Social Determinants of Health (SDH)

Social Determinants of Health (SDH)

• These are the non-medical factors influencing health outcomes.
• The SDH includes conditions in which people are born, grow, work, live and age.
• Also covered are forces and systems shaping daily life conditions.
• Economic policies and systems, development agendas, social norms, social policies, and political systems are other factors.

Key SDH Factors

• Economic stability is the state of having a reliable and livable income, and a good employment status.
• It also includes safe, affordable housing, and access to healthy foods.
• Access to healthcare directly impacts health outcomes and life quality.
• Healthcare access includes health insurance coverage for quality of life
• Another is distance to healthcare facilities, and the availability of health providers.
• Educational attainment impacts health and well-being later in life from continued education.
• It involves access to early childhood education and development.
• Neighborhoods and built environments with availability of sidewalks, bike lanes, trails, and green spaces improve physical activity.
• Lack of accessible features limits access for older populations and people with disabilities.
• Social and community context includes relationships with neighbors.
• Voting and civic engagement impact community outcomes.
• Access to healthy food stores, less crime, healthy environments, and access to transportation are other factors.

Examples of SDH Impact

• Steady income and health insurance help purchase nutritious food and get regular screenings.
• A car makes it easier to get to appointments or pick up medications.
• Not having paid time off or living far from a grocery store makes healthy living harder.

Erick Erickson's Psychosocial Development

• Erickson's theory states the human life cycle has eight developmental stages.
• Each stage requires physical maturation and societal demand.
• Social interaction and relationships play a key role in development and growth.
• Individuals can only progress emotionally when each psychosocial crisis is resolved.

Erikson's Stages

• Trust vs. Mistrust (birth to 18 months): trust in self and others vs. inability to trust, isolation
• Autonomy vs. Shame and Doubt (18 months to 3 years): self-control and environmental influence vs. fear and self-doubt
• Initiative vs. Guilt (3-6 years): sense of purpose and initiating activities vs. fearful behaviors and guilt
• Industry vs. Inferiority (6-12 years): ability to work and learn vs. feelings of inferiority and the inability to learn
• Identity vs. Role Confusion (12-20 years): sense of identity and future planning vs. submerged relationships and group memberships
• Intimacy vs. Isolation (20-35 years): developing connections with work vs. emotional isolation
• Generativity vs. Stagnation (35-65 years): establishing family vs. self-absorption and lack of interest
• Integrity vs. Despair (65 years-death): sense of integrity and life meaning vs. dissatisfaction and fear of death

Jean Piaget's Cognitive Development

• Children create ideas and aren't limited to knowledge from parents/teachers.
• They actively develop their knowledge.
• Knowledge is constructed when children create products or artifacts.
• Learners are more engaged when artifacts are relevant and meaningful.

Piaget's Stages

• Sensorimotor (0-2 years): gaining sensory information through mouth and hands, learning object permanence
• Pre-operational (2-7 years): understanding how things look, learning to use language
• Concrete operational (7-11 years): classifying, ordering, and sorting, solving concrete problems
• Formal operational (11+ years): thinking logically, following hypothetical arguments

Kohlberg's Moral Reasoning

• Logical reasoning/thinking about actions and what makes them right or wrong

Stages of Moral Reasoning

• Pre-conventional morality (2-7 years): right and wrong based on consequences, aiming for reward and avoiding punishment
• Conventional morality (7-11 years): aiming to be thought of as good, basing decisions on social rules
• Post-conventional morality (11+ years): adhering to laws and social rules, adopting ethical principles based on personal conscience