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Soc 382 > Sociological Determinants of Health > Flashcards

Sociological Determinants of Health Flashcards

1
Q

How to define health

A

Health is socially constructed through the body and interaction, although our focus is on sociological way of thinking; it is social, political, organizational, and commercial

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2
Q

Ottawa Charter for Health Promotion (n.d.) health definition

A
  • A state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity
  • It is a culmination of physical, mental, social & personal capacities
  • Individual responsibilities to create environment that endorses wellness
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3
Q

Salutogenic model of health

A
  • Can help us in defining health and illness better
  • Through this perspective, we can start to understand good health as sustainable wellness (good health, quality of life, etc.)
  • Brings an understanding of not just how people are sick but also the ways in which they are and stay healthy
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4
Q

Wellness

A

A concept that incorporates good health, quality of life, and satisfaction of living conditions

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5
Q

What makes people healthy

A

1) Health promotion
2) Social Determinants of Health

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6
Q

Health promotion

A
  • This party emphasizes the importance of personal practices
  • Under this camp, personal practice is learned through individual health consciousness and places most, if not all, responsibility on the individual to practice good health (ppl have the right, responsibility & freedom to do what is good for their bodies)
  • This individual responsibility not only covers behaviours and cultural knowledge (or what bourdieu would describe as cultural capital) to get healthy but also to take preventative/proactive behaviours in relation to health (dont smoke, eat full nutritious meals)
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7
Q

Cultural capital

A
  • Info gathered of norms & values used for one’s own leverage
  • Your responsibility to get info necessary to maintain health
  • Very neoliberal
  • Neoliberalism does play a key role in health promotion. When forcing ppl to dp things on macro level there is a clash, but when giving ppl the opportunity to do things it goes better.
  • Sociologists criticize the amount of responsibility as it often negates the impact of institutions, structures & histories in regards to gaining cultural capital to make informed decision (how accessible is it?)
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8
Q

Social Determinants of Health

A
  • Social determinants of health are the circumstances that people find
    themselves in, whether being born into, growing up, or having been placed in systems that directly impact health and illness. (race, class, geographical location, urban vs rural, etc.) Not just social factors
  • Health goes beyond the control of the individual, structural factors and systematic discriminations can be a disadvantage to health, to health prevention, illness intervention, and death (wholistic social constraints & individual factors)
    ○ We need to understand people’s resilience to social and physical conditions, whilst also taking into account personal histories with health and behaviour and cultural values regarding to health.
  • rejects individual (complete) responsibility & stresses the culmination of individual responsibility, structural factors & systemic discrimination that can be a disadvantge to health (illness prevention, intervention & death)
  • How ppl view their social determinants factors in which ppl are born, love, grow & die in (may not interact with that aspect of social life affecting their health (+) and/or (-)
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9
Q

Personal Vs Structural

A

Population Health -> Determinants of Health -> Structural Factors/ Personal Factors
- Combine the two factors to help us understand why people get & stay ill/healthy
- Living in a place with accessible grocery store, park, gym, doctor’s office (structural) -> you are more likely to have access to good health practices with influences (individual/personal)

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10
Q

Structural Factors

A

Evident at the societal level. Includes
aspects of social environments (Socioeconomic status, gender, race, ability, age, Social support) and
institutional organization (Health care services)

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11
Q

Personal Factors

A

Evident at the individual level. Includes
genetic make-up and individual beliefs,
values, and personal health practices (Health management (Selfcare, Coping skills) Personal health practices (Healthy lifestyle, Proactive health behaviours)

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12
Q

The Lalonde Report 1974

A
  • Canadian government published the Lalonde report to help determine the health of Canadians.
  • Argues that healthcare services are not fundamental to improving health, noted that with economic progress, social threats increase the risk to health and wellness and established four key determinants of health (1974)
  • At the time, the report found that to improve the health of Canadians, we must move beyond just investing in the health care sector and from 1974 onward, Canada shifted some of its federal policies from biomedical risks to understanding risks to health as more socially and behaviourally impacted.
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13
Q

4 key determinants of health

A
  1. Human Biology
  2. Lifestyle
  3. The environment
  4. Health care systems
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14
Q

Lalonde Report 1986

A
  • Canada followed up with the Achieving Health for All: A Framework for Health Promotion, which emphasized our understanding of health as embracing physical, mental, and social
    well-being.
  • One of the major aspects of this report was the recognition of the first and largest challenge to Canadians and their health: To reduce inequities in health between high- and low-income Canadians.
  • The report states a need to pay special attention to resource allocation, especially in communities
    who are at high risk of chronic disease, mental illness, and disability. It endorsed the health promotion framework.
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15
Q

Health promotion framework

A

Refers to health promotion as a multifaceted approach that aims at engaging communities,
governments, and other insitutitions to support individuals making healthy choices and creating
health social and physical environments through coordinated health policy.

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16
Q

Social determinants of health

A
  • Income and Social Status
  • Social Networks
  • Education and literacy
  • Employment and Working conditions
  • Social and physical Environments
  • Personal Health practices
  • Healthy childhood development
  • Biology
  • Healthcare services
  • Gender
  • Race and culture
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17
Q

Lifestyle

A

Education and Literacy, Personal Health Practices, Health Childhood Development

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18
Q

Environment

A

Social, physical, working conditions

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19
Q

Capital

A

Income and social status, Employment, Social networks

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20
Q

Social factors

A

Gender, race and culture

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21
Q

Human Biology

A

Each person inherits a combination of genes from both parents - and these genes can impact physical and emotional traits. Our biology also interacts with other personal and structural factors that impact the
status of our health

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22
Q

Drawbacks of Biology for population health

A
  • Critics of biology state that biological factors do not explain the large differences in population health
  • Biological determinism & Scientific Racism
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23
Q

Biological determinism & Scientific Racism

A

Draws support from contemporary xenophobia, antisemitism, sexism, colonialism, and imperialism.

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24
Q

History

A
  • Historically, colonial powers have conducted racist based empirical research on people of colour, often conducting such research to justify differential
    treatment.
  • Research feeds into the concept of othering and is compounded by the us-versus-them effect
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25
Q

Othering

A

A concept that describes the ways in which institutions use mechanisms to highlight minority and/or marginalized groups from the dominant groups.

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26
Q

Us-versus-Them effect

A

People prefer to surround themselves with people who they consider to be in the ‘us’ group over the ‘them’ group

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27
Q

Eugenics

A
  • Eugenics is the scientifically inaccurate belief and practice of improving the human population through controlled/selective breeding.
  • This process involves the limitation or discouragement of procreation from people who are considered less desirable - while encouraging the procreation of desirable people.
  • Eugenic ideologies stem from the conclusion that rates of inequity and illness (ex. Poverty, crime, drug
    overdoses) occur because of hereditary traits rather than from social organization.
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28
Q

Eugenics origin

A

Officially coined in 1883 by Francis Galton, an English statistician, demographer, and ethnologist.

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29
Q

Eugenics in Canada

A
  • Assumes that selective reproduction can achieve a colonial Canadian nation-state (The Indian Act (1876))
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30
Q

Eugenics across the globe

A

Scientists from many fields supported the Eugenics movement, including statistics, economists,
anthropologists, sociologists, geneticists, public health officials, and other members of the general
public.

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31
Q

Most notorious applications of eugenics

A
  • Nazi Germany & the Holocaust
  • It is estimated that 70,000 adults and 5,200 children were euthanized.
  • In addition, at least 400,000 individuals were victims of forced sterilization.
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32
Q

In the US

A
  • Fear of miscegenation and eugenics was prominent
  • Used these fears to introduce anti-immigration policies and sterilization of Black and other immigrant groups.
  • Allowed for The Johnson-Reed Act - passed in 1924 - which was a discriminatory immigration
    legislation which excluded immigrants from Asia.
  • Over 60,000 people were sterilized between 1900-1970.
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33
Q

Eugenics in Alberta

A
  • In 1921, Alberta elected the United Farmers of Alberta (UFA) to lead the province through post WW1.
  • At the heart of the movements culture: community and collective self-confidence, a sense of class
    opposition, gender assumptions (expected roles and traits).
  • Strength of the party came from the active role women played within the organization. Women were given the status, “mothers of the race”. Women leaders exhibited a version of maternal feminism.
  • As the UFA proceeded in leadership, eugenic policies wove their way to mould Alberta into an ‘ideal’ society. The Eugenics discourse was knitted together by maternal feminist ideologies and concerns about problematic populations (Indigenous peoples, immigrants, disabled individuals) spreading throughout the population.
34
Q

Maternal Feminism

A
35
Q

Sexual Sterilization Act

A
  • In 1928 Alberta passed the Sexual Sterilization Act, sanctioning, and often promoting, the surgical sterilization of those whom were deemed “mentally
    defective” or not ideal - most of which occurred without consent.
  • 2,835 individuals were sterilized (Grekul, 2011) 58% were women and 38% were teenagers
  • In 1972, Alberta repealed the Sexual Sterilization Act
36
Q

Alberta Eugenics Timeline

A
  • Forms of Eugenics persisted before 1928
  • 1928:
37
Q

Leilani Muir

A
  • She won a monumental suit against the government of Alberta in 1996 for wrongful sterilization and confinement
  • She was sterilized at 14 years old while institutionalized at the Provincial Training School for Mental Defectives
38
Q

Lifestyle - Health Behaviours

A
  • Health-related practices and beliefs (Positive health behaviours vs. Negative health behaviours)
  • Positive health behaviours are typically behaviours that work to prevent disease and illness. Where as
    negative health behaviours are either conscious or subconscious behaviours that inflict damage on the
    body.
  • A lot of what we know about health behaviours comes to us via cultural capital (education, social media, government websites, books).
39
Q

Factors that impact people’s choice and use of food

A
  • Income and income stability
  • Capacity to plan and/or budget → education, literacy, and mental health
  • Food capital → healthy eating habits, cooking skills, food knowledge
  • Availability and affordability of food
  • Pervasive marketing of food
  • Cultural and/or religious background
  • Peer pressure, norms, and eating behaviours
40
Q

Food Insecurity

A

According to Health Canada (2008), food insecurity refers to the inability to acquire or consume an
adequate diet quality or sufficient quantity of food in socially acceptable ways, or the uncertainty that
one can do so.

41
Q

Nutrition Insecurity

A

Lacks of availability of nutritious food; inability to access at all times nutrients needed for healthy & active lifestyles

42
Q

Who are most at risk of food and nutrition insecurity and its impacts

A
  • Low-income people, single mothers/parents, rural residents, and Indigenous peoples are most at risk
    for food insecurity and nutrition insecurity in Canada.
  • Food and nutrition insecurity are linked to poor self-perceived health, obesity in children and women, diabetes, depression, and anxiety
43
Q

Food deserts

A
  • geographical locations where access to affordable and nutritious food options are
    restricted or simply nonexistent.
  • In most cases, grocery stores are not in accessible travelling distances - meaning there is a reliance
    on personal vehicle use, reliance on public transport, and time to travel to get groceries.
  • Food desserts also involve prices of fresh produce within grocery stores, making nutritious food
    inaccessible to low-income individuals and families.
44
Q

Research on more affluent neighbourhoods

A
  • Research demonstrates that more affluent neighbourhoods generate better health outcomes.
  • Interestingly, proximity to some of these neighbourhoods can positively impact lower-income
    residents (aka the mixing of income of residents within the area result in better health outcomes for
    everyone.)
45
Q

Connections between health behaviours and lifestyle

A
  • Strongly connected
  • they typically paint a picture of how you behave in
    relation to your health.
  • For example: People who are physically active, Well balanced and culturally relevant diets, Work/Life balance
  • Lifestyle depicts health at every age.
  • Additionally, looking at lifestyle and connecting them to health behaviours allows us to look at (1) big data (aka illustrating current trends in the Canada) and (2) future directions for preventative disease measures
46
Q

Self-perceived health

A
  • important aspect in health research.
  • Some research suggests that the constant perpetuation of a particular lifestyle or the pressure to have a healthy lifestyle actually is determinant to
    mental health and in the long-run, physical health
  • Furthermore, when considering lifestyle as a determinant of health, it is important to consider individual agency - do people have access to
    resources that would promote a healthy lifestyle?
47
Q

Environment

A
  • The increase of industrialization and urbanization increased the need to incorporate the physical environment to health outcomes across Canada
  • Highlights the overrepresentation of marginalized communities
  • For example, 60 to 90% of all cancers are in some way environmentally or occupationally caused.
48
Q

Case Study: Water

A
  • Approximately ¾ of the drinking water in Indigenous communities is contaminated, resulting in an increased risk to gastrointestinal illness, skin diseases, and cancer (Bradford, et al., 2016).
  • Access to clean water not only poses a threat to physical harm, but also cultural harm their deep connections to land culturally & spiritually
49
Q

Grassy Narrows

A
50
Q

Climate Change and Health

A
  • Over the past century, the average temperature of the land and sea has risen about one degree - a rate
    that has approximately doubled since 1950.
  • Human activity is namely the reason for the impacts the increase in temperature. For example:
    ○ Carbon dioxide from burning fossil fuels
    ○ Methane and other greenhouse gases
    ○ Deforestation
51
Q

Temperature changes

A
  • Temperature changes are not uniform.
  • The northern polar region has sustained the most change in temperature.
52
Q

Weather Patterns

A
  • In addition, weather patterns have become more erratic, equating for an increase in extreme weather (ex. South Africa just got snow).
  • Weather systems have historically been able to ‘move’ more freely, but with the increase of heat, systems get trapped.
  • Droughts and flooding affect the food supply and the price of food.
53
Q

Communicable diseases

A
  • Climate change has also lead to the spike in communicable diseases - particularly those that have an insect vector.
  • West Nile Virus, Lyme disease, Dengue fever, Yellow fever and the Zika virus → all mosquito borne have become epidemics (even places that they previously did not exist)
54
Q

Natural Disasters and Health

A
  • Earthquakes, hurricanes, flooding, and landslides are natural, environmental phenomena; however,
    human impact chances their frequency and severity.
  • Low-income individuals are disproportionately impacted by natural disasters (short and long-term).
  • Low quality housing is more likely to collapse under environmental duress.
  • These areas are more likely to be subjected to heavy rain, mudslides, and often lack environmental
    infrastructure, such as rain drainage.
  • Low-income individuals are the most impacted by natural disasters before, during, and after in North America.
55
Q

Hurricane Katrina (August, 2005)

A
  • Struck Louisiana, killed approximately 2000 low-income people.
  • Low-income neighbourhoods with the worst storm infrastructure and emergency evacuation
    protocols were predominantly black neighbourhoods
  • It is important to note that infrastructure such as drain pumps, as well as rehousing displaced
    residents from this disaster was not completed when Louisiana was hit with hurricane Harvey in
    2017
56
Q

Built Environments

A
  • The physical environment goes beyond water, soil, and air (natural environment). Built environments can also be a determinant of health.
  • Built environments can be housing, workplaces, and city planning
57
Q

Urban vs Rural health outcomes

A

While other research suggests that because health care services (including specialty health services) in
rural areas are less accessible, individuals in less concentrated areas are more susceptible to negative
health outcomes.

58
Q

The impact the sprawling suburban neighbourhoods (Urban Sprawling)

A
  • A phenomenon found most heavily in North America
  • It is the result of building communities away from central transit and city centres and instead sought to
    build communities around the urban areas
  • Opposite to this is compact development
59
Q

Low residential density

A
  • Reliance on
    vehicles
  • Decrease in
    walking
    behaviours →
    related to
    cardiovascular
    disease
60
Q

Rigid zoning and separation from commercial businesses

A
  • The need to commute
  • Farther distances to health related services
61
Q

Personal vehicle use

A
  • Increased pollution
  • Traffic → (-) mental health
  • Automobile related accidents
62
Q

Less commercial activity in city centres

A
  • The need to commute out of the city centre
  • Farther distances to health related services
63
Q

Social environment

A
  • One of the most researched areas of health outcomes from our social environment is socio-economic status. Research suggests that higher socioeconomic status equates to being healthier.
  • Just to note - just because you work, it does not mean you are automatically subjected to being healthier
  • Workplaces can cause stress, reduce work life balance, take you out of your social circle → all of which can result as a detriment to one’s health
64
Q

Other inclusions in psychosocial impacts

A
  • Noise
  • Crowding
  • Conflict
  • Induce stress related symptoms increasing risk to physical environmental factors
65
Q

Social support in social environment

A

Social environments that have a sense of support are often correlated with higher self-perceived health, increase life expectancy, and lower rates of infant mortality. Here we see the importance of including the interactive and intersecting social (health care), political, commercial, and corporate determinants of health.

66
Q

Types of Social support

A
  • Emotional
  • Instrumental
  • Informational
67
Q

Health Care Services

A
  • Health care services are designed to prevent and intervene illness and disease
  • Health care services works on a more personal level of disease prevention and intervention rather than a population level, which would focus on health
    maintenance.
68
Q

Limitations of Research

A

Research cannot explain the extent that health care services contribute to the improvement of population health
- It becomes difficult to quantify improved health and life expectancy and its relation to the consumption of health care services
- Consumption - agency, misinformation
- Accessibility - agency, geographic location, culturally respective, economic

69
Q

Who’s responsibility is health care

A

Some argue that responsibility on health care is large and therefore, spending more money on health care does not solve the long-term and systemic health issues.

70
Q

Political determinant of health Overview

A
  • Government and public policy plays an integral role within determining health and illness.
  • In Canada, law, policy, and government programs have developed in order to increase access to healthcare services.
  • Rural environments can demonstrate the unfair distribution of resources, wealth, and power in society.
  • Political and governmental actors help dictate health equity.
  • We can refer healthcare more broadly as a political determinant of health: power structures & political decisions that factor into ppl’s health
71
Q

Commercial determinants of health Overview

A
  • Political and governmental actors work closely with commercial agents who own the means of production to health services and needs.
  • We can refer to these as commercial determinants of health.
  • By owning the means to harmful commodities, commercial determinants of health help drive the
    consumption of health care services and needs related to non-communicable diseases.
72
Q

Corporate Determinants of health Overview

A
  • In relation to commercial determinants of health, we have corporate determinants of health. This is referring to the ethical responsibilities of corporations and organizations within the health market.
  • Introduced by Millar (2013), corporate
    determinants of health shift the perspective
    from health as being a transaction of economics
    to an interrelated system of profit, people, and
    the planet.
73
Q

SDOH

A
74
Q

PDOH

A
75
Q

CommDOH

A
76
Q

CorpDOH

A
77
Q

Rural Populations

A
  • According to StatsCan (2022), 17.8% of Canadians live in rural areas. Rural populations often experience a lack of:
  • Access to higher education
  • Comprehensive health care services
  • Public funding
  • Resources for sustainable community development
    Rural environments can demonstrate the unfair distribution of resources, wealth, and power in society
78
Q

Policy makers in health and illness

A
  • Recently started exploring PDH, CommDH & CoprDH factors as determinants of health. Through this, we can combine the legal and regulatory systems that determine, design, and develop the consumption of health.
  • When we reference the consumption of health, we are referring to health as an economic system, which is the health services individuals consume (whether those are public or private) and the ways in which environments are designed to consume the product.
  • Health care services are often curated to fit within an urban environment, creating a disadvantage to
    rural communities.
79
Q

Unique disadvantages for rural populations

A

Age, geography, experience and interaction with political systems, and environmental impact create unique disadvantages to rural and Indigenous communities

80
Q

Susceptibility to negative health outcomes

A
  • Due to remote locations, rural communities are more susceptible to negative health outcomes related to compounded factors.
  • Access to public transit and/or personal vehicles dictate how rural communities consume health care
  • Rural areas typically have different governance culture, which impacts the government involvement and output of healthcare related services and programs.
  • Urban planning and economic investment related to health care service infrastructure can be difficult
    and create inequity to the consumption of healthcare services.
81
Q

Personal and community attributes

A
  • Create the opportunity to exacerbate health inequities

Soc 382 (12 decks)

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