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HLTH 101- Final Exam Guide - Comprehensive Notes for the exam ( 37 pages long!)


Department
Health Studies
Course Code
HLTH 101
Professor
Elaine Power
Study Guide
Final

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Queen's
HLTH 101
FINAL EXAM
STUDY GUIDE

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Dr. Elaine Power’s Podcasts
Audio Transcripts
Week 1: Introduction to the Social Determinants of Health (SDoH)
What are the social determinants of health? How are they different from determinants of health?
- The World Health Organization (WHO) states that the social determinants of health
(SDoH) are the conditions in which people are born, grow, work, live, and age
- They are the wider set of forces and systems shaping the conditions of daily life (including
economic policies and systems, social norms, social policies and political systems)
- They affect the distribution of money, power and resources at global, national and local levels
- The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in
health status seen within and between countries (the “upstream” factors affecting our health and how long we live)
- When we address the SDoH, we treat the source or underlying causes of poor health, not just the symptoms
- The SDoH always include consideration of social, political, and economic forces and systems that impact the conditions
in which people live and work because they set up the conditions of everyday life in which different groups of people
have different opportunities to enjoy health
- This affects the average health and longevity of these groups of people
Lists of the SDoH (12) invariably include:
o Income
o Education
o Housing
o Employment
o Gender
o Racism
o Childhood Development
o Food
o Neighbourhoods
o Transportation
o Health Care
o Social Support
- People who study SDoH focus on those who are most marginalized or excluded from the
mainstream, and thus have the worst health, and are interested in the range and distribution
of the social determinants, and the gap between the healthiest and the least healthy
- The most marginalized suffer most than others from unjust social arrangements
o These include people living in poverty, homeless people, and racialized minorities are
If scholars were focused on income, for example, as a social determinant of health, they would be
interested in the distribution of income, and the corresponding distribution of health, from the poorest to
the richest
In a workplace, these scholars might study the organization of the company, examining the range of
positions from the lowest to the highest in the economic and status hierarchy
- There is good evidence that the gap between the top and the bottom is important for the health of everyone, including
those in the middle
o The bigger the gap, the worse everyone’s health is
- For the purposes of research, scholars will generally pick one focus or the other
o Either on the most marginalized and least healthy groups, or on the range and distribution of social determinants
and thus of health
For the purposes of healthy public policy, it is important to keep both perspectives in mind
- There is also a split in the social determinants world about whether to focus on material social determinants of health,
such as income and housing, or psychosocial determinants of health, such as social support and the organization of status
hierarchies
o Even though material and psychosocial determinants are considered separately in the textbook, they are linked
Income, and what we can buy with that income where we live, what
food we eat, what leisure activities we can afford tells us and other
people who we are, thus affecting the psychosocial determinants of health
- How are social determinants of health different and determinants of health different?
o There are three main types of determinants of health
Genetic and biological determinants of health
Individual determinants of health (also known as lifestyle determinants of health)
Social determinants of health
o Even though personal health practices and coping skills are
not social determinants of health, they are socially patterned
Practices linked to health (like physical activity and diet) also follow social gradients
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Those who are wealthier and have more education tend to have better diets and higher levels of physical
activity
This is the result of complex and intertwined factors, including access to resources, doing what
other people in your social group do, and having the predisposition or orientation towards these
sorts of activities
People living on lower incomes tend to see health as a
resource to be used now for activities of everyday living
People living on higher incomes tend to see health as
something to work towards and bank for the future
What is Public Health?
- There are different ways in which the term public health is used
o In one way, it refers “the public’s health” or “the health of the public”
Points to the longevity of the population and the extent to
which the population is healthy and free from disease
The terms public health and population health can be used interchangeably
More commonly, public health is used to refer to “what we do as a society collectively
to assure the conditions in which people can be healthy” (institute of medicine)
o The main goal of public health is to prevent illness and
accidents, and the premature deaths that may result
o Overall, public health is interested in ensuring the
conditions that help people live long and healthy lives
o Public health is also responsible for the safety of our food
system, with regulations, procedures and inspections designed
to prevent the contamination of food like milk and meat
At the local level, there are public health inspectors who ensure
that restaurants are following safe food handling practices, so
that customers are less likely to get food poisoning
Some public health interventions take the form of laws regulating
individual behaviour, such as laws governing smoking, seatbelts,
motorcycle helmets, impaired driving, and vaccinations
Every community in Ontario is part of a public health unit
o For example, Kingston is covered by the Kingston,
Frontenac, Lennox & Addington public health unit
At the national level, we have the public health agency of Canada, set up in
the wake of the 2003 SARS infectious disease crisis
o When you include the social determinants of health, much of government
at all levels and from education to social services to environmental protection
is concerned with promoting the health and longevity of the public
o In other words, the successes of public health can be found in
numbers and statistics, not directly in people’s individual stories
When public health is effective, it is unnoticed and taken-for-granted
o Usually we only pay attention to public health when our public health systems fail
o With rules and regulations governing many aspects of our lives, including
individual behaviour, some argue that in the name of public health,
government has become what is pejoratively called a “nanny state
This refers to the idea that government is overprotective
and interfering with individual liberty or freedom
In Canada, there is more acceptance of the role of government
in promoting the common good and public health
In the United States, there is much
lower compliance in several states
This leads us to three primary philosophical
and political questions for public health
What is the problem that needs to be addressed?
What is the most effective way to reduce risk?
Who is responsible for taking action to protect the public’s health? Is it individuals? Corporations? Government?
How safe should we seek to make the public from hazards? What level of risk are we willing to accept?
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