Question 4

SDDOH

most improtant SDOH

when there’s income equality,
_ expectancy, 👶, ____ is better
- __ __, obesity, __ ___, 🔪 is lower

Answer 4

income = most impt determinant of health
=> allows access to other SDOH

• life expectancy, child wellbeing, literacy
• infant mortality, child pregnancy, homocide rate

Question 5

why are more seniors going bankrupt that before?

Answer 5

live longer => outlive their savings
retire w/ debt: give money to adult mbers, healthcare, 2 housing cost (when i person in nursing home)
loosing $ in stock market

Question 6

SDOH

2nd SDOH

Answer 6

better edu, better health

why? betters their literacy and ind preventative action
more opportunities if loose your job when middle-aged
=> facilitates civic engagement

Question 7

3rd SDOH: employment and job insecurity

Answer 7

income, self-hood, structure to day to day life
IF NOT, mat & soc deprived
psych stress
dvlop coping addictive action

Question 8

3rd SDOH: employment and job insecurity

w/ ____, __, __ ___-> more of these now
often invovle __-___ ___ __ so harder to manage
< __ + ___ stress
harms:

why?

Answer 8

w/ pt, contract, precarious employmnt -. more of these now
often involve non-standard working hrs -> so it’s hard to manage transport, childcare (esp when schedule is posted weekly)
< physc, psych stress
harm: rel, child, parenting

Question 9

give me an e.g of non-standard working hrs

Answer 9

some workers are paid only for direct care time, regardless of commute or waiting in between

Question 10

4th SDOH: working conditions

Answer 10

those w/ bad health often exp poor working conditions

Question 11

factors of health outcome?

last: opportunities for __ __ &__ ___

1. job security

Answer 11

2. physc conditions
3. pace
4. hrs & the degree of control over it
5. opportunities for self-expression and ind dvlopmnt

Question 12

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5. SDOH: early child dvlopment

Answer 12

there’s this latency effect: early childhood predispose to either good or bad health
have a cummulative effect:
longer the child is mat. & soc deprived, the more likely to have bad health & dvlopmental outcomes

Question 13

6/ SDOH: food insecurity

Answer 13

inadequte or insecure access
=> not enough nutr, chronic disease & low birth weight
COST MORE to cure

Question 14

prove that it cost more to cure for food insecrity

SOO…..

Answer 14

a recent study of 60,000 ontarians found that annual healthcare cost in food INSECURE fam&raquo_space;» much more than in food secure

• 23% higher for marginal
• 49% higher for moderate
• 121% higher cor severe

=> INDEPENDENT OF OTHER SDOH
Policy & prov.fed lvl could offset this cost

Question 15

what ist he paradox of hunger & obesity?

Answer 15

it can exist in 🏠 and in same 🧍
WHYYYY?

• need to max cal intake
• tradeoff btw quality & quantity
• overeat when food is available

Question 16

4 sides of food insecurity

Answer 16

• quantitive: not enough food
• qualitive: cheap, nutr food
• psych: daily stress
• social: your dignity and pride

Question 17

food banks: pros

Answer 17

give poverty a public profile
transport network for excess food
satisfy the present & urgent need
own property i.e comm garden

Question 18

food banks: cons

Answer 18

naturalise poverty, gov inaction, is institutionalised now

Question 19

SDOH: housing

Answer 19

lead, mold & pest < health risk
some house on aboriginal reserves lack clean water & basic sanitation -> adopt addictive coping action
early death rate among the homeless is 8-10x greater

Question 20

socially excluded cAD are more likely tb ____, earn __ __, have less access to ____ ___ & can’t __ ___
give 3 e.g

Answer 20

unemployed, lwoer wage, social service, further edu
e.g senior living alone, outcast kid, immigrants who can’t speak the lang & dont have fam here

Question 21

social safety nets?

Answer 21

= many programs & services that protect u from changes
could be normative: going to uni
or non-normative: car crash

e.g unemployment insurance or disability benefits

Question 22

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although we have universal healthcare,….

there’s health insurance and …? give 3 e.g

Answer 22

many services still provided by for-profit company or ind: dentist
=> not covered by health insurance

instead, it’s employer or we pay out of pocket: dental, med, home care

Question 23

geography influence: 💨

death rate is higher in: A. city B. surburbs C. rural & remote areas

Answer 23

💨 air/ food/ 💧/ enviro pollution
also access to healthrcare & edu (basic needs)

note: C– death rate is higher in rural & remote areas

waste sites & landfills are clower to comm of color / hood/ aboriginal reserves

Question 24

disability

Answer 24

many rely on social assistance; bt the benfits are low & vring them to poverty lines

Question 25

BEING INDIGENOUS .

effects of residential school system

Answer 25

1. fck up their health
2. cultural genocide
   3.* low socioeconomic status *
3. lack competencies

=> create intergenerational trauama

Question 26

proximal SDOH < intermediate SDOH < distal SDOH for Indigenous ppl

Answer 26

proximL: healtjh action & physc enviro
intermediate: healthcare syst, edu syst & community
distal: colonialism & racism

Question 27

why do women exp more adverse SDOH than men?

often employ in __ ___ jobs and when they do, do less

Answer 27

raise the children & do the housework
often employ in lower paying jobs & work Full Time more
face more workplace discrim

Question 28

men & SDOH

mental & physc health, crime

more likely tb offenders & victims of __ & __ => rep.

Answer 28

suicide rate is 4x higher than fem; for physc health, influenced by unhealthy aspects of amsculinity

more likely tb offenders & victims of robbery & physc assault
=> rep Canada 95% prison population
often young, disadvantaged men w. anti-social behaviours

Question 29

immigrants

Answer 29

as a group, have better health than their CAD-born counterpart, bt health flunks due to sical exclusion & racialised poverty

Question 30

how does race effect health outcome?

Answer 30

via institutionalised racism:
personally mediated…:
internalised racism.

Question 31

globalisation

Answer 31

a process in which natins, business, & ppl become interconnected via economic intergration, comm exchange, cultural diffusion

Question 32

]

globalisation
(+) share __ ___, ____, global __ on __ ___
(-) deregulated

Answer 32

(+) share health knowledge, immunisation, global treaties on human rights

(-) deregualted global finance, enviro disaster, less social protection programs

Question 33

what is the approach to all of this?

Answer 33

upstream thinking: target SDOH, poor quality of lifem premature death
downstream thinking: deal w/ outcomes of that SDOH w/ doctors & nurses

Question 34

removing obstacles to health such as poverty
eliminate ———

Answer 34

health equity
eliminate social disparities in health & its determinants (poverty)
to measure progress of health equity, track how disparities change over time ->

Question 35

prove that gov should spend more on social services

Answer 35

if 1 cent spent on social services / every 1$ on healthcare,
life expectancty <5%
avoidable mortality > 3$

Question 36

is basic min income possible?

Answer 36

for a half a year would cost 98 bil
bt federal spending on pandemic was 134 bil.
POSSIBLE

Question 37

benefits that gov provide instead of targeted social benefits

Answer 37

basic min income

Question 38

has basic min income been implemented before>

Answer 38

yes in manitoba.

less hospitalisation
better mental health, more high grad
while employment rates stay the same

Question 39

invest in social service

Answer 39

spend less on healthcare, more on scoial programs
early childhood edu, cheap & good childcare

Question 40

financial literacy

Answer 40

achieve financial stability: deal w/ imbalances before they cbeomce a threat
financial security: not worried abt your financial goal

Question 41

in a survey w/ saudi uni students

Answer 41

they think that savings & investment = financial security
AND NOT budget or emergency funds

Question 42

how can we respons in a patient lvl?

Answer 42

ask abt social history in a sensitive way
care for their health AND social needs
refer patients to social programs

Question 43

how can we respons in a practice lvl?

Answer 43

< access & quality of care to the unaccessible: bus fare
have patient social support team in prim care: help filling out form

Question 44

how can we respons in a community lvl?

Answer 44

partner w/ comm groups, public health, local leader
use clin exp to adovocate for social change