4. Social & cultural determinants of health

Question 1

What is SDOH?

Answer 1

• SDOH are the conditions in which people live, work, and age … and the structural determinants that produce these conditions
  > appropriate housing
  > suitable, sufficient diet
  > access to critical resources, ie clean water/air, land free of pollution
  > health education
  > control of communicable disease
  > leisure facilities

Question 2

What is Cultural Determinants of Health?

Answer 2

• originated from strength-based approach
• ackowledges the strong connection to culture and community build stronger individual and collective identities
• improves the outcome of SDOH, ie education, SES … [ATS health refers to the social and emotional wellbeings]

Question 3

Why is CDOH important in comparison to SDOH?

Answer 3

• SDOH emphasises Westernised standards when measuring QOL, which cannot fully address the health framework of ATS Peoples and communities
• SDOH reform needs long-term commitment and complex intersectoral collaborations [CDOH is much more convenient and flexible]
• Individual health behaviours cannot change without addressing the core values of the individual

Question 4

Cultural determinant case study:

Answer 4

• Bush mod aboriginal corporation
  > assist young ATS in making positive life choices ie school, alcohol
• National indigenous youth education council
  > To mobilise young ATS to drive a self-determined education system and prepare them for the future
• Indigenous basketball Australia
  > motivate young ATS to be proud of their identity

Question 5

How perceived racism impacts ATS health?

Answer 5

• perceived racism has a drastic impact upon the emotional SEWB of ATS Peoples

> 1st, ‘poor health’ is found correlated with increased reporting of experiencing racism
2nd, racism is a prominent determinant of SEWB due to its large effects as a psychological stressor, which constituted as a health risk factor comparing to other determinants like drinking/smoking
3rd, racism increases inequitable access to resources in many aspects of life, including education, employment, and constitutes to disengagement from health activities like exercise

• Overall, there’s a shifting from assuming the ‘health gap’ is determined by lifestyle factors, to a holistic understanding of broader factors, like SDOH, racism, SEWB …

Question 6

What is one key take-home message from the lecture?

Answer 6

The key message is the importance of the cultural determinants and its overlap with the social determinants of health, and thus this influences the health outcomes of ATS Peoples.
It’s important to point out that cultural determinants help to provide a holistic framework for the wellbeing of the general population, not just ATS Peoples.
Addressing cultural determinants will allow greater individual health behaviour changes and promotes the strength-based perspective, especially to members of society that are strongly connected to their future.

Question 7

Why does this message stand out for you?

Answer 7

There are more than ‘textbook’ reasons as why my health has its outcomes. I believe that culture and a sense of connection/belonging for many people matters to their health outcomes.
Acknowledging one’s stronger connection to the country, traditional practices like Yarning, and respect for elders, build stronger individual and collective identities that can contribute to individual health and population health.

Question 8

How does this lecture support your professional development as a nurse?

Answer 8

The integral role of a nurse of providing culturally-sensitive and person-centred care is the goal in my professional development as a future nurse. Being culturally sensitive is not only integral to the role of nurse, but throughout my role in the community and everyday interactions.
Respect, being open and aware, and being knowledgeable about the cultural determinants of health and its overlap with SDOH, biological and other factors are paramount.