HBS107 Lecture Notes - Lecture 2: Passive Smoking, Chronic Poverty
HBS107 Week 2
WEEK 2 LEARNING OUTCOMES
SOCIAL DETERMINANTS OF HEALTH:
• The conditions in which people are born, grow, live, work and age.
• The range of behavioural, biological, socio-economic and environmental factors that
influence the health status of individuals and populations.
Health is influenced by us. We make the change.
There is a correlation between wealth and health.
Consistent determinants:
• Early life experiences
o A good start in life means supporting mothers and young children
o The health impact of early development and education lasts a lifetime
o Poor circumstances in pregnancy can affect foetal development
• Social gradient
o Think of it as a ladder, we all sit on the ladder somewhere and this changes
throughout our life.
o The further we sit up the ladder, the better our health. The lower on the ladder,
the worse our health outcomes.
o There is a clear relationship between income and health, leading to the
development of a social gradient. Our socio-economic position is importantly
related to the gradient in health.
• Education
o Higher levels of education = better health outcomes
o Link occurs because:
• Education is related to other social determinants, including social gradient;
it can help individuals gain access to resources and moved up the social
ladder.
• Education creates employment and opportunity for community
engagement
• Education increases overall literacy and understanding of how to promote
health
• Employment
o Employment creates income = access to the resources needed for good health
(e.g. food, water, housing, health services)
o Income may allow access to education and the achievement of knowledge/skills,
possibly leading to movement up the social ladder
o Individuals with low education levels and incomes are more likely to encounter
adverse working conditions
o Level of control an individual has over working conditions is key to health
outcomes
• Gender
• Stress and coping/resilience
• Income and income distribution
• Social support/social exclusion
• Access to services
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• Food
• Disability
LEVELS OF DETERMINANTS:
PROXIMAL
(DOWNSTREAM)
INTERMEDIATE
(MIDSTREAM)
DISTAL (UPSTREAM)
Near to the change in
health.
Lifestyle and behaviour
factors.
Underlying health
conditions.
e.g. smoking
Access to material
resources.
Living and working
conditions.
Health system.
E.g. education
Remote from the point of
reference
National, political, legal and
cultural factors.
E.g. policy
Malnutrition, stress, substance abuse (smoking, illicit drugs, prescription drugs, alcohol) in
pregnant women can lead to poor foetal health and development.
SUMMARY:
• There are underlying factors that affect our health - some of these determinants
include early life, education, social exclusion, and work.
find more resources at oneclass.com
find more resources at oneclass.com
