Global Perspective on Social Determinants of Health - Research Paper Example

 Global Perspective on Social Determinants of Health Introduction In the current society, health researcher all over the world have come to appreciate the fact that the health of people and the entire society is powerfully affected by several societal factors as health determinants. However, these scientists have not acknowledged that the values of these health determinants are greatly affected by the way the society is organized and the way material resources are distributed among the members of the society. Furthermore, the political, social and economic forces that form these organizational and allotment practice of the communities. Many people now believe that population health is influenced by factors that are non-behavioral and non-medical in nature but this is usually to a varying degree by those who work within epidemiology, political and sociology and human rights advances to the appreciation and promotion of wellbeing. The perception of the societal health determinants is becoming the present shorthand that describes the healthiness advances that go far much past behavioral and biomedical risk cause strategies to promote the wellbeing; this is taking place all over the world making this a global issue that can be discussed in global (international) perspective. What Social Determinants of Health Means This term was developed by medical investigators to categorize the particular machinery by which associates of various social-economic categories come to face differing levels of illnesses. It’s evident that everywhere in the world (Esping-Andersen 2002), people from varying social-economic position experience overwhelmingly dissimilar levels of healthiness and disease incidence (Wilkinson 2005). The finding of national differences in the health of populations was another stimulus that led to the investigation of societal health determinants The international or global perspective for instance, the health conditions of Americans and Britons, based on health indicators like infant mortality, life expectancy and deaths by other causes, compares unfavorably to the populations of several other nations of the industrialized world (Marmot & Wilkinson 2000). It’s certain that the same factors that are used to give explanations to the differences in health among groups within a country can also be used to give explanation to the many differences observed among populations of different nations. The societal determinants of healthiness are categorized into several factors which include stress, work, unemployment, social exclusion, social gradient, early life, transport, food, social support and addiction. This paper will only concentrate on stress as a societal determinant of healthiness to give a detailed description in terms of the global perspective (Levis 2002). Stress as a Societal Determinant of Healthiness Even the countries that are viewed to be the most affluent like the western nations, inhabitants who are not well off experience short life expectancy and suffer other sicknesses than those who are well-off. These differences are no only social injustices in health but also draw the scientific attention to the determinants perceived to be the most powerful in influencing the health of people in the modern world (Marmot & Wilkinson 2000). This has led to the appreciating of the noteworthy understanding of healthiness to the societal surrounding and to what has come to be largely identified as social health determinants. One of such social environment is the stress condition of individuals. Stressful situations make people get nervous, get uneasy, fail to get by with some circumstances and this condition has been proved to be very dangerous to people’s health since it may cause premature or early deaths. Stress basically refers to a biological consequences of or situation whereby the human body is unable to respond properly to physical and emotional threats whether perceived or actual (Esping-Andersen 2002). Basically stress can be identified from the common symptoms that include lack of concentration, varied physical responses like headaches and increased heart rate, muscular tension and irritability (Wilkinson 2005). Some psychological and social situation can result in long term stress. Sustained anxiety, personal lack of confidence, social segregation, and little self esteem, work associated stress like poor organization of duties and home life all affect health immensely. These psychological risks build up in the life process and increase the probability of poor mental development and untimely death (Raphael 2004). Sustained anxiety, lack of friends or family who are supportive and insecurity are the major damaging factors in health and life entirely. Most people who are in the lower social class (lower societal hierarchy) in the developed nations suffer from these problems very often (Esping-Andersen 2002). Adam Meredith, a chiropractor and his team carried out work related stress in North Sydney and revealed very wonderful information, Spine & Health Centre (2009). The study included therapy session that aimed at removing risk factors for stress such as postures at workplaces. Good posture was found to have improved energy distribution throughout the working day. Generally, posture can remove a lot of stress from the body, enhance energy and concentration. Scholars like Roger Sperry (Seaward 2006) have done a great deal of research and he asserts that over 90% of energy output of the brain is consumed in relation to the physical position of the body and the gravitational field. If a person is more distorted in posture, very little energy is obtainable for thoughts, healing and metabolism. The workplace stress can be managed by changing posture and stretching exercises (Marmot & Wilkinson 2000). This is particularly so because bad posture and work associated stress are found to be synonymous and can be resolved as one condition. Though not all of the work related stresses are connected to bad posture, the results of these are in most cases similar, since when stressed, people get slump in their seats and sit improperly. Adam Meredith did a great job in North Sydney in managing bad posture and work associated stress. Adam and his team also indicted that the increased demands at workplaces in terms of responsibilities and subsequent need of time to meet these extra duties contributed to increased stress at work (Levis 2002). Other factors included job security threats, conflict with co-workers or the boss and possible redundancy. Chronic Stress In some cases, persistent stresses related to societal position can be interpreted into altered neuro-endocrine and physiological function with outcomes of vulnerability to illness. Mankind has advanced to respond swiftly to the outside challenges that are potentially fatal, although short-lived fear. Regular as well as sustained stimulation of the fight-flight reaction has not been very fast in making these adaptations and could attest to be fundamental in comprehending the way of social diseases are distributed for instance cardiovascular conditions among others. The neuroendocrine system interacts with pattern of stress reaction. In some research where the heightened stress reaction is established by concentration of pharmacological agents like methoxamine, the levels of stress hormone (cortisol) rose as it was provoked after some time. This increase can however be prevented by providing participants with some artificial endorphins which imitate the function of natural opiates (endogenous morphine like substances) (Levis 2002). Why Stress Affects Physical Health Previous studies have indicated that diet, cigarette smoking, as well as other behavioral characteristics contributed to health inequalities the world over. Psycho-social factors like self esteem affect behavior and directly connected to stress and the social class as seen in different nations (Jackson 2003). It’s clear that in times of emergencies, the body prepares itself for the immediate reaction to the physical threat through the nervous and hormonal system. This is the fight-flight response where the stored energy is mobilized, the heart rate increases and blood pressure rises supply to muscles and the body becomes fully alert. Though in the modern life especially with industrialization and occupation needs, the body rarely needs strenuous reaction or even modest activity, as stress response is turned on, energy is diverted away from physiological processes that are significant to long terms healthiness (Marmot & Wilkinson 2000). The immune system and cardiovascular systems are affected and when this is sustained for some time, the victims become susceptible to several other circumstances that include depression, hypertension, aggression, diabetes, and even stroke. Policy Implications The cost of managing stress related problems in terms of health is very difficult and as such governments are required to set up policies that will help to alleviate this problem. In Sydney Australia, the National Occupational Health report, the previous year indicated that high stress levels among the working individuals was responsible for the high work-cover claims each year. Mental stress had the highest mean and was also responsible for over 29% of new health conditions that had emerged in a year. Taking care of such costs is very expensive and the trend is even worse in developed nations. Its even more embarrassing that the people who suffer from these are the socially underprivileged (Australian Bureau of Statistics 2005). It has been a common trend all over the world that people who are socially disadvantaged get to suffer the worst health problems and premature deaths than those in more affluent environment. This is because they have inadequate access to the health resources; the bigger share of problems in health is attributed to the living conditions of the people and the government health policies that are basically focused on disease solutions and ignore the important societal environmental aspects (Jackson 2003). As a consequence of all these, inequalities have broadened and healthiness interventions cannot obtain optimal outcomes. The world health organization established the societal health determinants commission (CSDH) in 2005 to address the root cause the poor health and diminishing inequity in health all over the world. The report on the work of the CSDH by Hoda Rashad (in World Health Organization 2009) advocates for a paradigm shift from the current one in which health is perceived as only biological and that policies, action and governance should address issues like societal factors that can improve healthcare and access to this healthcare (Navarro 2002). For a very long time new, health has been treated as a consequence of medical care. On the other hand, being able to access medical care does not in itself give assurance of healthiness, especially when these people leave the healthcare facility to the their home and face the same conditions that had previously led to their sickness. Many people around the world are affected by such plight particularly those living and working in surroundings that are unhealthy (Jackson 2003). The root cause to these problems has been identified to be political, social, and economic factors that work against to create and worsen broad disparities in healthcare. Social determinants that are common include income, stress and not being able to access healthcare services. Most nations are conscious of the fundamental causes of poor healthcare, though very few have established policies that provide and maintain equal healthiness conditions for every citizen. Most nations are unable to meet the so called the millennium development goals of the United Nations specifically due to policies that do not in actual fact concentrate on the social aspects of health and general wellbeing of their citizens (Townsend et al 2002). The work of CSDH is to compile useful evidence based strategies that can help some regimens, international organizations, and communities to participate in informed activities to efficiently decrease inequalities (Krieger 2001). This commission set up by the world health organization (WHO) and the commissions are very critical participants in the global scene especially in advocating for fairness in terms of domestic and intentional social policies on healthcare. The Commission on Social Determinants of Health (CSDH) advocates for collective responsibility and cohesive action on the causal factors of the poor health all over the world. (Navarro 2002) Currently there are over 20 CSDH commissioners who work in collaboration with governments and academic institutions as well as the civil societies in over 50 states. The core concept of the commission’s equity lies in the central dogma of their work. Efficient and fair involvement can only be made feasible via intersectional action (Schnall et al 2000). The commission has previously been focusing on specific social health determinants as intervened for by the academic institutions, CSDH and several nations. Stress as a determinant of health can be managed by, World Health Organization. (2004); Ensuring that there is equal opportunity for early life development for all children (Navarro 2002) Ensuring that there is equality in global (international) making of policies making sure that people have decent jobs and work conditions solving social exclusion like minority discrimination, gender inequality provision of high-quality healthcare system and healthy city surroundings The need to promote health policy change all over the world is getting more or less ambitious in perspective (Raphael 2004). Many nations including the United States do not have clear healthcare policy plans and this leaves the people and institutions to fight in order to gain neutral grounds from which they can operate from (Durie 2004). The CSDH will target to use modest toolkit of intervention that will not require nations to change the existing budget on governance or the international financial policies and even donors. The following points will have to be achieved; 1. reducing the societal stratification by decreasing discrimination in power, earnings, wealth and prestige connected to various socio-economic positions (Durie 2004) 2. reducing the specific exposure to factors that damage health suffered by disadvantaged individuals (Durie 2004) 3. reducing the vulnerability of the underprivileged individuals to the health damaging conditions they usually encounter (Navarro 2002) 4. providing intervention via healthcare system to decrease the uneven outcomes of ailing healthiness and stop more socio-economic deprivation among the underprivileged individuals who fall sick Determinants of health in Sydney I have studied the factors that exacerbate health problems among poor people in Australia particularly among the aboriginal people in Sydney, and it’s evident that there is favoritism in allocation or resources. The force of the persistent deficiency and favoritism on cultural identification and society performance was identified by the state in the mid century (Australian Bureau of Statistics 2005). Stress has been identified to be affecting most men in Sydney compared to women as over the past years, much work has been going on about women’s health and how to improve it and integrate it into the corporate world while men have reluctantly responded to this influences. I also believe that there has not been effective policy on health issues and particularly on stress as a health determinant in this case (Stuurman 2007). Bearing in mind the immense interplay between the ten health determinants as classified by the renowned health body - world health organization, formulation of efficient health policy would greatly rely on evidence based strategy and all inclusive research (Carson et al 2007) Conclusion Stress was identified as the second factor among the determinants of health after food. When stress accumulates without sufficient time and proper support for its management, it results in eroded human health. The life context of many of the people that present to healthcare services is often stressful usually described by; job insecurity, long commuting, poor control of work environment, pressure to provide basic need for the family and more so lack of the sense of well-being or self esteem. These factors are serious stressors and produce periods of anxiety that affects physical and mental well-being. With the advent of the current industrialization in Sydney, I believe that there is serious need to carry out further studies on the possible negative consequences of these changes on the health on individuals. The health service practitioners have to be aware of the specific stresses that individuals encounter and the physiological effects of such stressor. The professional reaction towards this should be to provide health supporting labor and social atmosphere. References Australian Bureau of Statistics. (2005). The Health and Welfare. of Australia’s Aboriginal and Torres Strait Islander Peoples. Commonwealth of Australia Canberra. Carson B. Dunbar T. Chenhall RD & Bailie R. (Eds) (2007) Social Determinants of Indigenous Health. Allen and Unwin. Sydney. Durie M.H. (2004). Understanding Health and Illness. Research at the Interface between Science and Indigenous Knowledge. International Journal of Epidemiology. 33(5): P. 1137-1143 Esping-Andersen G. (2002) (Ed). Why We Need A New Welfare State. Oxford University Press Oxford UK Jackson P. L.R. (2003). An Argument on Culture Safety, in Health Service Delivery. Towards Better Health Outcomes for Aboriginal Peoples. Public Health and Community Medicine. University Of Sydney. Sydney Australia Krieger N.A (2001). Theories for social epidemiology in the 21st century. An eco-social perspective. International Journal of Epidemiology 30:667-678. Lavis J. (2002) Ideas at the margin or marginalized ideas?. Non-medical determinants of health in Canada. Health Affairs 21(2) :108-113 Marmot M & Wilkinson R. (2000). Social Determinants of Health. Oxford University Press Oxford UK retrieved from http://74.125.45.132/search?q=cache:Tn8HP-jctncJ:www.ccsd.ca/events/inclusion/papers/raphael.pdf+Marmot+M+%26+Wilkinson+R.+(2000).+Social+Determinants+of+Health.+Oxford+University+Press+Oxford+UK&cd=11&hl=en&ct=clnk&gl=ke Navarro V. (2002). (Ed). The Political Economy of Social Inequalities Consequences for Health and Quality Of Life. Baywood Press Amityville New York Raphael D (Ed) (2004). Social Determinants of Health Canadian Perspectives. Canadian Scholars’ Press Toronto Seaward B.L (2006) Managing Stress. Principles and Strategies for Health and Wellbeing. Jones & Bartlett Publishers Schnall PL, Belkic K, Landsbergis PA, & Baker D (2000). Why the Workplace and Cardiovascular Disease? In The Workplace and Cardiovascular Disease. Hanley and Belfus P. 97-122. Philadelphia Spine & Health Centre (2009). Work Related Stress and Bad Posture Treatment North Sydney Spine & Health Centre retrieved from http://www.spineandhealth.com.au/work-related-stress-and-bad-posture-treatment-north-sydney.htm Shukla A (2009). Looking at the WHO-CSDH report in context A. Lessons from the past. Retrieved from http://www.ucl.ac.uk/histmed/downloads/social_determinants/looking_at_the_who_csdh_report_in_context_abhay_shukla.pdf Thurman R. (2007). Aboriginal Identity in Contemporary Society. Retrieved on 19th May 2009 from: Http://Eprints.Qut.Edu.Au/Archive/00002081/01/2081.Pdf Townsend P. Davidson N. & Whitehead M. (2002). (Eds). Inequalities In Health The Black Report And The Health Divide. Penguin New York Wilkinson RG. (2005). The Impact of Inequality. How to Make Sick Societies Healthier. The New Press New York World Health Organization. (2009). Interview with Dr Hoda Rashad retrieved from http://www.who.int/social_determinants/advocacy/interview_rashed/en/index.html Read More