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Health Disparity
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Difference in health that is closely linked with social or economic disadvantage
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Health Equity
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When all people have the opportunity to attain their full health potential
- No one is disadvantaged from achieving this potential because of social position
- No one is disadvantaged from achieving this potential because of social position
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Health inequity
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A difference or disparity in health outcomes that is systematic, avoidable, and unjust (An outcome)
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Determinants of Health
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Factors that contribute to a persons current state of health.
These factors may be biological, socioeconomic, psychosocial, behavioral, or social in nature. (causes outcome)
These factors may be biological, socioeconomic, psychosocial, behavioral, or social in nature. (causes outcome)
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Social Determinants of Health
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The complex, integrated, and overlapping social structures and economic systems that are responsible for most health inequities
-Social structures include social environment, physical environment, health services, and structural and societal factors
-Social structures include social environment, physical environment, health services, and structural and societal factors
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Levels of Intervention
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Micro
Middle
Macro
Middle
Macro
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Examples of Health Inequities
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High BP
Obesity
Heart disease
Obesity
Heart disease
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Examples of Social Determinants of Health
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Neighborhood
Fast food
Power Plants
Landfill
Lack of healthcare
Gun violence
Fast food
Power Plants
Landfill
Lack of healthcare
Gun violence
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Health
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The complete physical, mental, and social wellbeing and not merely the absence of infirmity
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Personal Health
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Decisions, behavior, and actions taken by a person that impact their individual well being
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Population Health
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The physical, mental, and social well-being of defined groups of individuals and differences or disparities in health between and among population groups
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Sickness
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Socially and culturally held conceptions of health conditions
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Illness
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The subjective sense of feeling unwell that often motivates a patient to consult a physician
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Disease
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A deviation from normal health that derives from an identifiable pathological process and which the patient experiences as an illness
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Physical Determinants of Health: Natural Environment
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Physical environment
Weather
Water quality
Air quality
Pollutants
Natural disasters
Exposure to infectious disease agents
Weather
Water quality
Air quality
Pollutants
Natural disasters
Exposure to infectious disease agents
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Physical Determinants of Health: Built Environment
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Buildings
Roads Dams
Work
Schools
Parks
Housing
Roads Dams
Work
Schools
Parks
Housing
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Social Determinants of Health Examples
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Transportation
Culture
Language
Access to healthcare
Safe places to live, work, and play
Racism/Ageism
Culture
Language
Access to healthcare
Safe places to live, work, and play
Racism/Ageism
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What is culture?
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Everything in the person created environment that is passed down from one generation to another
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Components of culture
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Language
Religion
Architecture
Norms
Stigma
Religion
Architecture
Norms
Stigma
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Healthy People 2020
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One framework to work toward health equity to address SDOH.
aims to reach four overarching goals: Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. Achieve health equity, eliminate disparities, and improve the health of all groups
aims to reach four overarching goals: Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. Achieve health equity, eliminate disparities, and improve the health of all groups
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Measures of Health Outcomes include:
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Rate
Adjusted rates
Incidence rate
Prevalence rate
Adjusted rates
Incidence rate
Prevalence rate
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Why are measures of health outcomes important?
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They help in the development of interventions
Policy making
Research purposes
Academic journals
Policy making
Research purposes
Academic journals
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Rate
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The frequency that an event occurs in a defined population over a specific period of time
(Times the event occurs/total population)
(Times the event occurs/total population)
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Adjusted Rates
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Adjusted by specific characteristics of the population
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Incidence Rate
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Rate of new cases of disease in a specific population during a specific period of time
(# of new cases/ Population at risk * 1000)
(# of new cases/ Population at risk * 1000)
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Prevalence Rate
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Total number of cases in a specific population during a specific time
(# of all existing cases/ population measured * 1000)
(# of all existing cases/ population measured * 1000)
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Morbidity
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Illness or disease
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Economic Inequality
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Income of people from the bottom of the tier to the top.
the difference found in various measures of economic well-being among individuals in a group, among groups in a population, or among countries.
the difference found in various measures of economic well-being among individuals in a group, among groups in a population, or among countries.
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What is status?
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Position in a social system
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Ascribed Status
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Status that an individual has no control over. Individual is either born into this status or assumes it involuntarily later in life
(Ex. Race, ethnicity, poverty, disabled, wealthy people, sex assigned at birth, age)
(Ex. Race, ethnicity, poverty, disabled, wealthy people, sex assigned at birth, age)
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Achieved Status
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Status that is earned/ merit based
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Social Stratification
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A hierarchical system of social status- distribution of social rewards is based upon position in the stratification system
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How is poverty measured?
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Compares pre-tax cash income against a threshold that is set at 3 times the cost of a minimum food diet in 1963, updated annually for inflation using the Consumer Price Index, and adjusted for family size, composition, and age of householder
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What is SES?
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A measure of the social standing or class of a group or individual.
SES is measured by a combination of income, education, occupation, wealth, and area of residence
SES is measured by a combination of income, education, occupation, wealth, and area of residence
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Impact of SES on health status
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- Inequality impact on personal rating of health and mortality
- Physiological response to stress (Whitehall study)
- Access to resources
- Environmental exposure
- Occupation, employment quality, safety
- Quality of housing
- Isolation
- Violence
- Behavior and lifestyle choices
- Physiological response to stress (Whitehall study)
- Access to resources
- Environmental exposure
- Occupation, employment quality, safety
- Quality of housing
- Isolation
- Violence
- Behavior and lifestyle choices
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How has the high rate of uninsured impact everyone?
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- 40% of the costs of uninsured were being passed on to consumers in higher premiums
- 7/10 deaths were result of preventable illnesses- 75% of health care costs spent on treatment
- US spends more on health care than other industrialized nations
- 7/10 deaths were result of preventable illnesses- 75% of health care costs spent on treatment
- US spends more on health care than other industrialized nations
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Mortality
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Death on a large scale
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Affordable Care Act
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aka Obamacare, meant to make health care, and health care insurance affordable to all Americans. Will make it mandatory for all Americans to have health care insurance. Several constitutional challenges.
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Black Lung Trust Fund
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provides monthly payments and medical benefits to coal miners totally disabled from pneumoconiosis (black lung disease) arising from employment in or around the nation's coal mines. The law also provides monthly benefits to a miner's dependent survivors if pneumoconiosis caused or hastened the miner's death.
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Black lung Disease
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caused by long-term exposure to coal dust. It is common in coal miners and others who work with coal. common symptoms include shortness of breath, decreased exercise tolerance, chronic cough, coughing up phlegm and inability to breathe lying flat.
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List, define, and describe the determinants of health status. Provide one example from each determinant and explain how they impact health status. Name 2 social determinants of health that impacted Henrietta Lacks and describe how they impacted her health.
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Determinants of health: Factors that contribute to a person's current state of health
- May be biological, socioeconomic. psychosocial, behavioral, or social in nature
Biological- Sex & age
Individual behavior- alcohol, drugs use
Social- Discrimination, gender, income
Physical- Where a person lives
Health services- Access to quality health care
Henrietta Lacks social determinants: gender (being women in the 1920s), race (She is black), & economically deprived.
-her family continued to experience economic hardship, poor health and limited access to health care.
- May be biological, socioeconomic. psychosocial, behavioral, or social in nature
Biological- Sex & age
Individual behavior- alcohol, drugs use
Social- Discrimination, gender, income
Physical- Where a person lives
Health services- Access to quality health care
Henrietta Lacks social determinants: gender (being women in the 1920s), race (She is black), & economically deprived.
-her family continued to experience economic hardship, poor health and limited access to health care.
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Name 2 of the health inequities Clint Smith mentions in his video. What are the social determinants of health mentioned? How do they impact health inequities?
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Health inequities: High BP, obesity, heart disease
Social determinants: Neighborhood, fast food, power plants, landfill, lack of healthcare, gun violence
These impact health inequities in several ways: If one lives in a poor neighborhood with little access to fresh food or grocery stores, they will most likely eat fast food which can lead to serious health problems such as obesity. Living by power plants and landfills could cause diseases. The lack of access to healthcare is a major factor because if one's health is declining and they cannot get the proper healthcare they need, then things could possibly get worse which could lead to death.
Social determinants: Neighborhood, fast food, power plants, landfill, lack of healthcare, gun violence
These impact health inequities in several ways: If one lives in a poor neighborhood with little access to fresh food or grocery stores, they will most likely eat fast food which can lead to serious health problems such as obesity. Living by power plants and landfills could cause diseases. The lack of access to healthcare is a major factor because if one's health is declining and they cannot get the proper healthcare they need, then things could possibly get worse which could lead to death.
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