History of Science 2220 Lecture Notes - Lecture 14: World Health Organization, Health Care Reform, Public Health
2 May 2018
School
Department
Course
Professor
Public Health Lecture
Overview
1. Social determinants of health
2. Public Health
3. Epidemiology
1. How does statistics come to dominate epidemiology
4. World Health Organization
5. Health care reform
1. Where do we go from here
About prevention
Doctors play a role, but much less central
About government, public policy, and economics
Key idea: social determinants of health
How does health relate to social determinants/SES?
About trying to reduce gaps in access to care , racial discrimination , poverty levels and education
Social Determinants of health
The World Health Organization (WHO) definition of health:
“Health is a state of complete physical, mental and social well-being and not merely the
absence of disease or infirmity.” (link)
- very broad definition
- about the mind & body, not only medicine (which focuses on the body)
- hard not to be sick with this motto- bar is set high for health care system
- the social well being is something other than physical and mental causation going on
How does socioeconomic status (SES) affect health?
-social determinants of health focusing on economics
-Marxist framework
SES is also known as a key “social determinant of health”
Social Determinants of Health = “the conditions in which people are born, grow, work, live, and
age, and the wider set of forces and systems shaping the conditions of daily life. These forces and
systems include economic policies and systems, development agendas, social norms, social policies
and political systems. (WHO)
Very broad
All states have some social welfare component that will equalize the gap between the rich and poor
These are the things you look at in terms of demographics
Statistics help to highlight the differences
About the members of the group getting sick
A gap in income/disposable income translates into a higher likelihood of you getting sick
Racism- the victims are most likely to experience poor health outcomes
Women are the oppressed
The higher education = earn more = be healthier
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◦ Food and water security
◦ Control over reproduction
◦ Political security
◦ Education (literacy)
◦ Gender equality
◦ Racial equality
◦ Wealth redistribution (poor vs. rich)
(D, 424)
❖ See
Unnatural Causes
(link) for excellent examples of social inequality and its effects on
health
❖ Clip 1: “Growing wealth divide …”
The higher the grade, the better the health
More options, resources and power to control their lives, all contributing to better health
In the U.S. the links are more clear due to their healthcare system
❖ Clip 2: Cultural Loss and Culture of Diabetes (about the symbolic status)
How does stress impact your body and affect your ability to heal?
Locals believe that the emotional and spiritual turmoil is due to the cultural loss and self-
sufficiency- leads to self-esteem issues and depression, as a result see an increase in diabetes and
alcoholism and alcohol related deaths
Can you afford vegetables?
Is food providing the nutrients you need for good health
❖ Clip 3: Disadvantaged neighbourhoods
Chronic stress affects the body by pumping out cortisone and adrenaline (stress hormones):
increases risks for every chronic disease
See a cumulative effect of all these things that amount to stress, the body then starts to work in
overdrive
Statistics help to identify a threshold in which you are labelled as “poor”
Where you are on the social ladder affect the outcome- not about poor vs well off but rather if you
are lower in rank in comparison to others
Something causal
More likely to be better or worse off depending on your social state
❖ Health outcomes may be greatly improved by trying to reduce social inequality
generally
❖ Scandinavian countries such as Sweden and Iceland do a much better job of
this (link)
Better social support
❖ Non-medical factors and group dynamics should be included in public health
initiatives
❖ Prevention and health promotion (link), not just emergency response or
reactive intervention
❖ What are the greatest challenges to such a preventative approach?
find more resources at oneclass.com
find more resources at oneclass.com
