Intro to Social Determinants of Health Flashcards
Determinants of Health
Luck (genetics, circumstances born into, etc)
Choices (diet, exercise, other behaviors)
Health care
Social determinants
Social Determinants
SES = determines access to resources for health and wellbeing, one of the most crucial)
Race = Biology? SES? Social Construct? –> most diseases do not have a genetic background that is race specific
Social Environment
Socioeconomic Status:
What accounts for SES gradient in Smoking?
Knowledge, Attitudes, Beliefs = education ~ more knowledge about effects of smoking
Conspiracy = effective advertisements by tobacco companies
Structure = differences in target demographics for tobacco advertising - they target lower income communities
Race
Multiple minority groups in the US have lower levels of income, education, and professional status compared to Whites
Race differences in health status decrease when groups are compared at similar levels of income and education; however, differences remain
* shows us that race =/= SES =/= education, etc
4 views of Racial Disparities in Health: Biomedical Lens Pyschosocial Lens Epidemiological Lens Social Determinants Lens
Biomedical Lens: genetic differences between black + white Americans
Pyschosocial Lens: psychosocial differences such as “fatalism”, mistrust of health care systems
Epidemiological Lens: cultural differences in lifestypes
Social Determinants Lens: interpersonal and institutional discrimmination
Social Environment
As a social determinant:
Requires “multi-level” thinking for understanding population patterns in health
- safe neighborhood conducive to exercise
- access to vegetables and fruits
- social network? Connections?
Social Epidemiology
Branch of epidemiology that studies the social distribution and social determinants of states of health
–> focuses on exposure rather than disease
(socioeconomic stratification, social networks, discrimination, workplace organization, and public policies)
–> concerned with the ways in which societies are organized to produce/impede development + maintenance of good health
Guiding Concepts in Social Epi
A Population Perspective
Individuals are embedded in societies and populations
Individual’s risk of illness can’t be considered separately from disease risk of population
Must incorporate social context into explanations of differential health outcomes
Guiding Concepts in Social Epi
Social and Economic Context of Behavior -“Risk of Risks”
- Behaviors are not randomly distributed; they are socially + economically patterned, often cluster with one another
- Specific behaviors once thought to come from individual choice occur in a social context
- Social environment influences behavior by:
- shaping norms, enforcing patterns of social control, providing or not providing environmental opportunities to engage in certain behaviors, reducing or producing stressors that trigger/discourage poor coping strategies
Guiding Concepts in Social Epi
Contextual Multilevel Analysis
Multilevel analysis allows us to:
- Disentangle compositional versus contextual effects
- Examine pathways linking environmental exposures to individual health outcomes
Guiding Concepts in Social Epi
A Developmental and Lifecourse Perspective
3 Main Life Course Trajectories:
1. Exposure in early childhood - could influence development, could make an individual vulnerable or resistant to disease in adulthood
- Most adult disease is result of lifetime of accumulated exposure
- Early life exposures impact adult exposures, which directly influence adult disease risk
Guiding Concepts in Social Epi
Resistance and Susceptibility to Disease
Social Factors Influence disease processes by creating a vulnerability / susceptibility to disease
Stressful experiences activate multiple hormones and inflammatory processes and could affect multiple systems
Cumulative effects of stress may alter neuroendocrine-mediated biological pathways and lead to various dsorders
