4: social determinants

Question 1

Define social determinants of health

Answer 1

conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels.- WHO

Question 2

Define determinants

Answer 2

a factor that decisively affects the nature or outcome of something.

Question 3

List the 10 determinants of health listed in the solid facts

Answer 3

1) The social gradient
2) Stress
3) Early life
4) Social exclusion
5) Work
6) Unemployment
7) Social support
8) Addiction
9) Food
10) Transport

Question 4

What are the sustainable development goals

first 6 particularly

Answer 4

1- no poverty 
2- zero hunger 
3- good health and wellbeing 
4- quality education 
5- gender equality 
6- clean water and sanitisation
7- affordable and clean energy 
8- decent work and economic growth 
9- industry, innovation and infastructure
10- reduce unequalities 
11- sustainable cities and communities
12- responsible consumption and production 
13- climate change 
14- life below water 
15- life on land 
16- peace and justice
17- partnerships for goals

Question 5

Explain the who and why of the sustainability goals

Answer 5

• developed by the United Nations (UN) in 2015, are a universal call to action to end poverty, protect the planet and improve the lives and prospects of everyone, everywhere.
• 17 goals
• 15 years to succeed and will be reviewed at the 2030 Agenda for Sustainable development

Question 6

How have the sustainability goals been going so far?

Answer 6

So far
< extreme poverty
< under 5 mortality

• Immunisations have haves millions of lives
• Vast majority of world has access to electricity

However there are still significant issues that need to be addressed.

• Global hunger is on the rise
• Half of the world’s population lacks essential health services
• More than half of the world’s children do not meet standards in reading and mathematics
• Only 28 per cent of persons with severe disabilities receive cash benefits
• Women in all parts of the world continue to face disadvantages and discrimination.

Question 7

What are the sustainable development goals?

Answer 7

Goals stated by the UN cover different apects of social development, environmental protection and economic growth.

The attempt to solve and eradicate the biggest issues facing the current society.

Question 8

Health

Answer 8

“the state of complete physical, mental and social well being and not merely the absence if disease or infirmity.” (WHO, 1948)

Question 9

Who definition for social determinants of health

Answer 9

“conditions in which people are born, grow, work, live and age, and the wider set of forces and systems shaping the conditions of daily life” (WHO, 1948)

Question 10

What are some of the forces for social determinants

Answer 10

• economic policies and systems (tax)
• development agendas
• social norms
• social policies
• political systems

E.g. childhood experiences, housing, education, social system, family income. Employment, our community and health care.

Question 11

Health determinants

Answer 11

factors that raise or lower level of health.

Question 12

Can the determinants of health be altered

Answer 12

altered (behaviours) or not (age, genetics)

negative (risk factors that increases the risk of health) or positive (protective facotrs)

Question 13

Risk factors for poor determinants of health

Answer 13

smoking, vaping, poor diet, sedentary lifestyle, being overweight, age (more time to damage health)

Question 14

Protective behaviours from poor determinants of health

Answer 14

healthy diet, exercise, mindfulness, education

Question 15

Define social determinants of health

Answer 15

economic and social condition that influence health of people and communities.

• Such conditions are shaped by money , power and resources
• SDH affect factors that are related to health outcomes.

Question 16

List some factors that relate to health outcomes

Answer 16

• Early childhood development (vaccination, education early, birth weight)
  
  • Education (quality, length)
  • Job (gain a job, attain a job, quality, income, duration)
  • Work (physical labour)
  • Food security (access, quality, expenses)
  • Health services (quality ease of access, quantity)
  • Housing status (location, do you have a house, quality)
  • Money (how much, is it stable)
  • Discrimination (are you equal)
    Social support (network of family and friends, community, church, club) as humans we need social support

Question 17

1- solid facts

Answer 17

1) The social gradient
2) Stress
3) Early life
4) Social exclusion
5) Work
6) Unemployment
7) Social support
8) Addiction
9) Food
10) Transport

Question 18

Why and how does the social gradient effect health?

Answer 18

Poorer social or economic circumstances -> ^ risk of poorer health -> ^ rates of illness, disability and premature death, live shorter lives than those more socially and economically advantaged

Question 19

What are the greatest impacts on social gradient

Answer 19

• Education
• Occupation
• Income
• Gender

Question 20

Health inequalities definition

Answer 20

differences in health status’ of population groups that are social produced.

Hence why are unfair and only rely on what money can buy

differences in health status between population groups. E.g. ATSI and white

Question 21

Health inequities are

Answer 21

1. Are systematic differences health outcomes, differences in health status or the distribution of health resources, unfair as they are based on unchangeable health determines, Influenced by government policies
   
   2. Everyday 16000 children die before their fifth birthday. (pneumonia, diahorrea)
   3. Maternal mortality a key indicator of health inequity. Shows a wide gap between rish and poor and between countries.
   4. TB affects many in their most productive years of their life (youth) meaning they cant secure a job and income therefore lack so much else.
   5. 80% of premature deaths are due to non communicable diseases- drain the family leading to poverty
   6. Life expectancy varies 4o years between countries.
   7. Alarming health inequities within countries
   8. Health disparities can occur within cities.
   9. HI have a significant cost to society
   10. HI slow development which means sustainable development goals cant be reached.

Question 22

Define upstream factors

Answer 22

(at a macro level) include international influences, government policies and the fundamental social, physical, economic and environmental determinants of health.
- These can include, access to housing, transport, unemployment benefits and family allowances

Question 23

Define midstream factors

Answer 23

factors include things such as nutrition/diet, smoking, physical inactivity, mental health and depression.

- These can also be referred to as ‘behavioural risk factors’ 
- These can be controlled

Question 24

Define downstream factors

Answer 24

factors are micro level and are affected by both upstream and midstream factors and include biological, physiological reactions to all of these influences.
- They affect morbidity, mortality, quality of life and life expectancy

Question 25

Why is this important for us as nurses/midwives?

Answer 25

• Reduce the burden of disease- a care plan such as what is best to eat.
  
  • Promote health of the general population
  • Achieve health equity – everyone has the opportunity to attain their full health potential and no one is disadvantaged because of their social position or other socially determined circumstances
    Recognising health determinants prevents disease, illness and injury