Module 5 (Social Determinants of Health) Flashcards
What are the 3 main goals (to promote health equity) of the Commission on Social Determinants of Health (CSDH)?
- Improve the circumstances in which people are born, grow, live, work, and age
- Tackle the inequitable distribution of power, money, and resources
- Measure the problem, evaluate action, and expand the knowledge base
What is the Commission of Social Determinants of Health (CSDH)?
a commission created by the World Health Organization in 2005 as a response to concern with global health inequity
How many annually are forced into poverty due to out-of-pocket healthcare?
100 million (globally)
How does the US compare to other economically developed countries with regard to the poverty rate?
It has the third highest rate (below Turkey and Mexico) at 11.6%
What are the 5 umbrella categories of Social Determinants of Health?
Education Access and Quality, Economic Stability, Healthcare Access and Quality, Neighborhood and Built Environment, Social and Community Context
How does the US relate to other countries in terms of life expectancy?
30th
How many US citizens do not have healthcare coverage?
8.4% or 27.6 million
What is the concept of “excess death”?
Death numbers above what is predicted based on estimated mortality; death with excess suffering and preventable diseases
What were the main points of the Whitehall studies?
Employment grade compared to health grade
The lower the employment grade, the higher the risk of every major cause of death
Risky behaviors / lifestyle factors accounted for no more than 25% of social grade within mortality
What is the most important determinant of health?
socio economic status
What are some major risks of prolonged, excess cortisol?
Impaired memory, brain shrinkage
Inability to properly handle insulin and glucose
What social factors directly relate to less cortisol produced during the day?
More income and more education
Less illness, potentially less autoimmune disorders and cancers
How many US children live in poverty?
21% (2008), 17% (2022)
What major factors lead to cumulative burden on health?
Food insecurity, job insecurity, hypervigilance due to discrimination
What was the average life expectancy in 1908?
42
What reforms raised the life expectancy in the 20th century
The 8 hour work day, sanitation laws, universal education, and personal income tax
What reforms do and don’t affect social health factors in the modern era?
Medical innovation does very little
Better education, housing, distribution of wealth, and public health infrastructure does help
What is the realistic goal of US economic hierarchy in relation to public health?
To lessen the disparity between levels, not eliminate the hierarchy entriely
What events occurred during the Nixon administrations which negatively impacted public health?
Financial recession, slashing of social programs, reduced taxes for the wealthy, less regulation of industry
Why are other economically viable nations reporting better health stats?
Free healthcare, 4 weeks paid mandated vacation, higher minimum wage, free college education in some countries
How much money does the world lose due to chronic illness?
1 trillion annually
What are the two choices for making social change to public health?
Infrastructure change or damage control
How much longer do college grads live than high school grads?
2.5 years on average
How many health dollars does the US spend annually?
$2 trillion (almost half the global amount of health dollars)
Which countries are considered economically viable?
Organisation for Economic Co-operation and Development countries (OECD)
What factors influence population health?
healthcare, physical environment, social environment, individual behavior and biology, genetics
What are the measures and disparity groups of health outcomes?
Race/ethnicity, Socio Economic Status (SES), Geography, Gender
Measured by mortality, morbidity, and quality of life
What are the social determinants of health?
housing, education, social support, childhood experiences, family income, employment, our communities, and access to health services
What percent of government backed home loans went to non-white households prior to 1962?
less than 2 percent
Why did so many more black people die than white people from COVID 19?
Essential worker employment
density of living arrangements and higher rates of public transport use
higher risk of chronic disease (due to chronic stress)
living conditions (less grocery stores, more fast food and liquor)
What are the Key Elements of Health in All Policies?
incorporate health equity and sustainability into policies
embed health as a value in government decision making
make healthy public policy the default way
partnerships to promote health
What are the key elements of the National Prevention Strategy?
healthy and safe community environments
clinical and community preventative services
empowered people
elimination of health disparities
What factors are included in Socio Economic Status?
income, education, and occupational status
What factors are typically included in social supports?
marital status, number of close friends and relatives, church membership, and affiliation with other organizations
What is the health belief model?
several factors are likely to lead a person to change a health behavior when faced with a health threat:
the extent to which they feel vulnerable to the threat
the perceived severity of the threat
perceived barriers to taking action to reduce risk
perceived effectiveness of taking an action to prevent or minimize the problem
What is a large perception factor related to health behavior?
self-efficacy, sense of control over one’s life
what is the transtheoretical model?
envisioning change as a process involving progress through a series of 5 stages: precontemplation, contemplation, preparation, action, and maintenance
what is the ecological model?
a health behavior model that looks at how the social environment, including interpersonal, organizational. community, and public policy factors, support and maintain unhealthy behaviors.
what are self-efficacy goals of health promotion campaigns?
belief in personal threat
belief in response efficacy
belief in personal efficacy
belief that new behaviors are consistent with group norms / social supports
What is an example of changing the environment for health promotion?
Safer designs of highways and automobiles
(which are proven to be more effective than driver’s ed)
What is the significance of Infant Mortality Rate (IMR)?
a gauge of society’s attention to child health and overall health population status
Why did IMR lower in the 1970s?
family planning services and abortions
(wanted babies are more likely to thrive)
What are maternal mortality rates?
number of mothers who experience death associated with childbirth
What are congenital disorders?
AKA congenital anomalies, structural or functional anomalies
often-inherited medical conditions which occur before birth
How many infant deaths are attributed to congenital disorders?
as many as 20%
What are the top causes of infant mortality?
congenital disorders, preterm birth and low birth weight, maternal complications, SIDs, and injuries such as suffocation
What is the specific definition of prematurity in infants?
disorders of short gestation and low birth weight
What percent of infants are born premature?
10.5% (2021)
What is the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)?
a program run by the US Department of Agriculture (USDA) since the 1960s which provides vouchers for milk, fruit juice, eggs, cereals, and other nutritious foods for pregnant women, lactating mothers, infants, and children up to 5 years old.
Also nutrition education and support services for poor, young families
What is the Supplemental Nutrition Assistance Program (SNAP)?
Formerly called Food Stamp Program
Based on household size and income
Grants an electronic benefits card
Cannot be used for tobacco, alcohol, or nonfood items
Why is SNAP criticized?
well publicized abuses of the program
lack of services for immigrant families
What are the typical immunizations in the US program?
diptheria, tetanus, pertussis, polio, measles, rubella, mumps, and Hepatitis B
What is the vaccines for children program?
Established in 1993 by the federal government, employed public and private sector organizations to help provide free vaccinations to uninsured children ages 19 to 35 months
What are maternal mortality rates for white people versus black people?
black people experience over 3x the rate (per 1000) that white people do
What has more genetic diversity - difference between races or difference within races?
within races
How did the US compare to the top 10 OECD countries in terms of infant mortality (2018)?
The US rates were over double each of these countries
How does black and Hispanic prenatal care compare to white prenatal care?
Blacks and Hispanics receive prenatal care at a rate about 10% to 15% lower than whites.
How does infant mortality rate compare between US white persons and black persons?
In the United States, infant mortality is approximately twice as high among blacks as it is for whites.
How do US white people and Native Americans compare in Diabetes prevalence?
American Indians and Alaska Natives now have the highest diabetes prevalence rates of all racial and ethnic groups in the United States. More than 16% of the members of this population have been diagnosed, compared to 8.7% of non-Hispanic whites.
What is the most important factor in US infant mortality rate?
poverty
What caused the epidemic of birth defects in Minamata, Japan?
mercury contamination of a fishing bay
