Social Determinants Flashcards
What is a social determinant?
The conditions in which people are born, grow, work, live, snd age, as well as the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems
Commission on social determinants of health conceptual Framework
Socioeconomic and political context (governance; policy; cultural and societal norms and values)
–>
Social position (education; occupation; income; gender; ethnicity / race)
–>
Material circumstances (social cohesion, psychosocial factors, behaviours, biological factors feed into health care system)
= distribution of health and well being
Social class
Position in a system of structured inequality based on the unequal distribution of power, wealth, income, and status. People who share a class position, typically share similar life chances
Socio economic status
A statistical measure of relative inequality that classifies using a combination of income, occupation, and education
Can health cause class?
No evidence suggests health causes a change in employment grade
Social difference same for lung cancer (months to live) and chronic bronchitis
Therefore class must “cause” health
Social causation hypothesis
Risk factors only account for a small % of social gradient
Social, economic and political factors impact on living and working conditions (poverty, discrimination, education, employment, nutrition and housing) and these directly impact on health
More recent understanding: inequality, work intensification and unemployment increases stress, anxiety, insecurity, anger and depression
Stress
Flight or fight response
Causes change in bodily functions
Repeated frequent response causes negative longer term changes in body function Eg Diabetes HBP Stroke Depression, aggression
Working conditions
Workplace health risk and injury/illness is patterned on inequality
Jobs at lower levels: more physical work, lower paid, more unsocial house, work intensive, more casualised, less autonomy/control and more stress
MEN AND WOMEN HAVE THE SAME LEVEL OF INJURY BUT MEN HIGHER DEAth rate - particularly men working in agriculture, forestry, fishing and construction
Unemployment
Unemployment has direct effect on health apart from SES or previous health issues
Stress Poverty Social isolation Anxiety and depression Suicide
Social exclusion
Being left out of society
Marginalisation
Inequity
Discrimination
Active or passive
Denied to explained and “important” reasons
Just not considered important
4 aspects of social exclusion
- legal constraint and recognition
- failure to supply needed social goods (eg access for people with disability or accommodation for homeless)
- unable to contribute to society as belong to “unacceptable” rejected group
- economic exclusion ie cannot afford what is considered “normal in society”
10 solid facts
1 social class 2 working conditions 3 stress 4 unemployment 5 social exclusion 6 social support 7 early life 8 addiction 9 transport policy 10 healthy food 11 gender
