Social Determinants of Health and Well-being - Essay Example

Social determinants of health and well-being June 27 2009 Social Determinants of health and well-being Social determinants of health are said to be the social and economic conditions which are prevailing in a certain region, helping to determine and result in the type of health that affects the individuals of this area. These determinants are of vital importance because research has proven that all major diseases existing in the world today are a direct consequence of a series of interacting exposures that can result in the increase or decrease of health risks. The World Health Organization claims social determinants to be the conditions under which individuals live, grow and age (WHO). There is a long list provided by the WHO of the social determinants necessary to influence the well-being and health of every individual. While some parts of this list are far from being social influences, many do indeed fall within the list of determinants in society that affect its individuals. This list includes: income, education or more specifically health literacy, employment, physical environment, child development, biology, gender and culture. Thus, as proven, some factors are a far cry from what can be considered as social determinants to the prevailing health system today. Yet aspects like housing: physical environment, education: health literacy and culture can play a tremendous role in determining the kind of health services available. Additional aspects of social determinants to health are the early life of an individual, their working conditions, income distribution and food security (The Social Determinants of Health). The importance of these social determinants is not one that is lost on everyone. Individual writers like Raphael speak of the social determinants as responsible for the economic and social conditions that assist in shaping the health of not just individuals but also communities and jurisdictions. He defines social determinants as responsible for determining the degree to which their resources: physical, personal and societal can satisfy their needs and help cope with the surrounding environment. To better understand the part played by social determinants it is necessary to understand how these determinants can affect the health and causes diseases. Research has been carried out that determines a cultural/behavioral or materialistic/structuralist approach to understanding the mechanisms that influence this process (Townsend, Davidson & Whitehead). Cultural/Behavioral approach The cultural/behavioral theme concentrates on the individual's choices and behavior. For instance, it can include the amount of tobacco or alcohol in their diet However, the criticism to this theory is that all behavior is dependant on the material conditions of any individual. This type of theme can provide very little assistance in determining the rates of incidence and deaths from various diseases. Despite this, many countries like Canada continue to focus on the role an individual's life-style plays in their attempts to recognize methods to prevent diseases (Raphael 2008). Materialistic/structualist approach A better approach is the materialistic/structuralist approach which concentrates on the material aspects of human life: amenities, working conditions, quality of food and housing conditions. The structuralist approach focuses on three ideas: materialist, neo-materialist and psychosocial. Materialist speaks of how living conditions are the determining forces for health. Neo-materialist discusses how these materialist conditions occur and psychosocial discuss the comparisons drawn by individuals between themselves and others and how these affect their lives. This theory speaks of the socio-economic conditions that help determine an individual's health. This includes the over-all wealth of the nation this individual belongs to. It's a powerful indicator also because the lifespan of an individual or the distribution of wealth can be easily monitored: showing the social conditions within the nation (Graham 2007). When deprived of material satisfaction, these people revert to behaviors that can pose to be threatening and risky for their health. Use of excessive tobacco, alcohol and diets rich in carbohydrates are said to be means of coping with difficult situations (Wilkinson 1996). The materialist concept helps explain the role played by material goods in the behavior and health of different individuals. By investing less in education and health, countries unequal jurisdictions on their citizens, resulting in low healthcare (Kaplan, Pamuk, Lynch, Cohen & Balfour). Social Comparison approach Another way of determining social effects on health is the social comparison approach. This concept pays attention to the roles, individuals feel and interpret the social hierarchy to which they belong (Kawachi & Kennedy). This approach is divided into two parts: individual and communal. At an individual level one's unequal status in society can lead to stress. By comparing their status and possessions to that of someone else, a feeling of unworthiness becomes apparent leading to psychological effects on health which directly affect metabolic and immune systems. At a communal level, the wide and strengthened hierarchy system can lead to a weak social cohesion which many feel is vital for a society's health. While showing distrust and suspicion towards fellow members, individuals create stress within themselves and weaken structures like public education and health. This concept concentrates on the role played by the psyche in weakening public structures. Material aspects reign as most important thus causing an immediate and untoward effect on the human body. Life-course perspective The most radical of these approaches is the life-course perspective. Instead of concentrating strictly on traditional methods, the life-course concentrates on the importance of history in understanding social determinants (Davey Smith). This perspective sheds light on the entire stage of human growth: early childhood, childhood, adolescence, and adulthood. . Thus, after discussing the various theories it becomes vital to choose one and discuss three important social determinants of health and well-being. The three aspects that are considered are: housing, education and culture. They will all be viewed from a structuralist's perspective, not only because it's vast but because it is subjected to the least amount of criticism: making it a strong and valid concept. Analysis of some social determinants Housing Housing is vital in the life of any individual. It represents not only the place where one takes shelter from the physical dangers of the outside world but it is also the refuge that is sought after a long and tiring day. The WHO feels there to be no specific definition of a perfect house. The house is not seen as a perfectly modeled tool fits into a specific vision. Instead, the house is seen as an environment that is comfortable, hygienic and safe for those who reside in it. With such basic principles needed to make a house, it seems but natural for every individual to possess it in the world today. Yet, as proven by the structuralist approach, housing is in fact tremendously uneven in every country. With the huge gaps in income, individuals belonging to a lower paid job are unable to buy and fashion their houses according to the likes of those who are paid much higher salaries. Thus, dissatisfaction seeps in when they see these houses and compare them to their own. This concept of materialism rings true in houses which are created in industrialized countries. Basic amenities in the countries differ too. For instance, in a country like the United States a television set is seen as a vital amenity in the household while a developing country like Africa would seek running water as a basic amenity in their houses. Thus, if the structualistic model is to be obeyed then a lot of problems arise in health because of our quest to succeed in creating the house which will meet the standards that have been set by others. Important aspects like: mould growth, indoor air pollution and lack of hygiene are ignored in this desire to beat other community members in creating the perfect house. The house should be a place where neighbors can be met without harming the privacy and independence of the abode. Once this has been achieved they should try to seek satisfaction in what they have instead of craving what they do not possess. Only after they realize the importance of a clean and safe home, will the right values ring true to them. Policy makers should realize the importance of housing and focus on construction that can meet physical, mental and social well-being of the people. Education Education as a social determinant for health and well-being is seen mainly as creating awareness, changing attitudes and recognizing alternatives so that people can lead an optimum level of physical and mental health. The broad structural mechanism is vital in explaining and identifying the part played by education as a social determinant. Health education is seen as the responsibility taken by individuals to control and improve their health. Kulbolk sees health education as any steps taken by someone to improve and promote their well-being and health (1997). Thus health education is also seen as a thought-out mixture of learning experiences that allow the individual to use, enable and reinforce behavior that will benefit the health of the group, the community or the individual themselves. The problem with education of any kind: be it ordinary or related to health, is the huge disparity it creates between the rich and the poor. Once again, public structures display a weakness that prevents the ordinary citizen from achieving the same education as that of their fellow society members. This lack of education can result in the lower classes knowing and gaining fewer medical benefits then those around them. Also, the upper classes: including the employed and insured groups, will ignore whole segments of society and their problems. The solution is an establishment of equal medical care for all. This way, there is no bias caused by the material distribution of wealth. Each member of society gains equally. If this cannot be achieved then the policy makers should concentrate on forming policies that will provide medical care and education to each of its members instead of limiting this to those with a higher status. Culture Culture is seen as a driving force in any type of society. This culture plays a vital role in creating social determinants. Seen from a structuralist approach, culture often creates a root to many of the problems that arise in the health and well-being of many societies. Work like the Health Promotion Practice work on cultures followed by specific groups such as Puerto Ricans to better understand the ideologies, norms and practices that effect their health and well-being. Thus, in the same way culture influences the work done by individuals to maintain or reduce their health. As material possessions and their use is enforced onto the minds of a child from a very young age, they carry it on to teach it to future generations: creating a vicious cycle that is dangerous and unhealthy. Culture is an ideology that can never be taken away from any group. Thus, the structuralist method should focus on how this ideology came about and if material changes can help break the cycle that will affect the well-being of the entire community. Social determinants are a vast and never-ending topic that focuses on the needs and requirements of a well-versed and efficient healthcare system. If the different concepts are followed and understood, a great deal of change can be brought about to the deficiencies in the health system today. Bibliography Davey Smith, G. (Ed.). (2003). Inequalities in Health: Life Course Perspectives. Bristol UK: Policy Press. Graham, H. (2007). Unequal Lives: Health and Socioeconomic Inequalities. New York: Open University Press. Health Promotion Practice, Culturally Responsive Health Promotion in Puerto Rican Communities: A Structuralist Approach, Available from Sage Journals Online, http://hpp.sagepub.com/cgi/content/abstract/9/2/149 Accessed June 27 2009 Kaplan, G. A., Pamuk, E. R., Lynch, J. W., Cohen, J. W., & Balfour, J. L. (1996). Income Inequality and Mortality in The United States. BMJ, 312, 999-1003. Kawachi, I., & Kennedy, B. (2002). The Health of Nations: Why Inequality Is Harmful to Your Health. New York: New Press. Kulbolk 1997, Integrated Health Promotion, Susan Leddy, Available on Google Books, http://books.google.com.pk/booksid=LYcqCIvmC_IC&pg=PA10&lpg=PA10&dq=structuralist+approach+on+education-health+and+well-being&source=bl&ots=kbumE5FdCg&sig=r0nFzYTq9v2TgbeuX96YS0-HZP0&hl=en&ei=OzlFSqqvG9aLkAXEhuGoDw&sa=X&oi=book_result&ct=result&resnum=3 Accessed June 27 2009 Raphael, D (2008) Social Determinants of Health: Canadian Perspectives (2nd ed.). Toronto: Canadian Scholars' Press Incorporated. Public Health Agency of Canada, The Social Determinants of Health, available at http://www.phac-aspc.gc.ca/ph-sp/oi-ar/01_overview-eng.php Accessed June 27 2009 Townsend, P., Davidson, N., & Whitehead, M. (1992). Inequalities in Health: the Black Report and the Health Divide. New York: Penguin WHO, Social Determinants of health, Available from World Health Organization http://www.who.int/social_determinants/en/ Accessed June 27 2009 Wilkinson, R. G. (1996). Unhealthy Societies: The Afflictions of Inequality. New York: Routledge. Read More