SSCI 318 review from study guide 3 and above Flashcards
What do we mean when we talk about “the determinants of health”?
range of personal, social, economic, and environmental factors which determine the health status of individuals or populations.
Which determinants have a more direct and which have a less direct impact on peoples health?
rank from most direct impact to least impact
1. General socioeconomic, cultural, and environmental conditions
2. Living and working conditions ( unemployment, water and sanitation, health care services, housing, work environment, education, and agriculture and food production)
3. Social and community networks
4. Individual lifestyle factors
5. Constitutional factors (age/sex).
Why are the social determinants of health considered to be so important?
can help to identify causative factors that lead to the development of health disparities and poor individual health
What are the factors that would most determine the health of a poor person in a low-income country?
The factors which the most direct impact, which is socioeconomic, cultural, and environmental factors would most determine the health status of a poor person in a low-income country as there is a strong correlation between country income and health status
If you could pick one indicator to describe the health status of a low-income country, which indicator would you use and why?
“life expectancy at birth” as it is a measure of the average life expectancy of a newborn if current mortality trends were to remain constant and outside factors, such as wars and pandemics, did not occur.
Life expectancy at birth cause it takes average years of a newborn if no outside forces are interfere such as war or poverty. Most commonly indicator used. Takes into account the current time think white men example.
What might prevent a country from having an effective vital registration system, and how could such systems be strengthened?
inequitably of the system, cultural barriers, and weak health care systems with limited number of well-trained physicians.
Furthermore, the investment of time and resources into improving and strengthening the current health care systems could also encourage improvement of the vital registration system.
How much credence should you put in data on key global health indicators?
deserve a decent amount of credence as these indicators are a good way of comparing and evaluating the health of different countries. However, it is worth keeping in mind the possibility that low-income countries may not have a completely accurate method of recording data which can result in inaccuracies in global Health indicators.
Why are some people healthy, while others are not? In other words, what are the major determinants of health? What are the social determinants of health? What framework has the WHO developed to understand and attempt to influence those determinants?
the major determinants of health as “range of personal, social, economic and environmental factors which determine the health status of individuals or populations.
social determinants of health as the “conditions in which people are born, grow, live, work and age. The framework of root causes (natural environment: water, macro issues: war, Inequalities: distribution of wealth) underlying causes (built environment (transportation system) (Social context:education), and proximal causes (material circumstances:income, behavioral activity: smoking, psychosocial factors: education level.)
To who or what are those in global health interventions usually accountable to?
Usually accountable to governments and institutions in high income countries.
How can better data help us understand the SDoH better and thus inform health
decision-making and improve health, well-being, and health equity?
This would allow for a more complete understanding of SDoH SDoH (Social determinants of health) in a given context, the needs of vulnerable populations and existing inequities. A more complete understanding of SDoH, in turn, offers major opportunities for informing policy and practice, and to increase accountability. A human rights-based approach to data will ensure the use of data is consistent with international human rights norms and principles, including for participation, self-identification, transparency, privacy, and accountability. Third, data use is challenged by the complexity and interconnectedness of SDoH, calling for integrated and intersectoral approaches to tackle health outcomes. Data collection and disaggregation must go beyond gender, geography, and age, ensuring that all health determinants are identified and addressed, to leave no one behind
Addressing SDoH therefore requires integrated and intersectoral approaches, e.g., regulating
food advertising and designing urban environments
conducive of health [66], as well as school interventions, nutrition policies, and taxes on sugary
drinks [67]. The example of obesity also highlights
the need to consider additional determinants of
health in the CSDH framework such as politics,
commercial interests [68], emotions, culture, and
religion, as well as health outcomes such as mental and emotional health.
Over a calendar year, 50 of the 350 initially disease-free inhabitants of a village in Sierra Leone contracted Ebola. What was the incidence over the year? What were a villager’s chances of contracting the disease over the year?
50/350 = .143 = a 14.3 percent chance
Why is it important to measure health status? What are the main indicators
used to measure it, and what types of data are needed in order to assess it? How
do we measure the burden of disease? Why is DALY used more than HALE?
There are a number of very important uses of data on health status. We need data, for example, to know from what health conditions people suffer. We also need to know the extent to which these conditions cause people to be sick, be disabled, or die. We need data to carry out disease surveillance. They can be used to screen for disease, to predict adverse outcomes, and to measure clinical outcomes when treatments are tested or medical care is evaluated.
ideally, such an index would take account of morbidity, mortality, and disability; allow one to calculate the index by age, by gender, and by region; and allow one to make comparisons of health status across regions within a country and across countries
Main indicators: life expectancy at birth: the average number of additional years a newborn baby can be expected to live if current mortality trends were to continue for the rest of that person’s life.
infant mortality rate: “the number of deaths of infants under age 1 per 1,000 live births in a given year.
Maternal Mortality ratio: a measure of the risk of death that is associated with childbirth, the number of women who die as a result of pregnancy and childbirth complications per 100,000 live births in a given year.
Neonatal mortality rate: the number of deaths to infants younger than 28 days of age in a given year, per 1,000 live births in that year.
Under 5 mortality rate: the probability that a newborn will die before reaching age five, expressed as a number per 1,000 live births.
disability-adjusted life year, or DALY, health-adjusted life expectancy, or HALE.
DALY disability life adjusted year, used the most have to see a lost year, what chunk of years was lost due to serious disability or disease.
The main advantage is that DALYs provide a composite, internally consistent measure of population health which can be used to evaluate the relative burden of different diseases and injuries and compare population health by geographic region and over time.
why the study is not based on life tables for each individual country. In very simple terms, one could respond by noting that, in principle, any death before the life expectancy of the people who live the longest globally is “premature.” One might also add that in order to make the world a healthier place, a goal must be to have people live “as long as possible,” rather than live only as long as they live now.
What are the factors that have most determined your personal health?
1.) Genetic makeup/prone to disease
2.) Sex
3.) Age
What impacts have the social determinants of health (and which ones?) had on
the COVID-19 pandemic? In turn, how has the pandemic influenced those social
determinants? What health inequalities have we witnessed, and why is it correct
to call them health inequities?
The social determinants of health are the conditions in which people are born, grow, work, live, and age and people’s access to power, money and resources.
Inequalities in the social determinants of health have
been unmasked by the COVID-19 pandemic, and have
led to glaring inequities in COVID-19 health outcomes
between population groups, partly mediated through
differences in capacity to adhere to public health and
social measures that reduce viral transmission (such as
handwashing, use of face-masks, physical distancing,
and closure of workplace, schools and public events).
In turn, the broader impacts of the COVID-19 pandemic
have unequally impacted on the social determinants
of health themselves, further exacerbating health
inequities.
The specific social determinants that have driven these inequities include: Poverty and deprivation Imposed mobility of low-paid workers in precarious employment Lack of social protection Crowded housing Poor protection at work and low occupational health standards Unequal legal or residential status Stigmatization Unequal access to acceptable public health information
COVID-19 has affected people unequally because of unequal pre-existing health, and unequal living and working conditions, which mean that they have unequal exposure and vulnerability to the virus. Disadvantaged population groups have therefore borne the greatest burden of the epidemic, which has exacerbated poverty, deprivation and discrimination
What is structural violence?
violence in sense of negative health consequences comes from the way in which the system is set up and works