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Social Determinants of Health - Ch 1.docx

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Wilfrid Laurier University
Health Sciences
Robb Travers

S OCIAL D ETERMINANTS OF H EALTH :C HAPTER O NE Introduction: - Social determinants of health are the economic and social conditions that shape health - Determine extent to which a person possesses the physical, social, and personal resources to identify and achieve personal aspirations, satisfy needs, and cope with the environment - Social determinants of health are about the quantity and quality of a variety of resources that a society makes available to its members o E.g. childhood conditions, income, availability/quality of education, food, housing, employment, working conditions, healthy/social services - Requires attention to economic and social policies to improve health o Also political, economic, and social forces that shape policy decisions - Surveys: Canadians don’t know important role of living conditions on determining health - Mass media reinforces behavioral causes by reporting studies of how how a gene or behavior (e.g. drinking coffee, drinking wine, sleeping certain amounts, too much TV) prevents/causes medical condition A Historical Perspective on the Social Determinants of Health - Engels, Virchow in 1800’s studied living conditions and disease British Contributions - Black Report 1980, Health Divide 1992  low employment-level groups = greater chance of diseases and dying prematurely o Step-wise progression across socio-economic range o DESPITE UK having universal health care Canadian Contributions - A New Perspective on the Health of Canadians 1974 - Achieving Health for All: A Framework for Health Promotion 1986 - Canadian Public Health Association (CPHA)  Action Statement for Health Promotion in Canada o Solution: advocating for healthy public policies o - Two key problems dealt with in the study of social determinants of health 1. What are the societal factors (e.g. income, education, employment conditions, etc.) that shape health and explain inequalities? 2. What are the societal forces (e.g., economic, social, and political) that shape the quality of these societal factors What Exactly Are the Social Determinants of Health? - Differences in population health – America vs. Sweden - Social determinants of health explain differences within populations and among populations Current Concepts of the Social Determinants of Health - Prerequisites for health: peace, shelter, education, food, income, stable ecosystem, sustainable resources, social justice, equity o Concerned with structural aspects of society and the distribution of economic and social resources Origins of the Canadian Social Determinants of Health Conference and This Volume - National conference: “Social Determinants of Health across the Lifespan: A current Accounting and Policy Implications” - Purpose: o Consider state of key social determinants of health across Canada o Explore the implications of these conditions for the health of Canadians o Outline policy directions to strengthen these social determinants of health - Identified 12 key social determinants of health especially relevant to Canadians - Four criteria to identify them: 1. Social Determinants are important to the health of Canadians  Consistent with existing empirical literature to relevance 2. Social Determinants are understandable to Canadians  Consistent with public understandings of factors that influence health 3. Social determinants have clear policy relevance to Canadian decision makers and citizens  Clearly aligned with existing governmental structures and policy frameworks (e.g. ministries of education, Native affairs) 4. Social determinants are timely and relevant  Has to be an area of active governmental policy activity (e.g. health care, education) or policy inactivity that provoked criticism (e.g. food security, social safety net) - Social safety net and Aboriginal status added to the list - Aboriginal status represents interaction of culture, public policy and systematic exclusion from Canadian life - 12 key social determinants: o Aboriginal status o Early life o Education o Employment and working conditions o Food security o Gender o Health care services o Housing o Income and its distribution o Social safety net o Social exclusion o Unemployment and employment security Current Themes in the Social Determinants of Health Field Theme 1: Empirical Evidence of the importance of the Social Determinants of Health - The social determinants of improved health among Canadians since 1900 o Only 10-15% = improved health care o Improveme
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