Textbook Notes (368,242)
Canada (161,733)
HE301 (3)
Chapter

Social Determinants of Health - Ch 2.docx

3 Pages
145 Views
Unlock Document

Department
Health Sciences
Course
HE301
Professor
Robb Travers
Semester
Fall

Description
S OCIAL D ETERMINANTS OF H EALTH :CHAPTER T WO Introduction - Broad frameworks that consider how social determinants of health directly and indirectly influence health are of great value o Identify the immediate and more distant societal structures that shape quality of social determinants Individual Approaches - Limits analysis of health risks to individual biomedical and behavioral risk factors for disease o Responses =behavioral regime or treatment with drugs o Approach makes individual carry out series of behavioral changes - Lack of evidence to give biomedical factors a primary role in contracting disease/illness - Lack of evident that supports people at risk can change their behaviors o Behavioral interventions in vulnerable populations aren’t very successful - Ideological view that poverty is from individual’s failure to seize opportunity/to work sufficiently hard within current social structure o Individualism assumes current social system provides equal opportunity for individuals to move within social system according to abilities - Individualist approaches dominate public beliefs, health care, governmental policy to health promotion/population health Social Determinants of Health and Living Conditions - Social determinants = social living conditions people experience - Quality of SD’s = reflection of societal organization, distribution of economic and social resources - Brunner and Marmot  model to show how organization of society shapes various SD’s/ health o No mention of political, economic, societal forces that impact social structure o 3 primary pathways  Direct link: social structure  material factors (e.g. living conditions)  health status  Social structure  social/work environments  psychological/ behavioral responses  brain responses (endocrine, immune)  health status  Social structure  social environments  health status o All have forward/backward effects  E.g. social structure  work conditions BUT work conditions influence power & ability to determine aspects of social structure (e.g. degree of political influence)  Low income neighborhoods w/ health problems b/c of societal structure can develop adverse reputation - negatively feedbacks - limits ability to influence societal attributed towards their community - Four models  materialist, neo-materialist, life-course, social comparison Materialist Explanations for the Social Determinants of Health and Health Status Relationship - Sees objective living conditions as explaining how social determinants of health shape health status - 3 key mechanisms that link SD’s to health: o Experience of material living conditions o Experience of psychosocial stress o Adoption of health-supporting/health-threatening behaviors - Individuals experience differing exposures to positive and negative living conditions o Exposures accumulate to produce adult health outcomes - Material conditions: o Childhood advantage/disadvantage related to nourishment, housing o Adult issues of employment/unemployment o Occupational quality and hazards o Access to health/social resources - Influence development, family life, community environments - Graded effects (lower middle class worse off than middle class) b/c people have different level/lengths of exposure - Income potential: accumulation of abilities, skills, education in childhood that are important determinants of adult employability and income capacity o Education, family circumstances most important - Health Capital: accumulation of health resources (physical and psychological) acquired in early stages of life that determine current health and future health potential - Childhood circumstances  HEALTH and transitions to adulthood (accumulated IP & HC) HEALTH and adult circumstances  HEALTH - Living conditions determine presence/absence of health-threatening stress o Fight or flight – activated sympathetic/parasympathetic NS, neuroendocrine system, metabolic system - Chronic threats (low income, insecure employment, housing/food insecurity) = weaken immune system disrupt neuroendocrine/metabolic systems - Maladaptive responses to stress, weakened immunity to infections/disease, greater likelihood of metabolic disorders - CVD, type 2 diabetes o Stress can promote adoption of health-threatening behaviors (tobacco, lack of PA, increased fat/sugar intake), alcohol consumption o Coping mechanisms – not reflection of lack of knowledge, incompetence of poor Life-Course Perspectives on the Social Determinants of Health and Health Status Relationship - How exposures to varying economic and social conditions have cumulative effect on health - 3 types of health effects that have relevance for life-course perspective o Latent effects: biological/developmental early life experiences that influence health later in life  Life long effects regardless of circumstances in adulthood  Nutrients, incidence of infection, tobacco use  Can lead to CVD, diabetes, cognitive development o Pathway effects: experiences that set individuals into trajectories that influence health, well-being and competence  Living conditions shape children’s vocabulary upon entering school  Sets on path that leads to differing educational expectations, employment prospects  Material/social conditions  quality of neighborhoods, schools, housing set paths o Cumulative effects: accumulation of advantages/disadvantages over time  Combination of latent and pathway effects
More Less

Related notes for HE301

Log In


OR

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


OR

By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.


Submit