chapter 4: the social determinants of health

people with more wealth are healthier

- income
- education
- occupation
- gender
- race

equal societies

- equity in society
- equity in access to materials, health-care, political power, education, religion
- decision-making and choice

1. material model
2. neo-materialist model
3. social-psychological model
4. political-economy model
5. life course approach

Access to material goods (i.e., having sufficient and stable income) is absolutely necessary for the health of the individual.

sufficient and stable income

Perceived equality is essential to the overall health of the population (equitable redistribution of materials)

societies w progressive redistribution policies have better health

more social capital -> more social inclusion -> positive social comparsions, better self-esteem -> better health

- degree of income inequality
- public expenditures
- health-care benefits
- public support for families

contribute to poor health, disease and death in a population

when poverty, inequity, lack of redistributive policies and social exlusion intensely affect children and wil always affect them

- pathway effects
- latency effects
- cumulative effects

early experiences

children that have been abused, or lived in poverty before 6 have insecurities and do worse in life than those under 6, who's been loved, and had a home tend to do better in life.

early developmental effects

past generations could've had health effects that were passed on

accumulation of disadvantages or advantages over a lifetime

a person with chronic diseases, lives in housing with mould/mildew, and secondhand smoking (these factors enhance your ability to contract the disease).

neo-liberalism

o Markets are the best and most efficient allocators of resources in production and distribution.

o Societies are made of autonomous individuals (producers and consumers) motivated by material/economic considerations.

o Competition drives innovation

equitable trade without too many barriers (involves UK, US and Canada)

there's no social cohesion, inequality and social-exclusion between countries which eventually leads to poor health

health of individual and population

- inequality
- food security
- poverty
- education
- employment/unemployment
- housing
- neighbourhood

globalization of capital- trade rules and regulations
neo-liberal ideologies- encouraged dominance of free markets
- disease burden increased

developing societies turn to allopathic medicine (example ADHD is seen as hyperactivity)

redistribute income to improve everyone's health

products
- foods
- drugs
- sterile needles
- condoms

structures
- bridges
- well-lit streets
- buildings satisfy safety criteria

- PSAs and messages promoting health

upstream- treatment and tertiary care (80% of resources go here)

downstream- prevention and primary care (20% of resources go here)

Our healthcare policies focus on providing diagnosis and treatment once a problem has been detected (upstream) rather than preventing the development of health problems in the first place (downstream) by advocating policies that focus on dealing with the social determinants of health.

80% and only 20% of our money would be spent on healthcare

downstream

- smoking and alcohol
- seat-belt use
- stress
- self-esteem
- sense of coherence, social and instrumental support
- resilience and religiosity

- income inequality -> worse health outcomes (lower life expectancies)

males- 79
females-83

not enough money for nutrition

the poor (min wage workers) and elderly

- aborginals and immigrants
- racism in employment, housing and government and industry

cheaper foods are less healthy (high caloric content, more sugar and carbs) and cause obesity

- inaffordable housing
- health problems
- medical costs
- low wages
- social isolation

more poverty, worse health

- learning disabilities
- language delays
- anti-social behaviour
- underachievement
- continuance of poverty

- childhood issues
- low birth weight
- various mental health problems
- chronic diseases
- distress
- low self-esteem

- safety and stability of work
- salary
- hours of employment
- degree of responsibility, creativity, autonomy experienced

safety, employment stability, good wages

- gender
- education level and type
- ethnic background
- immigrant status
- age
- rural/urban location

limits person's ability to eat healthy, exercise, prevent and detect diseases

- employment
- status of occupation
- level of income

physical and mental illness

- degree of social support/integration
- amount of vandalism/litter
- vacant housing
- crime

- working poor
- unemployed/mentally ill
- lone-parent families
- recent immigrants and aborginal people (on reserves and urban areas)

capitalist countries prioritize maximizing profit over health

- poverty
- poor nutrition
- inadequate housing and transportation
- lack of effective birth control

less stringent health, safety, environment regulations

-healthcare system is rooted in our capitalist system
-healthcare is a commodity
- allows destructive practices to maximize profit

reduces smoking:
- less taxes funding the government
- extra costs for caring for ppl who quit and have longer life expectancies