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HLTA02H3 (176)
Chapter

Week 7 readings

6 Pages
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Department
Health Studies
Course Code
HLTA02H3
Professor
Toba Bryant

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READINGS FOR WEEK 7
1.Social Determinants of Health: An Overview of Concepts and
Issues by Dennis Raphael
(Chapter 5 of Staying Alive)
Rudolph Virchow and the Social Determinants of health
German physician (1821 – 1902), medical discoveries so extensive that he is known as the “Father of
Modern Pathology
His Report on the Typhus Epidemic Prevailing in Upper Silesia argues that lack of democracy, feudalism
and unfair tax policies in the province were the primary determinants of the inhabitants’ poor living
conditions, inadequate diet, and poor hygiene
What are Social Determinants of Health?
mechanisms by which members of different socio-economic groups come to experience varying
degrees of health and illness
The 11 key determinants that are especially relevant to understanding and improving the health of
Canadians are: aboriginal status, early life, education, employment and working conditions, food
security, health care services, housing, income and its distribution, social safety net, social exclusion
and unemployment and employment security.
Evidence Concerning Social Determinants of Health
Research based on the SDoH provides explanations for (a) the general improvement in health among
citizens in developed nations over the past 100 years (since 1900), (b) health differences observed among
populations within nations, (c ) differences in overall health among Canadians and citizens in other
developed nations
Emerging Themes (Frameworks)
Materialist Approach conditions of living as determinants of health
oIndividuals experience varying degrees of positive and negative exposures over their lives that
accumulate to produce adult health outcomes
oWealth of nations is a strong indicator of population health, but within nations, socio-economic
position is a powerful indicator of population health (as it is an indicator of material advantage or
disadvantage over the lifespan)
oMaterial conditions of life lead to differing likelihood of physical (infections, malnutrition,
injuries), developmental, educational (learning disabilities, poor learning), and social problems
Neo-materialist Approach conditions of living and social infrastructure as determinants of health
www.notesolution.com
oDifferences in health among regions are related to how economic and other resources are
distributed among the population
oUnequal jurisdictions have much poorer health profiles
oHow a society decides to distribute resources among citizens is especially important
Social Comparison Approach hierarchy and social distance as determinants of health
oHealth inequalities in developed nations are strongly influenced by citizens’ interpretations of
their standings in the social hierarchy
oAt the individual level, the perception and experience of personal status in unequal societies lead
to stress and poor health
Comparing their status to others, individuals experience feelings of shame that have
psychobiological effects on health
oAt the communal level, widening and strengthening of hierarchy weakens social cohesion, a
determinant of health.
Individuals become more distrusting, they by weakening support for communal structures
such as public education
oThis approach directs attention to the psychosocial effects of public policies that weaken the
social determinants of health
The Importance of a Life-Course Perspective
Life-course approaches emphasize the accumulated effects upon health of experience across the lifespan.
Exposures to adverse economic and social conditions have a cumulative effect upon health.
oLatent effects: biological or developmental early life experiences that influence health later in
life.
oPathway effects: experiences that set individuals onto trajectories that influence health, well-
being and competence over the life course
oCumulative effects: accumulation of advantage or disadvantage over time that manifests itself in
poor health. These involve the combination of latent and pathways effects
Epidemiological Perspectives
Horizontal structures that influence health: immediate factors that shape health and well being. Ex. The
quality of childhood and family environments
Vertical structures that influence health: distant macro-level issues that influence health and well being.
Ex. The political, economic and social forces that determine in large part the quality of the horizontal
structures
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Description
READINGS FOR WEEK 7 1. Social Determinants of Health: An Overview of Concepts and Issues by Dennis Raphael (Chapter 5 of Staying Alive) Rudolph Virchow and the Social Determinants of health German physician (1821 1902), medical discoveries so extensive that he is known as the Father of Modern Pathology His Report on the Typhus Epidemic Prevailing in Upper Silesia argues that lack of democracy, feudalism and unfair tax policies in the province were the primary determinants of the inhabitants poor living conditions, inadequate diet, and poor hygiene What are Social Determinants of Health? mechanisms by which members of different socio-economic groups come to experience varying degrees of health and illness The 11 key determinants that are especially relevant to understanding and improving the health of Canadians are: aboriginal status, early life, education, employment and working conditions, food security, health care services, housing, income and its distribution, social safety net, social exclusion and unemployment and employment security. Evidence Concerning Social Determinants of Health Research based on the SDoH provides explanations for (a) the general improvement in health among citizens in developed nations over the past 100 years (since 1900), (b) health differences observed among populations within nations, (c ) differences in overall health among Canadians and citizens in other developed nations Emerging Themes (Frameworks) Materialist Approach conditions of living as determinants of health o Individuals experience varying degrees of positive and negative exposures over their lives that accumulate to produce adult health outcomes o Wealth of nations is a strong indicator of population health, but within nations, socio-economic position is a powerful indicator of population health (as it is an indicator of material advantage or disadvantage over the lifespan) o Material conditions of life lead to differing likelihood of physical (infections, malnutrition, injuries), developmental, educational (learning disabilities, poor learning), and social problems Neo-materialist Approach conditions of living and social infrastructure as determinants of health www.notesolution.com
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