Lecture 1 Social And Structural Determinants Of Health

Question 1

According to WHO what is health?

Answer 1

Heath is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.

Question 2

Health is a _____ for everyday life

Answer 2

Resource

Good health allows you to fully participate in society and allows you to pursue your personal goals.

Question 3

What is social well-being?

Answer 3

A sense of belonging to a community and contributing to society through having positive interactions with other people and with local communities and social institutions (inclusion on society). It gives people a sense of meaning and trust.

Question 4

What is health disparity?

Answer 4

The differences in health status between different populations of people, genetic or not

Question 5

What is health inequity?

Answer 5

The unfair disparity in health status between groups due to avoidable differences in social, economic and environmental or healthcare resources between different groups of people.

Question 6

What are the causes of health inequities?

Answer 6

Social determinants
Structural determinants

Question 7

Why are health inequities a social injustice?

Answer 7

Because they are unfair differences

Question 8

What are the determinants of health?

Answer 8

A broad range of factors that determine individual and population health.
- Genetics
- Age
- Gender
- life conditions and circumstances
- personal lifestyle practices

Question 9

What determinant contributes the most to an individuals health?

Answer 9

An individuals environment and life conditions/ circumstances

Question 10

How much does health care contribute to health?

Answer 10

Only 25%

Question 11

What are the social determinants of health?

Answer 11

The conditions which people are born, grow, live, work and age which have a positive or negative influence
* income
* education
* employment
* food insecurity
* housing
* early childhood development
* social belonging and non-discrimination
* health services

Question 12

Why does discrimination negatively impact health?

Health inequalities video in Canada

Answer 12

Discrimination is an additional unfair barrier that others may face

Question 13

What is the relationship between life expectancy and income or education?

Health inequalities video in Canada

Answer 13

Tend to live shorter lives on average
* T2D
* poor mental health

Question 14

What is food insecurity?

Health inequalities video in Canada

Answer 14

Unable to afford the the quality and quantity needed for good health

Question 15

Which minority groups are most likely to experience food insecurity?

Health inequalities video in Canada

Answer 15

• Indigenous more than non-indigenous
• Black and and Latin American more than white
• bisexual more than heterosexual

Question 16

What is the relationship between immigrant status and housing standards?

Health inequalities video in Canada

Answer 16

Twice as likely to experience housing below standards
* unaffordable
* too crowded
* needs major repairs

Question 17

Why do Indigenous peoples experience inequities?

Health inequalities video in Canada

Answer 17

Rooted in colonization and the policies and practices that came out of this through the Indian Act
* forced dispalcement
* banning of culture
* residential school system

Resulted in generation trauma

Question 18

How could health inequities experienced by Indigenous peoples be addressed?

Answer 18

Providing better support in the determinants of health by making them available to all to enjoy optimal health and addressing the Calls to Action
* Truth and Reconciliation Report
* United Nations declarations on the Right of Indigenous Peoples

Question 19

What is the strongest SDoH?

Answer 19

Income moreso than weight or PA
* lower income reported to have greater prevalance of chronic disease related to diet

Question 20

What is material and social deprivation?

Answer 20

In the context and given point in time in a society there are certain goods and activities that are typical in order to fully participate
* vehicle
* cellphone
* internet
* credit card
* participation in sport

Question 21

What is the result of low income?

Answer 21

• increased prevalance of diet-related chronic disease
• material and social deprivation
• lower affordability of basic prequisities of health
• lower sense of personal control of their health which may lower capacity to take action
• contributes to social exclusion and may lack social support networks

Question 22

What is social exclusion?

Answer 22

conditions in which it is difficult to participate in activities such as culture, education, and recreation.

Question 23

what are the typically food environments seen in low income areas?

Answer 23

• fast food deluge/swamp
• food dessert

Question 24

What are the food choices for low-income households in Edmonton?

Answer 24

2.3 times more likely to have fast-food outlets 5-10 min walk so more exposure
* Indigenous persons
* renters
* single parents
* low-income households
* public transportation commuters

Question 25

Describe education as a SDoH

Answer 25

Education increases ones ability to participate in society by equiping individuals with knowledge and skills for daily living and gives opportunity to to be a community participant and employed.

Question 26

Describe early childhood development as a SDoH

Answer 26

Exerperiences during preconception, prenatal and early childhood can have a positive or negative effect in health

Question 27

Race/ racism as a SDoH

Answer 27

a variety of factors experienced imapct health
* economic and social deprivation
* occupational health inequities
* psychosocial trauma
* inadequate access to healthcare

Question 28

What is an example of racism?

Answer 28

Racism towards black peoples at a multitide of levels leading to unequal distribution and denial of SDoH.
* school discrimination
* Racial profiling by police
* hiring discrimination
* Landlord discrimination

Question 29

What is victim blaming?

Answer 29

Blaming persons for circumstances outside of their control, stigmatizing them and making them feel ashamed for their situation

Question 30

What is disease stigmatization?

Answer 30

• Feelings of embarressment or shame for ones disease because they have been told their condition is their fault

Question 31

What is the life course approach/ tragectory?

Answer 31

From fetal life to old age, the accumulated experiences and exposure to SDoH results in the outcomes of ones health and well-being over time and subsequent generations/

Question 32

What is the concept of linked lives?

Answer 32

This gives meaning to inteconnectedness of the members of a family and how a life course is transmitted with advantage or disadvantage.

Question 33

What is the driver for social determinants of health?

Answer 33

Structural determinants

Question 34

What do the structural determinants of health shape?

Answer 34

The distribution of power and resources through policies, laws and institutions thay skew opportunities for health producing and maintaining inequities

Question 35

What is a structural determinant of health that has strongly shaped Indigenous peoples to have poor SDoH?

Answer 35

The Indian Act

Question 36

What is am example of structural determinant of income?

Answer 36

Taxation Policy
* skewed to favor the wealthy
* higher tax brackets for the wealthy could reduce disparity and raise money for services to reduce health inequities

Question 37

What is a structural determinant of housing?

Answer 37

Rent control Policy in Alberta
* Province has the highest food insecurity as well

Question 38

What does health promotion focus on to address determinants of health?

Answer 38

upstream causal factors
* make changes that will benefit the health of the whole population

Question 39

difference between upstream, midstream and downstream approaches

Answer 39

downstream: people are already sick
midstream: Addressing SDoH
upstream: Addressing SDOH

Question 40

Describe upstream interventions

Answer 40

diminishing the causes-of-the-causes
* Seek to reform the structural determinants in place for better distribution and equity

Question 41

Describe midstream interventions

Answer 41

Changing the causes
* reduce exposure to negative conditions and promote healthy choices

Question 42

Describe downstream interventions

Answer 42

changing the effects of the causes
* clinical care and medical intervention