groundwater approach
attempts to uncover the root cause of all issues/health disparities in a society
fish allegory example
what makes a community healthy?
strong access to healthy food and clean water
low rates of injury
low air pollution
low toxins
strong healthcare infrastructure
community centers and services which are both available and effective
what makes a community unhealthy?
lack of strong leadership
pollution
contaminated water
lack of access to healthy food, food desserts
social factors: smoking, drugs
lack of access to healthcare
housing
high crime rates
poor education
outbreaks in infectious disease
the social ecological model
concentric circles which determine health
ranges from innate traits to broad social, economic, cultural, health, and environmental conditions and
each circle influences the circles that fall under it
identify the levels of the social ecological model of health from the innermost to outermost circle
1. innate individual traits - age, sex, race, and biological factors
2. individual behavior
3. social, family, and community networks
4. living and working conditions - psychosocial factors, employment status, socioeconomic status, the natural and built environments, public health and health care services
5. broad social, economic, cultural, health, and environmental conditions and policies at the global, national, state, and local levels
difference between innate traits and individual behavior: smoking example
you may have an increased risk of addiction which is innate, but your decision to actually engage in such decisions is an individual behavior
true or false: the social determinants of health refer to the social conditions in which we live, work, and learn/play
social determinants
the complex, integrated, and overlapping social structures and economic systems that are responsible for most health inequities (and equities)
shaped by macroeconomic factors rather than individual behavior
social environment, physical environment, health services, and structural/societal factors all carry influence
shaped by the distribution of money, power, and resources throughout local communities, nations, the world
can be discussed within national or global context (covid vaccine example)
how much of health is socially determined?
social determinants of health represent 75% of population health including the social environment, physical environment, and health services/medical care
health equity
full health potential achieved for everyone
achieving maximum health and meeting everyone where they are - not giving everyone the same thing, but rather giving different groups what they need in order to achieve optimal health
health inequity
type of health difference linked with disadvantage
used interchangeably with health disparity
not all health differences are necessarily inequities or disparities - biological health differences are not inequities
differences based on race, location, socioeconomic factors are classified as inequities and disparities
equality vs equity
equality is giving everyone the same thing, whereas equity is when you give everyone what they need to be at the same optimal level
true or false: striving for equity means giving people what they need rather than giving everyone the same thing
true
health disparity
differences in health linked to social disadvantage
systemic obstacles
historical linkage to exclusion
differences that are preventable, unfair, unjust
not all health differences are disparities
is closing the health gap always considered a good thing?
no! closing the gap is a good thing when it benefits the ENTIRE population - when the gap closes because one demographic is making progress and the other is suffering is not what we should aim for
social epidemiology
the branch of epidemiology concerned with ways that social structure, institutions, and relationships influence health
concerns with both levels and distribution (who is experiencing it the most and who is struggling the most)
health gradient
demonstrates that health happens on a gradient - the extent to which each social determinant impacts your health is on a gradient as well
living in poverty at one level will impact your health - the more impoverished you are, the more it will impact your health
people usually do not fall into a singular category
how do we actually get at the groundwater solutions?
by constantly asking WHY