Population Health (Part 2 of 3) - Defining the Social Determinants of Health- A Basic Primer
WHO Definition: The social determinants of health (SDOH) are the conditions in which people are born, grow, live, work and age.
Ø The SDOH are affected by the distribution of money, power and resources at global, national and local levels. They are thought to be mostly responsible for unfair and possibly avoidable differences in health status seen within and between countries (health inequities).
The basic list of these SDOH (WHO) is as follows:
Employment conditions - Employment and working conditions shape people’s social position. Health is affected by different types of jobs, conditions at these jobs, and the threat of job loss.
Social exclusions - Health inequality is affected by unequal access to healthcare. Exclusionary dimensions include:
Ø Economic
Ø Political
Ø Social
Ø Cultural
Ø Individual
Ø Household
Ø Group
Ø Community
Ø Country
Ø Global
Public health programs and social determinants - Historically, public health programs have missed the fact that SDOH are extremely important when working towards solving health problems. At the present time, through the efforts of Population Health professionals, public health programs are more appropriately moving towards more effectively using SDOH to improve health on a global level.
Women and gender equity - Gender inequality damages the physical and mental health of millions of females worldwide. Despite the many tangible benefits it gives men through resources, power, authority and control, males are also affected by biases as well. Because of the large numbers of females affected by this problem, taking action to improve gender equity in health is a powerful way to reduce this health inequity as we mobilize governments, people, and especially women themselves.
Early child development - Healthy early child development includes the physical, social/emotional, and language/cognitive domains of development. Proper early childhood development strongly influences well-being, obesity/stunting, mental health, heart disease, competence in literacy and numeracy, criminality, and economic participation throughout life. This period sets the stage for the health and wellness development of people as they grow.
Globalization – Globally, health is affected by trade liberalization, integration of production of goods, consumption, lifestyle patterns, and household level income. The uneven distribution of globalization’s gains and losses and the impact it has on inequities is important when evaluating the actual and potential harmful effects of worldwide health levels. Globalization affects health through changes in social stratification, differential exposure or vulnerability, health system characteristics and differential consequences.
Health systems –These three pieces act as powerful determinants of health:
Ø Design – Health equity improves with proper design.
Ø Operation – Effective incorporation of proper approaches to overcome social barriers to health.
Ø Finance – Proper financing is highly relevant especially in countries with tight resources
Measurement and evidence – Measurement of the causes, pathways and health outcomes of healthcare interventions to tackle the social determinants of health and health inequities is difficult but very important. Appropriate quantitative and qualitative evidence, selection of indicators and variables, and development of measurement tools is difficult and complex.
Urbanization – “Healthy urbanization" is the goal. The positive determinants of healthy urbanization, which optimize urban settings for health, include:
Ø Land tenure and land use policy
Ø Transportation
Ø Sustainable urban development
Ø Social protection
Ø Settlement policies and strategies
Ø Community empowerment
Ø Vulnerability reduction
Ø Better security
Ø Others
Originally Posted: https://www.linkedin.com/pulse/population-health-part-2-3-defining-social-health-meyers-m-d-
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