Raphael; Introduction to Social Determinants of Health.docx

Raphael, Dennis; "Introduction to the Social Determinants of Health" Wednesday, January 15, 2014 7:57 PM • Social determinants of health are the economic and social conditions that influence the health of individuals, communities, and jurisdictions as a whole • Determines persons level of health, and success • About quantity and qualuity of resources that a society makes available to its members • Conditions of childhood, income, availability of food, housing, employment, working conditions and health and social services A historical perspective on the social determinants of health • Mid 1880s engels studied health of working people in englangd • Engels showed correlation between death rates and housing • Described how material conditions of life - poverty being main concern - led to poor health • They turn to the drink, further harming their health as a way of coping • Lowest level employed groups had greatest risk of dying early • Rudolf virchow found disease a social effect of political and social facts in upper silesia • Membership in lower rungs of ses ladder correlated with loweer education, income, health • Canadians began to identify social determinants of health as early as the 1970s, putting into policy • "A new perspective on the health of Canadians" identified biology, environment, lifestyle, health care organization as determinatns of health o Identified determinants other than the healthcare system • Documentation of health effects of unemployment, homelesslessn, general economic conditions • Canadian studies usually focus on income and poverty What are social determinants of health? • Inequalities in quality of housing, education, social acceptance, unemployment, income • Disease-related processes • Health of americans compares unfavourable to health of citizens in most other industrialised nations • Population health of scandinavian nations generally superior to most other nations Current Concepts of the social determinants of health • Varety of contemporary approaches to social determinants of health • Commonalities among these varities stand out • Ottawa; peace, shelter, education, food, income, stable ecosystem, sustainable resources, social justice, equity • Health canada; income, social status, social support networks, education, eomployment and working conditions, physical and social environments, biology and genetic endowment, peersonal health practices and coping skills, health child developmentm, health services, gender, culture • Lack concrete experience of peoples lives • British group named; social class, stress, early life, social exclusion, work, unemployment, social support, addiction, food, transport • York u; aborginal status, early life, education, employment and working conditions, food security, health care services, housing, income and its distribution, social safety net, social exclusion, unemployment and employment security o All these are important to canadians o All these are understable to canadians o All have clear policy relevance to canadian decisionmakers and citizens o All determinants are timely and relevant • Gender is another important determinant of health in canada Current Themes in the social determinants of health • Four themes 1. Empirical evidence of the importance of the social determinants of health • Evidence is beginning to show an improvement in health among canadians over the past 100 years, persistent differences in health among canadians, and differences in voerall health among canada and other developed nations • Estimated only 10-15% of increased longevity is due to better care • Dramatic declines in death rates occurred before the advent of vaccines • Reductions in tobacco use, improvements in diet, also hypothesized to contribute to better level of health • Most analysts conclude improvements are due to improving material conditions of everyday life • Improvements occurred in areas of early childhood, education, food availability, heatlh and social services, housing, and every other determinant of health Social determinants of health inequalities among canadians • Income is especially important insofar as social determinants of health • Determinant of health