Introduction To Social Determinants Of Health PDF

HLST 152 Foundations in Health Income Social Class Employment Physical Environment (Neighbourhood) Yvonne Shelast, RN, BScN, MN 11/21/2024 1 11/21/2024 2  Learning Outcomes Followin...

HLST 152 Foundations in Health Income Social Class Employment Physical Environment (Neighbourhood) Yvonne Shelast, RN, BScN, MN 11/21/2024 1 11/21/2024 2  Learning Outcomes Following this lecture, the student will be able to: 1.Explore the meaning of social class. 2.Identify components of social class. 3.Explore the meaning of socioeconomic status (SES) and identify components of SES. 4.Identify different models of class structure. 5.Describe the relationship between social class, SES, and health. 11/21/2024 3  Learning Outcomes Following this lecture, the student will be able to: 6.Explain the social gradient in life expectancy. 7.Identify underlying premises and implications on health of the following social determinants of health: income (and income distribution), unemployment and job security, and work and working conditions. 8.Describe explanations for health inequalities. 9.Define social justice, social cohesion, and social capital. 10.Describe the relationship between neighborhood 11/21/2024 4 and health  “The primary factors that shape the health of Canadians are not medical treatments or lifestyle choices but rather the living conditions they experience” (Mikkonen & Raphael, 2010, p. 7) 11/21/2024 5  Social Determinant of Health - Income and Income Distribution Underlying Premises Health status improves at each step up the income and social hierarchy High income determines living conditions The healthiest populations are those in societies which are prosperous and have an equitable distribution of wealth 11/21/2024 6  Social Determinant of Health - Income and Income Distribution Income and health relationship studied at two levels Health and Health and the actual income distribution of an individual or income across family receives the population 11/21/2024 7 Chart 5: Life expectancy at birth, by sex, neighbourhood income quintiles, 2005–2007 11/21/2024 8 Source: Statistics Canada. Vital Statistics. Special tabulation. Date modified 2011-04-15 Socioeconomic status or social class is the strongest and most consistent predictor of a person’s health and life expectancy throughout the world (Cockerham, 2016) 11/21/2024 9 Some scholars use the term social class interchangeably with socio-economic status 11/21/2024 10  Socioeconomic Status (SES) Income Socioeconomic Status Occupatio Education n 11/21/2024 11  Different Models of Class Basic 3-class Structure scheme (upper, middle, and lower) 5-class model (upper, upper- middle, lower- middle, working class, lower) Britain – focus on occupation to determine class standing; location in 11/21/2024 12 a class hierarchy  Components of Social Class Status Wealth Power Social Class 11/21/2024 13  Power - A Health & Social Justice Issue! Think about the impact power has on health. What are the 4 levels of power, according to the World Health Organization? 11/21/2024 14  Power - A Health & Social Justice Issue! 1.Power over Where individuals are able to organize or change existing hierarchies or structures. 2.Power to ___ 3.Power with 4.Power Each individual's capacity to exercise control within or act on their own will. ___ Which is When someone or some people are able to the most influence or coerce others. ___ negative form of The collective power of communities or 11/21/2024 15 power? organizations. ___  How are class differences generated in the first place? 11/21/2024 16  Class Inequality in Canada.... 1. Inequality in income distribution “The gap between the rich and the poor continues to increase” 2. Inequality in Wealth 3. Inequality in Economic Power 11/21/2024 17 4. Inequality in Health  Low Level Unemploymen Low Educatio t Income n Lower Health Levels (all age groups) 11/21/2024 18  Employment/Working Conditions Underlying Premises Unemployment, underemployment, stressful, or unsafe work are associated with poorer health People who have more control over work circumstances and fewer stress related demands of the job are healthier and often live longer than those in more stressful or riskier work activities 11/21/2024 19 Explaining Health Inequalities Individual Explanations Materialist/Structural Explanations Psychosocial Explanations 11/21/2024 20  Explaining Health Inequalities Individual Level Explanations The “artifact” explanation/statistical anomalies The Social Darwinist explanation Cultural/behavioural explanations 11/21/2024 21  Explaining Health Inequalities Materialist/Structural Explanations Role of social, economic, and political factors in determining the social distribution of health and illness Focuses on the basic class structure of society 11/21/2024 22  Explaining Health Inequalities Psychosocial Explanations Match the terms on the left with the correct definition on the right Social relations and networks that exist among groups and communities 1. Social justice that facilitate cooperation for mutual 2. Social benefit ___ cohesion A belief system that gives high priority 3. Social capital to the interests of the least advantaged ____ Refers to social ties that are the basis for group behaviour and integration 11/21/2024 23 ____  Intersectionality Theory “how certain health determinants influence other health determinants in the construction of individuals’ experiences in health” (Hankivsky & Christoffersen, 2008; Hankivsky & Cormier, 2010) 11/21/2024 24  View video clip (1:29) posted on meskanas (Lec. #16). Canada's Chief Public Health Officer, Dr. Theresa Tam, looks at how our communities and neighbourhoods are planned, designed, and built can greatly affect our physical and mental health https://www.canada.ca/en/public-health/services/publications/chief-public-health- 11/21/2024 25 officer-reports-state-public-health-canada/2017-designing-healthy-living.html Topic: NEIGHBOURHOOD Recall the in-class DVD Debrief and the discussion about neighbourhood: How did Corey’s neighbourhood affect his health? (Not only physical, but other dimensions of health, e.g., mental health?) What features of Corey’s neighbourhood were different from Jim’s neighbourhood? What characteristics of Corey’s neighbourhood could be considered “health damaging”? What characteristics of Jim’s and Tondra’s neighbourhood can be considered “health 11/21/2024 26 promoting”?  Neighbourhood Astle, B. & Duggleby, W. (Eds.) & Potter, A., Perry, A.G., Stockert, P. & Hall, A. (US 9th ed. Eds.). (2019), p9 8-11. Physical Environment (p.8) Includes factors in the built environment, such as housing, food security, and community planning, as well as factors in the natural environment (geography, quality of the environment, and climate change) Includes geographic conditions that contribute to isolation and limit access to health care, as well as environmental quality Children from low-income families often live in 11/21/2024 27 neighbourhoods located near highways and industrial areas – areas that are likely exposed to air,  Neighbourhood Astle, B. & Duggleby, W. (Eds.) & Potter, A., Perry, A.G., Stockert, P. & Hall, A. (US 9th ed. Eds.). (2019), p9 8-11. Social Environment (pp.10-11) Includes social safety net, social exclusion, and disability “The array of values and norms of a society that influence the health and well-being of populations” Includes a sense of community belonging Includes safety – violence both in the home and the community Healthy social environments include freedom from discrimination and prejudice 11/21/2024 28  Built Environment “The external physical environment where we live, work, study and play. It includes buildings, roads, public transit systems, parks, and other types of infrastructure. It is linked to how we design, plan and build our communities.” https://www.canada.ca/en/public-health/services/publications/chief-public-health-officer-reports-state-public- health-canada/2017-designing-healthy-living.html 11/21/2024 29  Neighborhood Where you live influences your health Strong associations have been demonstrated between area of residence, health behaviour, and self rated health Neighborhoods differ in the degree of personal security and sense of safety, access to social services and health care, proximity and character of green spaces, etc. 11/21/2024 30  Neighborhood Some neighbourhoods have food deserts People “do better” when residing in “mixed” neighborhoods (poor and rich together) “Disordered neighbourhoods” 11/21/2024 31  References Astle, B. & Duggleby, W. (Eds.) & Potter, A., Perry, A.G., Stockert, P. & Hall, A. (US 9th ed. Eds.). (2019). Canadian fundamentals of nursing (6th ed.). Elsevier. Cockerham, W.C. (2016). Medical Sociology (13th ed.). Pearson. Davidson, A. (2019). Social determinants of health: A comparative approach (2nd ed.). Oxford University Press. Germov, J. & Hornosty, J. (Eds.). (2012). Canadian edition: Second opinion: An introduction to health sociology. Oxford University Press. Kindig, D.A., (2007). Understanding population health terminology. The Milbank Quarterly, 85(1), 139-161. Mikkonen, J. & Raphael, D. (2010). Social Determinants of Health: The Canadian Facts. http://www.thecanadianfacts.org/ Public Health Agency of Canada http://www.phac-aspc.gc.ca/ph-sp/determinants/determinant-eng.phpStatistics Canada - Summary tables http://www.statcan.gc.ca/tables-tableux/sum-som/index-eng.htm 11/21/2024 32