Social determinants of health Flashcards

1
Q

Key concepts
● Health outcome
● Prevention
● Treatment
● Risk factor

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a

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2
Q

malaria exmaple

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2
Q

Examples

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● Malaria
● Coronary heart disease
● COVID-19

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2
Q

Health outcome

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● Morbidity (illness, sickness, disability)
● Mortality (death)
● Disease (virus, condition, syndrome)
○ Communicable disease (infectious disease) – pneumonia, measles, COVID-19
○ Non-communicable disease (chronic disease) – diabetes, heart disease, cancer
○ Injury
● Nutritional outcomes
○ Overweight / obesity
○ Malnutrition / undernutrition (lack of micronutrients or macronutrients)
● Birth outcomes (preterm birth, stillbirth)

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3
Q

Prevention

A

● Decreases the risk of…
○ Getting a disease
○ The severity of a disease
○ A disease progressing to an adverse health outcome
● Can be an activity, behaviour, medication
● Examples:
○ Vaccinations, handwashing, hygiene, physical activity,
nutritious diets, sunscreen, condoms, sleeping under a bed net,
wearing a mask, social distancing

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4
Q

Treatment

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● Eliminates, cures, or heals a disease
● Decreases…
○ The severity of a disease
○ The risk of a disease progressing to an adverse health outcome
● Can be a medication, therapy, or procedure
● Examples:
○ Paracetamol, antibiotics, heart surgery, physiotherapy,
chemotherapy

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5
Q

malaira exampel

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5
Q

coronary heart disease examples

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5
Q

Risk factor

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● Increases the risk of…
○ Getting a disease
○ The severity of a disease
○ A disease progressing to an adverse health outcome
● Examples:
○ Smoking, drinking alcohol, drug use, overweight/obesity,
unhealthy diet, sedentary lifestyle, being pregnant, age, air
pollution, contaminated water
● Some health outcomes are risk factors for other health
outcomes
○ E.g. diabetes, obesity, maternal anaemia

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5
Q

malaria exaple

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6
Q

malaria example

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7
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7
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7
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7
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7
Q

Social determinants of health

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8
Q

Key points

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● Health outcomes include morbidity (disability), mortality (death), disease, nutritional outcomes, and birth
outcomes.
○ Can be both positive and negative (e.g. survival, healthy birthweight, paralysis)
● Preventative activities, behaviours, or medications DECREASE the risk of getting a disease, the severity of a
disease, or a disease progressing to an adverse health outcome.
● Risk factors INCREASE the risk of getting a disease, the severity of a disease, or a disease progressing to an
adverse health outcome.

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9
Q

The “Iceberg model” of health photo

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9
Q

Determinants of health

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Determinants of health

“Determinants of health are the broad range of
personal, social, economic and environmental
factors that determine individual and population
health.”

9
Q

Determinants of health

A

● Determinants of health affect our health by changing the likelihood of
○ being exposed to risk factors
○ adopting prevention strategies
○ having access to treatment options

9
Q

Determinants of health

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9
Q

Social determinants of health

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“The social determinants of health are the non-medical factors that
influence health outcomes.”
“They are the conditions in which people are born, grow, work, live,
and age, and the wider set of forces and systems shaping the conditions
of daily life.”
~ World Health Organisation

10
Q

Social determinants of health

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“Social determinants of health refer to a specific group of social and
economic factors within the broader determinants of health.”

“These relate to an individual’s place in society, such as income,
education or employment, [and for some people,] experiences of
discrimination, racism, and historical trauma.”

~ Government of Canada

11
Q

Examples of social determinants

A

● Income and social protection
● Education
● Unemployment and job insecurity
● Working life conditions
● Food insecurity
● Housing, basic amenities and the environment
● Early childhood development
● Social inclusion and non-discrimination
● Structural conflict
● Access to affordable health services of decent
quality

11
Q

Health equity

A

“Equity is the absence of unfair, avoidable or remediable differences among groups of people, whether those
groups are defined socially, economically, demographically, or geographically or by other dimensions of
inequality (e.g. sex, gender, ethnicity, disability, or sexual orientation).”
“Health equity is achieved when everyone can attain their full potential for health and well-being.”
~ World Health Organisation

12
Q

Australia’s Health 2016

A

● “Mothers in the lowest socioeconomic areas were 30% more likely to have a
low birthweight baby than mothers in the highest socioeconomic areas.”
● “Unemployed people were 1.6 times as likely to use cannabis, 2.4 times as
likely to use meth/amphetamines and 1.8 times as likely to use ecstasy as
employed people.”
● “People living in the lowest socioeconomic areas were more than twice as
likely to delay seeing—or not see—a dental professional due to cost compared
with those living in the highest socioeconomic areas.”

12
Q

Key points

A

● A person’s health is “determined” by many factors, seen and unseen, that are often beyond their individual
control.
● The “determinants of health” are the broad range of social, economic, environmental, and biological
factors that determine individual and population health.
● The determinants of health affect someone’s likelihood of receiving prevention and treatment for a disease,
and/or for having, or being exposed to, a risk factor for a disease.
● The “social determinants of health” are a subset of the determinants of health that concern a person’s
place in society, their income, education, employment, and for some people, discrimination and racism.

13
Q

Social determinants & health equity

A

“Health and health equity are determined by the conditions in
which people are born, grow, live, work, play and age”
~ World Health Organisation

13
Q

Social determinants & health equity

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● It is because health is socially determined that we care about health equity.
● If health was purely up to the individual, we wouldn’t be worried about health equity, because everyone
would have the same opportunity to be healthy.
● But because health is socially determined, and because the social determinants affect people differently,
different people have more or less opportunity to be healthy – and this inequitable.

14
Q

Australia’s Health 2016

A

● “Australians living in the lowest socioeconomic areas lived about 3 years less
than those living in the highest areas.”
● “The 20% of Australians living in the lowest socioeconomic areas were 1.6
times as likely as the highest 20% to have at least two chronic health
conditions, such as heart disease and diabetes.”
● “People reporting the worst mental and physical health (those in the bottom
20%) were twice as likely to live in a poor-quality or overcrowded dwelling.”

15
Q

Examples from other countries

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16
Q

Examples from other countries

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17
Q

Poverty

A

Many of the social determinants of health are linked to income

● Low-income
● Poor
● Socio-economic status (SES)
● Social gradient
● Poverty

18
Q

What causes poverty?

A

● Different theories of poverty:
○ Individual deficiencies
○ Cultural belief systems
○ Economic, social, political distortions or discrimination
○ Geographical
○ Cumulative/cyclical
● “Community development [should] address the complex
and overlapping sources of poverty [rather than] address a
single theory”

19
Q

Socio-economic status

A

● Socio-economic status is itself a determinant of many of
the other determinants of health
● Socio-economic status is linked to…
○ Housing and the built environment
○ Nutrition
○ Education
○ Access to health care
○ Social exclusion

20
Q

Poverty

A

● Absolute poverty = when people have insufficient income to afford the necessities of life, such as food,
clothing, and shelter
○ The World Bank defines “extreme poverty” as those who live on less than $2.15 per day
○ This is known as the “international poverty line” and allows comparison across countries
● Relative poverty = relates to the economic status of members within a society
○ People are “poor” if they fall below prevailing standards of living in a given societal context

21
Q

Poverty and the poor health cycle

A

● Poverty and ill-health are
intertwined
● Poverty leads to ill-health,
and ill-health keeps poor
people poor

22
Q

Poverty and the poor health cycle photo

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23
Q

Key points

A

● “Health and health equity are determined by the conditions in which people are born, grow, live, work,
play, and age.” (World Health Organisation)
● In Australia, and around the world, people of different race, education level, and income level have
significantly different health outcomes.
● The concept of socio-economic status (SES) encompasses many of the social determinants of health, and is
a notable predictor of someone’s health.
● Poverty and ill-health are intertwined and can create a cycle that is difficult to get out of.
● To improve health, we need to improve people’s conditions of daily life, which involves tackling inequitable
distributions of power, money, and resources – globally, nationally, and locally

23
Q
A

Many of the social determinants of health are also linked to race / racism

24
Q

Three “principles of action”

A

● Improve the conditions of daily life – the circumstances in which
people are born, grow, live, work, and age.
● Tackle the inequitable distribution of power, money, and resources –
the structural drivers of those conditions of daily life – globally,
nationally, and locally.
● Measure the problem, evaluate action, expand the knowledge base,
develop a workforce that is trained in the social determinants of
health, and raise public awareness about the social determinants of
health.

24
Q

Topics, weeks 1-6

A

I. Overview of Global Health
1. Unit introduction, definitions and globalisation
2. Global health trends and burden of disease
II. Determinants of Global Health
3. Social determinants of health
4. Nutrition transition
5. Water, sanitation and hygiene
6. Climatic impacts and global health
These topics can be included in the mid-semester exam in week 7

25
Q

Determinants of health

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“The determinants of health include:
* the social and economic environment,
* the physical environment, and
* the person’s individual characteristics and behaviours.
The context of people’s lives determine their health, and so blaming individuals for having poor health or
crediting them for good health is inappropriate. Individuals are unlikely to be able to directly control many of
the determinants of health.