Lecture 1 Social And Structural Determinants Of Health Flashcards
According to WHO what is health?
Heath is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.
Health is a _____ for everyday life
Resource
Good health allows you to fully participate in society and allows you to pursue your personal goals.
What is social well-being?
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.
What is health disparity?
The differences in health status between different populations of people, genetic or not
What is health inequity?
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.
What are the causes of health inequities?
Social determinants
Structural determinants
Why are health inequities a social injustice?
Because they are unfair differences
What are the determinants of health?
A broad range of factors that determine individual and population health.
- Genetics
- Age
- Gender
- life conditions and circumstances
- personal lifestyle practices
What determinant contributes the most to an individuals health?
An individuals environment and life conditions/ circumstances
How much does health care contribute to health?
Only 25%
What are the social determinants of health?
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
Why does discrimination negatively impact health?
Health inequalities video in Canada
Discrimination is an additional unfair barrier that others may face
What is the relationship between life expectancy and income or education?
Health inequalities video in Canada
Tend to live shorter lives on average
* T2D
* poor mental health
What is food insecurity?
Health inequalities video in Canada
Unable to afford the the quality and quantity needed for good health
Which minority groups are most likely to experience food insecurity?
Health inequalities video in Canada
- Indigenous more than non-indigenous
- Black and and Latin American more than white
- bisexual more than heterosexual
What is the relationship between immigrant status and housing standards?
Health inequalities video in Canada
Twice as likely to experience housing below standards
* unaffordable
* too crowded
* needs major repairs
Why do Indigenous peoples experience inequities?
Health inequalities video in Canada
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
How could health inequities experienced by Indigenous peoples be addressed?
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
What is the strongest SDoH?
Income moreso than weight or PA
* lower income reported to have greater prevalance of chronic disease related to diet
What is material and social deprivation?
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
What is the result of low income?
- 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
What is social exclusion?
conditions in which it is difficult to participate in activities such as culture, education, and recreation.
what are the typically food environments seen in low income areas?
- fast food deluge/swamp
- food dessert
What are the food choices for low-income households in Edmonton?
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
Describe education as a SDoH
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.
Describe early childhood development as a SDoH
Exerperiences during preconception, prenatal and early childhood can have a positive or negative effect in health
Race/ racism as a SDoH
a variety of factors experienced imapct health
* economic and social deprivation
* occupational health inequities
* psychosocial trauma
* inadequate access to healthcare
What is an example of racism?
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
What is victim blaming?
Blaming persons for circumstances outside of their control, stigmatizing them and making them feel ashamed for their situation
What is disease stigmatization?
- Feelings of embarressment or shame for ones disease because they have been told their condition is their fault
What is the life course approach/ tragectory?
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/
What is the concept of linked lives?
This gives meaning to inteconnectedness of the members of a family and how a life course is transmitted with advantage or disadvantage.
What is the driver for social determinants of health?
Structural determinants
What do the structural determinants of health shape?
The distribution of power and resources through policies, laws and institutions thay skew opportunities for health producing and maintaining inequities
What is a structural determinant of health that has strongly shaped Indigenous peoples to have poor SDoH?
The Indian Act
What is am example of structural determinant of income?
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
What is a structural determinant of housing?
Rent control Policy in Alberta
* Province has the highest food insecurity as well
What does health promotion focus on to address determinants of health?
upstream causal factors
* make changes that will benefit the health of the whole population
difference between upstream, midstream and downstream approaches
downstream: people are already sick
midstream: Addressing SDoH
upstream: Addressing SDOH
Describe upstream interventions
diminishing the causes-of-the-causes
* Seek to reform the structural determinants in place for better distribution and equity
Describe midstream interventions
Changing the causes
* reduce exposure to negative conditions and promote healthy choices
Describe downstream interventions
changing the effects of the causes
* clinical care and medical intervention
