Social Determinants of Health: Social and Health Inequalities and Inequities, and International Efforts to Target Social Inequities

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University of Ottawa
International Development and Globalization
Sonia Gulati

January 13, 2014 Video; what is the Happiest Country on Earth? • Despite being believed to be less happy, predominantly Socialist countries score higher in happiness. o Guaranteed health care o Work benefits like higher vacation times  Higher per capita incomes o Bottom Line; better work-social life balance • China scored less happiness. o Make a lot less GDP per capita than their European counterparts o Norway has the highest GDP, however, but are 9 on the list—therefore money isn’t the only factor • Good measuring scale of happiness being used as both quantitative and qualitative measures are used o Pain scale;  To comparatively gauge who needs more help at a clinic  To see what kind of medication to provide  Valid way of tracking information on people, despite subjective differences among individuals • Health disparities exist between rich-poor nations o Within rich nations, the gap between rich and poor can be great o There are nations within nations that may be dealing with extreme health disparities (ie. Aboriginals) • Small increases in per capita income (up to $5000 US) tend to be associated with substantial gains in health • Top 20% saw net income increase by 43% from 1984-1999 o People being paid more to do the same things o Cost of living has also increased, however, thus not making us any happier • Bottom 20% saw net income decrease by 51% in the same period • Development perspective of health o Development policy should focus on maximizing the rate of economic growth in the expectation of “trickle down”  However, some countries may ignore human rights or vulnerable groups while experiencing high levels of economic growth  Doesn’t increase health in some situations, as government may still not provide adequate health services and populations may consume unhealthy, “Americanized” goods  Disparity may still exist despite “perceived equity” • Ie. Even if all children begin going to school, private-run institutions emerge that offer better standards of education to those that can afford it in countries like India. • In some situation, countries with universal education rates experienced higher levels of unemployment. o Over-qualification for jobs available, yet not qualified enough for administrative jobs etc. • Quality of life; an essentially subjective judgment of the way people perceive themselves as content and happy or otherwise and able to function physically, emotionally, and socially. Affected individual is the ultimate judge. o Social determinants such as social status, gender, social supports/community supports etc. o Aspirations, goals o Access to social services o How time is spent; ie. Productive role, leisure time, etc. o Policy-level issues and government infrastructure, more mentioned in developing countries • Health-Related Quality of Life (HRQOL) o Medical Outcomes of Study Short-form is a survey of 36 questions that as about functional health, access to community resources,
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