W9: Social Determinants of Health Through an Occupational Lens

Question 1

How do social determinants of health affect people?

Answer 1

shift opportunities available to people

• stigmatized or socially acceptable occupations are very much determined by social determinants of health

Question 2

What are the 12 elements of a healthy community?

Answer 2

(health equity and resiliency)

• access to health
• affordable quality housing
• community safety
• economic opportunity
• educational opportunity
• environmental quality
• food access
• community design
• parks and recreation
• social/cultural cohesion
• social justice
• transportation options

Question 3

Social Determinants of Health from a First Nations Perspective

Answer 3

“The First Nations Health Council is part of a unique health governance structure that includes the First Nations Health Authority and the First Nations Health Directors Association. Collectively, this First Nations health governance structure works with BC First Nations to achieve our shared vision.”

Question 4

SDH with a Neoliberally Governed Society

What is neoliberalism?

Answer 4

ideology directed at individual self-interest and self-reliance over mutual interest of a group or collective

• has shaped policy-making
• guided by particular values

Question 5

SDH with a Neoliberally Governed Society

What are the 3 principles of neoliberalism?

Answer 5

• individualism
• free market
• decentralization

(government wants to do less, and get individuals to do more)

Question 6

SDH with a Neoliberally Governed Society

Principles of Neoliberalism: What is individualism?

Answer 6

self-interest rather than mutual interest, individual responsibility

Question 7

SDH with a Neoliberally Governed Society

Principles of Neoliberalism: What is the free market?

Answer 7

favours de-regulation and privatization of public and state-owned enterprises where economic growth takes precedence

• ie. Canadian Pension Plan used to be more robust – could rely on it to live through later life

Question 8

SDH with a Neoliberally Governed Society

Principles of Neoliberalism: What is decentralization?

Answer 8

advocates transferring power, responsibility, and accountability from national to regional and municipal levels

Question 9

SDH with a Neoliberally Governed Society

Describe the neoliberal mindset and healthcare.

Answer 9

• cost cutting for efficiency
• health care serves as private and good for sale rather than public good paid by tax dollars
• social policies are viewed as a type of discrimination (preferential treatment) because only certain people benefit from government intervention – ie. only low income seniors benefit, yet service is funded by everyone’s tax dollars

Question 10

SDH with a Neoliberally Governed Society

Citizens as Consumers: Neoliberalism is characterized by what assumptions?

Answer 10

• you are responsible for your health
• you are responsible for your economic status
• you can purchase the health care services you want at the agency you want – ie. diagnostic tests, scans, surgery, home care services, psychotherapy, prosthetics and orthotics, occupational therapy. . .

Question 11

What is the challenge of individualism? (What are the critiques of the predominance of an individualistic lens within occupational science and occupational therapy?)

Answer 11

• frames social issues/problems as individual problems – takes away government from having to address issues (ie. blaming homeless people for not having housing)
• obscures how social, economic, historical, and political factors shape occupation in practice and research
• risks reproducing inequities and injustices

Question 12

(Beagan et al., 2017) Food Provisioning – The visible and invisible occupations of food provisioning in low income families

What are the main concepts of this article?

Answer 12

• food provisioning as an occupation requires knowledge, skills, and work, but these are often invisible or unacknowledged
• food provisioning is also an occupation whose meaning is contextually shaped
• low income creates additional work in food provisioning

Question 13

(Beagan et al., 2017) Food Provisioning – The visible and invisible occupations of food provisioning in low income families

What are the findings of this article?

Answer 13

• planning
• complex knowledges
• strategies
• other means
• parenting

Question 14

What do intersectionality health equity lenses do?

Answer 14

help us understand that every person’s experience is fundamentally different than the experiences of others

• more than just a theory or framework – it is a commitment to developing a relentlessly critical and self-reflective lens that begins with the premise that race, class, gender, and other social determinants are intertwined and mutually constitutive, and that such lens can help advance health disparities research, practice, and leadership by making the invisible visible

Question 15

What is intersectionality?

Answer 15

proposed by Kimberle Crenshaw as a tool to examine perpetuation of a single-axis framework when approaching anti-discrimination law and politics

Question 16

What is the relevance of intersectionality for occupational science and occupational therapy?

Answer 16

• limitation of single-axis framework
• marginalization outside prototypical identities
• interrelated (rather than additive or compounding)
• social positions

Question 17

What does a social determinant of health acknowledge?

Answer 17

acknowledges a role for individual action, but also recognizes that the individuals’ choices are strongly influenced by their social circumstances over the life course and that positive or negative effects of these social determinants accumulate across the life course