Social Determinants of Health

Question 1

What are the WHO definitions of health?

Answer 1

• State of complete physical, mental, social wellbeing and not merely the absence of disease/infirmity
• Resource for everyday life, not the objective of living (more to life than just good health)

Question 2

What is the difference between equality and equity?

Answer 2

• Equality = Sameness (only works if everyone starts in the same place) (people are given the same thing but it does not work unless they start from the same background)
• Equity = Fairness (access to the same opportunities regardless of circumstances)
• Need EQUITY before we can get EQUALITY

Question 3

What are three factors to consider when considering health inequities?

Answer 3

• Where we live
• Who we know
• What we do
• Health inequities are avoidable inequities between groups of people within or between countries
• Some people may have access to aspects of health care that others do not

Question 4

What is the definition of the social determinants of health?

Answer 4

• Mainly responsible for health inequities
• Conditions in which people are born, grown live, work, and age and the wider set of forces and systems shaping the conditions of daily life

Question 5

What are the 12 determinants of health?

Answer 5

• Income
• Education
• Employment
• Early childhood development
• Physical environment
• Food insecurity
• Culture
• Social support networks (social exclusion/safety net)
• Health services
• Gender
• Race
• Disability
• Or any combination of the above 12

Question 6

What are actions that can be taken to help the income social determinant of health?

Answer 6

• Link health policy with income equality policy

- E.g., increase minimum wage, boost assistance levels, taxation, unions, etc.

Question 7

What are latency effects?

Answer 7

• Refer to how early childhood experiences predispose to health outcomes later in life, regardless of life circumstances (e.g., low birth weight)

Question 8

What are pathway effects?

Answer 8

• Refer to situations that do not immediately have an impact on health but can have an effect later on in life (e.g., low education early on)

Question 9

What are cumulative effects?

Answer 9

• Notion that the longer children live under conditions of deprivation, the more likely they are to exhibit poor health and development outcomes (e.g., cognitive emotional deficits)

Question 10

What are the three aspects of social support networks?

Answer 10

• Sense of belonging
• Social safety net
• Social exclusion

Question 11

Describe the social safety net

Answer 11

• Protection during life changes transitions
• Creation of a system (welfare) to support citizens dealing with these threats (family allowances, childcare, unemployment, health and social services, disability benefits)
• More than just a financial safety net

Question 12

Describe social exclusion? What are the four key aspects?

Answer 12

• Refers to the exclusion of specific groups from being able to fully participate in life
• Marginalized groups have decreased access to a variety of social and economic resources, agency
• Sense of powerlessness influences the living conditions and personal experiences of individuals and populations; impacts health, housing, income, education, employment, social services
• Four key aspects: Denial of participation in civil affairs; denial of social goods (health care, education, housing, income security, food security); exclusion from social production (inability to participate/contribute to social and cultural activities); exclusion from economic resources (paid work)

Question 13

What are strategies for action in improving the negative effects of the determinants of health?

Answer 13

• Adopt improved governance
• Promote participation in policy-making and implementation
• Further re-orient the health sector towards promoting health and decreasing health inequities
• Strengthen global governance and collaboration
• Monitor progress and increase accountability

Question 14

What are aspects of healthy public policy?

Answer 14

• Increase minimum wage and boost assistance levels for those unable to work
• Taxation
• Controlled tuition fees (by government) so low income can have access to higher education
• Additional training options to unemployed
• Affordable, quality child care
• Affordable housing
• Maintain accessible health care
• Anti-discrimination laws

Question 15

In the socio-ecological model, what factors are known to influence an individual?

Answer 15

• Individual factors (knowledge, attitude, skills)
• Interpersonal (family, friends, social networks)
• Organizational (organizations, social institutions - e.g., university)
• Community (relationships among organizations)
• Public policy (national, state, local)

Question 16

What is population health?

Answer 16

• Approach to health that aims to improve the health of an entire population and health inequalities among population groups - “unifying spectrum of health system interventions”
• Recognizes interrelated conditions/factors that influence health of a population and systematic variances
• Initiatives that take a multi-system approach (community, policy, etc.)
• Population health is: Vaccinations, smoke-free parks, clean water, sanitation, community mobilization, food safety, seat belts and helmets, side walks, farmers markets