Social Determinants of Health and the Current Public Health Policies - Term Paper Example

Health and Social care Social Determinants of Health and the Current Public Health Policies Institution Name Introduction Precise Health is a multi-aspect concept that goes beyond merely the absence of illness in an individual. Primary health care actually stems itself mostly from the policies presented during Alma-Ata Declaration in September 1978 which is still the main pillar of health and social care even today. The declaration set out the policies underpinning social determinants of health which include; Health inequity: The policy states that health is a comprehensive aspect in a country and is acceptable socially, economically as well as politically. Therefore, it is the concern of both the government and the society as well. Community participation that integrates individuals in planning and implementation of the health care guidelines is very important. Governments are ought to implement cross-sectoral policies as a holistic strategy in primary health care especially when addressing critical health challenges facing individuals in the country. Since primary health care has a strong correlation with social aspects, the policy endorses the development of PHC system that is sound logical and socially accepted as well. This will encourage successful partnership at an efficient cost affordable for community and government in lifespan human development. According to Wood and Giles-Corti (2006), health starts anywhere; in our homes, workplaces, society or at school. Taking care of our health by eating well and doing exercises while avoiding behaviors such as smoking and excess taking of drugs perhaps do not only determines your health. However, access to better socio-economic opportunities, good social relations and relationship also contribute largely to health living (Commission on Social Determinants of Health, 2007, 25-32). What is health? World Health Organization (1978, 6) defines health as “a state of complete physical, mental and social well being of an individual without merely the absence of illness or infirmity.” Form this definition, ‘health’ is spotted as an objective and subjective element composed of environmental and state policy as well as cultural elements related to the population. The idea is, if ‘health’ is associated with the state of ‘wellbeing’ (wellbeing is defined by state of being happy, relaxed, good with satisfactions form conditions of existence), then psychological, societal (culture inclusive) and policy aspects are largely the determinants. What are social determinants of health? These are conditions in the surrounding beneath from home to the workplace or school that affect functionality as well as the quality of life (Marmot and Wilkinson, 1999). Examples of these conditions include access to education, quality of education social support, literacy, access to daily needs (food and good housing), workplace stressors or physical barriers in the environment especially to the disability group in the population. Establishment of policies that positively influence socio-economic conditions as well as those that tends to support people’s behaviors will basically improve the health of a large number of people in the society (Marmot and Wilkinson, 1999). For example, improving the relationship of people in the society by initiating a social inclusion activity (football) will build a health relationship between the participants in the society which will eventually lead to healthier population. The origin of the social care and social work: According to Marmot and Wilkinson (1999), industrialization and urbanization enlightened social needs in the society in the 20th century. The growing network of mental health, poor workplace medical center of the sick and traditional approaches in addressing health needs indeed marked the starting point of health and social care. The emergence of NHS in the 19th century enhanced the protection of medical income in order to ensure standards in the medical set up. The report will discuss health and social care policy considering the guidelines of Alma Ata and WHO 1978 collectively in regard to four basic principles. These principles include; Appropriate access of all sexes to health services, Appropriate plans and strategies for health care projects for the population, for instance health education to all and immunization plans. Regular upgrade of health professionals in order to work effectively on the areas of needs assessment of the population and evaluation of evidence without prejudice. Appropriate health check programs for all in the society beneath from the lower class group to the upper class group. To western world at a glance, social and environmental aspects influencing individual’s health is actually not a 21st century concept. However, the significance of these factors (socio-economic and environmental) was realized over 150 years ago since the improvement of working states as well as living standards in the western world. Though this aspect of social determinants of health was realized those many years ago, there are still constrains due to widening of health inequalities as well as the under-resourced public care system which fails to take care of the people’s demand in health. International health research indicates that individuals from lower socio-economic societies are more likely to have health problems than those in upper class (Commission on Social Determinats of Health, 2007). It is very important to draw a boundary between health inequities and health inequalities. Health inequities concerns with health disparities that results from physiological factors or genetics while health inequalities concerns disparities in health status and access to health care due to social injustice. National Policies inclined to Health and Social Care There are three current policy blueprints that target the aspect of health inequality in various social groups. They include: Organizational policies: These policies determine the structure of health and social care system in relation to health access by individuals in the society. Performance policies: Perhaps these policies do not directly influence health status of individuals but at the end of the day it guides the performance of the health system when it comes to management of health disparities in social set up. It is directly linked to the staff in health institutions. Specific policies for health and social care: These policies tend to focus on service rendered to children and older people in the society and generally on health improvement programs. Basically, the main aim of the above policy category is to develop high level outcomes on wider grounds as public service transformations, health delivery and enhance people support in all capacities. This means that any endorsement whatsoever would lead to improved health, well-being, social inclusion and responsibility at all levels in the society. The Social Determinants of Health These factors are founded around health living states, education and literacy, stress, cases of employment and unemployment, culture, age, sex and social support and interactions. The following blueprint integrates all the aspects of social determinants of health. The chart above shows an approach of understanding social determinants of health a) Social Participation and Support Networks Looking at the poverty for example, income levels enhance social exclusion thus interaction within the society will possibly be experienced. Perhaps an individual will lack a connection with the entire community in terms of consumption, production and political engagement. In terms of consumption, an individual may not be able to purchase goods and services to cover his/her needs, while during production, socially valued activities that would lead to high productivity may not be experienced from an individual whatsoever. Therefore, am equal correlation was established between social participation and depressing consequences for both physical and mental health (Marmot and Wilkinson, 1999). b) Health Literacy Experience that result from education is a key to social determinant of health. As could Wood and Giles-Corti (2006) states that health literacy entails cognitive and social skills that at the end of the day determines individual’s motivation and ability to access, scrutinize and use the information to promote his/her health status. Health literacy also comprehends the capacity to empower individuals to use health information effectively for the purpose of improving their health. Being a health literate means; one can improve health status by use of health information, make informed decisions especially on his/her personal health, ability to comprehend health information and do the recommended procedures and directions as per the medical advice. c) Racism and Discrimination The discrimination from colonialist, which still exists up to date especially in the colonized societies, has raised the stress level which at the end of the day contributes to social exclusion (Commission on Social Determinants of Health, 2007). Racism have contributed to reduced employment opportunities, housing and medical care, depressive reactions that lead to stress and mental health problems and physical manifestation for instance intimidation. Basically, these factors besides language barrier, places a significant pressure on access to adequate health care, employment and social support. d) Access to Health Care Access to suitable health care services has a great positive impact on individual’s health and wellbeing, especially those with birth disadvantage. From the first policy of Alma Ata Declaration 1978, management of health inequality is very vital since it will allow equal provision of preventive health services, for instance, child immunization. It is important to note that, Alma Ata Declaration was more concern of preventive health care to the societies World Health Organization Report, 1978). Therefore, it is the responsibility of the community as well as the government to implement policies that mitigate access to health care services. For instance, from WHO Report (1978), it was found that individuals from disadvantage areas in Australia were twice as more in the waiting list in hospitals compared to those from advantaged areas (those that can access health services without much difficulty). e) Income and Social Status Personal income cannot be underestimated when it comes to determining health and wellbeing of an individual. The report of Commission on Social Determinants of Health (2007) states that an individual with satisfactory income is able to effectively access better health, good nutrition and often they live longer. Also when it comes to literacy, individuals in the upper class have better information and can cope with situations at simple outlay. Therefore, variations in income distribution in the society perhaps are connected with negative health outcomes for instance, increase in mortality rate due to poor diet or substance abuse. In most cases, behavioral risks factors are associated with the individuals in the lower class since this group is less active in social participation and connectedness. The Nature of Public Health Systems in Addressing Health Inequalities This section of the report will identify policy measures in Canada and use it to explore the nature of public health systems and applications of public health policies in addressing health inequalities. It is very important to note that individuals, communities or states striving to prioritize initiatives that tend to address inequalities in health face quite a number of challenges. A policy that is intended to focus on health inequalities are ought to be very precise. Otherwise, interventions that perhaps focus on exclusively on particular groups may not close the gap of socio-economic differences in the society. There are various evidences that are concerned in addressing health inequalities issue basing neighborhood renewal strategy. Neighborhood renewal means rejuvenation of human basic needs by focusing on social determinants of health. The strategy is composed of three main features; Strategic Partnership: The role of strategic partners is to provide an overall plan for development and implementation of comprehensive neighborhood renewal strategies in addressing inequalities in health. The focal point of the strategy is on mainstreaming programs to address the deprived needs of lower class groups in the community without isolating them in the larger picture of public health system. Endorses the action plan for the cross-sectional implementation of local and national policy framework. In addressing health inequalities, Canada’s public health framework identifies seven universal indicators of health inequalities that exist in various societies. They include: a) Population Resource Evaluation: This examines population characteristics in terms of education level, cultural diversity population growth and the structure in terms of gender and age. The evaluation determines the long term monitoring of demographic changes. b) Society Affordability Measures: This evaluates the level of income earned and the cost of living. c) Employment Quality Measure: Since employment determines the class where an individual belongs, this measure examines employment dimensions, for instance, the ability of labor market to provide, efficient and equal opportunities among the groups in the community. d) Housing Measure: This aspect examines the ability of an individual in the society to access good housing especially with the current increase in life standards due to high taxes. e) Stress Measure: The policy under this measure examines the evaluation of vulnerable groups to stress that result from limited access to basic living conditions. f) Community Health and Safety Measure: Security is also an important aspect in health inequality. Communities in the lower class are more likely to experience crimes as compared those in the upper class. Therefore, this policy measure is very objective in offering equal safety measures. g) An Integrated Community Involvement: The policy examines how the community is involved in public participation and civil literacy when it comes to engagement in community health projects, for instance, health promotion. Operational Issues in Public Health System Raising awareness regarding integrated primary health care service to the community is an inclusive aspect when in comes to addressing health inequalities. Taking Canada for example, most provinces in the country had no mandated program to focus on health status of the population. The bare reason from the provincial informant was that there was no political commitment and limited resources allocated for health issues in the country. This has made health professionals to see inequalities in health in a narrower perspective. This implies that medical and clinical officers are usually trained to work within a discourse of independence. Therefore, it is normally hard to structure issues related to health inequalities when it comes to health professionals. However, working within the medical ethics would relatively address equal access to health services by all individuals. Health Determinants Partnership Policy Health is a community concern (WHO, 1978). It defines the benefits of social support, education and employment. Health determinants partnership policy therefore sets out a structure that supports these determinants of health in the community. For instance, to reduce inequality in a social set up, the policy recommends a positive health environment for an individual to live, learn and work. Policy Strategy Implementation in Selected Settings Clinical preventive policies and educational approaches have been the main measures that have been used by most public health systems in addressing health inequalities. However, these two measures have addressed inequalities in health only on the short-term objectives. The current complex political, physical and social environments recommend policies or measures that target high-risk individuals in the society. The measures ought to complement universal public health approaches form WHO and Alma Ata Declaration such that at the end of the day it creates a supportive environment that sustains good health. Perhaps, this process may involve new policy development, organizational change and legislations to guide broader social determinants of health in the community. Examples of these settings include: a) Reorientation of Services: A part from the routine duty execution to the clients, medical services especially the professionals are supposed to be ideally placed such that as they offer services to clients they also provide advice on health living. A good example is a dentist. As far as they treat tobacco effects on teeth, they should also give health advice on oral health. b) Supportive environments: WHO (1978) developed a holistic plan of action to improve social and physical environment by inclusion of health promotion strategies in school curriculum. World Health Organization defined a school as a social set up that has the capacity to set a health living and working environment to all. Therefore, social care policies that regards health promotion has been developed by various local governments to enhance effective delivery of health information. Southern Brazil is among the countries that have adopted this strategy for the purpose of reducing health inequalities within the population. c) Community action: Variety of community agendas that encourage participation in health programs have been introduced by majority of public health systems. For instance, in Thailand outreach programs in health have made the local community not only more inclusive but also active when addressing their needs. Conclusion Future improvements in reduction in health inequalities largely depends on implementation of health and social care strategies that focuses on social determinants of health especially those that have instantaneous effects. Though the report has discussed a range of complementary actions that support guidelines from Alma Ata declaration and World Health organization (1978), for instance, reformation public health systems to enhance inclusion, there is still a big task when it comes to implementation of this policies. Addressing of social determinants of health in the society (income disparities, access to health, health literacy and racial discrimination) is an integral aspect. However, poor response by government and the community to the policies defining strategies for reducing health inequalities perhaps will slow down the attainment of WHO vision 2030 “Health for All”. Therefore, local governments have a big role to play in addressing social barriers of health and well being. Holistic approaches are needed to guide the implementation of policies that address inequalities in health at all context beneath from home to work place of schools. Reference Commission on Social Determinants of Health 2007. ‘Social Determinants of Indigenous Health: The International Experience and its Policy Implications’, International Symposium on the Social Determinants of Indigenous Health Adelaide. Marmot, M and Wilkinson, R (Eds) 1999. Social Determinants of Health, Oxford University Press, Oxford; Wilkinson, R and Marmot, M. 2003. Social Determinants of Health: The Solid Facts. 2nd edition, World Health Organisation, Denmark. Saccoss Information Paper 2008. The Social Determinants of Health: South Australia Council of Social Services. World Health Organisation 1978. ‘Declaration of Alma-Ata’ International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978, Viewed 31 March 2008, Wood, L., & Giles-Corti, B .2006. ‘Social determinants of health: Healthway review’, Report prepared for the WA Health Promotion Foundation (Healthway). School of Population Health, The University of Western Australia, Perth. Read More