Chapter 7

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University of Toronto Scarborough
International Development Studies
Anne- Emanuelle Birn

Chapter 7: Societal Determinants of Health and Social inequalities in Health What makes the underlying determinants of health societal as opposed to individual? o Ill health can be understood in societal terms though people experience ill health as individuals. Ex: construction worker falls of scaffolding and dies L]]o9^ZZ]LL]L]LZ] ]Lo }LZ ]}Z}Z_~310) ,}ZZ}o9]}Ko}L2 }KK}}l7}ZL[2L}2ZZo because of the poor built of his home Intermediate: earns minimal salary as an undocumented worker and poor enforcement of minimum wages National: poor government regulation to require his employer use quality materials for the scaffolding and ensure safety training Global: emphasis on profit over worker safety or unionization to ensure social security o Social determinants of health J ^ }Zo}]L ]}LZK}L2}oL }KKL]]Z;Z} ]o Z ]Z] ]Z]LZ] Zo]]L2lZo _ (310) o Societal determinants of health J ^structural forces;}o]] o7 }L}K] 7Z} ]oL cultural structures ZZZZoZLZoZLZ_ (310) the causes of causes o Health inequalities J ^~]L]]oZoZ]L Z~]L Z]LZoZL population groups (c) differences between groups linked to broader social inequalities LLoZ} ]oZ Z_ (310) o Social inequalitiesinequities of health J ^ZoZ]Z]]Z7]Z]LLL countries..that systematically burden populations rendered vulnerable by underlying social structures and politi o7 }L}K] Lo2o]LZ]]}LZ_ (311) o Equity in health J ^absence of systematic and potentially remediable differences in one }K}Z Z}ZoZ }ZZ;}o]}LZ_ (311) o Health disparities J ^implies difference in health status without necessarily implying the ZL }]LEZ] _ (311) ^;]KK]K]LLZ}ZoZZZ}ZZZ ]]o]7LZ]ZL }ZL ]ooLZZZ}ZZ}oL }KKL]ooZ_ (311) J e.g. Unhealthy behaviors (smoking, violence, etc) L]}LoooK]LLZ}2Z}^Z} ]o}o] L2}LKLo2o]}L_ (311) that directly or indirectly affect health J e.g. social security protections, inadequate regulation of pollution, discriminatory policies TZ2o}ooo]L oZ^ZLo]L2Z} ]o7}o]] o7 }L}K] LZ]Z}] o }L:Key determinants include class and social structure, distribution of wealth and power, and ]LL]}Lo2]KZ_ (311). o E.g. (+) side land redistribution and fair trade policies can improve farmer livelihood, democractization of power can improve welfare state, economic redistribution, environment regulation, infrastructural improvements o E.g. (-) side trade agreements often eliminate price protections for small farmers, o]L2} o]LZ]LoLL_, emphasis on production for export as oppose to
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