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Lecture #6- Oct 21.docx

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University of Toronto St. George
Robb Travers

SOC309Y1 October 21, 2011 Social Determinants of Health Term Test I (25%) all lectures and readings ( reading) Oct. 21 Unnatural causes film not online refer to notes why African Americans in the us have poor health outcomes having to do with prejudice, racism and living in a society like that and what it does to immune systems - 75-80 multiple choice/true or false - When reading article read thoroughly via first and last sentence of each paragraph, read highlight, and then go back reading whole article, what are the 2 key things in each paragraph through next read through Lecture Social determinants are opposite of lifestyle determinants of health (lifestyle: holy trinity of risks: exercising dieting) Social determinants are obvious Concept of vulnerability vs. risk- why all health conditions vulnerable Ex: Who gets cancer- disproportionately affects poor people, same with the flu = these diseases follow lines of social inequality/marginalization and produces conditions where we see a vulnerability to the disease by particular groups Health Promotion - Standard ways health promoters proscribe health considerations use proscription - Level of a population- the cumulative group - Population health- a population health perspective zeroing in on particular population asking what keeps them from becoming ill etc. Ottawa Charter 1986 - We spend majority on prevention and intervention - There are more efficient ways to ensure a population stays healthier but politicians think in terms of short term, not what will really help - The Charter for Health Promotion moved away from simply describing health determinants- and looked at instead what makes population healthy or sick Prerequisites for Health - Peace - Shelter - Education - Food - Income - A stable eco-system - Sustainable resources - Social justice and equity has exploded and become real focus how do impact peoples health Charter was first to lay out these prerequisites for health HEALTH PROMOTION Process of enabling people to: Health promoters took up this document and said there work was to increase control over, and to improve, their health Broad definition of health To reach a state of complete physical, mental. The Holy Trinity of Risks As with any area of medical or scientific research, the selection of factors to be studied cannot be immune from prevailing social values and ideologies IT is also evident that so-called lifestyle or behavioural factors such as the holy trinity of risks (diet, smoking and exercise receives a disproportionate amount of public health attention (90%). As we have seen the identification and confirmation of risk factors are often subject to controversy and the We are already inoculating health people SUMMARY- HEALTH PROMOTION 1. FOCUS ON EMPOWERMENT 2. FOCUS ON PERSONAL AGENCY 3. FOCUS ON REDUCING LIFESTYLE RISK BEHAVIOURS Condoms are unnatural to people changing health behaviours What are the social determinants of health? Social determinants of health are the economic and social conditions that influence the health of individuals, communities, and jurisdictions as a whole. SDOH are about the quantity and quality of a variety of resources that a society makes available to its members Dennis Raphael (2004) - We do not ask why poverty is present in some societies Social determinants of health also determine the extent to which a person possesses the physical, social and personal resources to identify and achieve personal aspirations, safety needs, and cope with the environment Raphael (2004) - Smoking is a buffer for some women, responseTHE FOCUS OF THE CANADIAN SDOH CONFERENCE Raphael (Social Determinants of Health) - One area of criticism because apparently simply named them: social exclusion - Aboriginal status (why Canada uses this status, only one, due to lower life quality, health) - Disability status - Early life (children that attend daycare, early, by 10 score superior in cognitive testing) - Education - Employment and working conditions - Food security - Health services - Gender - Housing (people who own own homes, are healthier, rather than those who rent for life, home ownership gives greater sense of stability) - Income and income distribution (distribution: relative to others) - Racism - Social exclusion (meaning all ways people prevented from taking part in society as full citizens) - Social safety net - Unemployment HEALTH Gradient EXAMPLE - White whole studies- longitudinal study for over 2 years tracking health of British social service SURVEYS and interviews to figure out what has changed in your health and why called prospect and cohort studies best way of determining Cause and Effect with health outcomes - There is a great LADDER effect where you are in income ladder determines others income above
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