8.2 Social determinants of health

Social determinants of health shape our well-being beyond medical care. Factors like income, education, and social status significantly impact health outcomes. Understanding these connections is crucial for addressing global health disparities.

The social gradient in health shows that as socioeconomic status improves, so does health. This highlights the need for policies tackling inequality at all levels. Education, gender equality, and social inclusion are key areas for improving global health outcomes.

Socioeconomic Status and Health

Economic and Social Factors Influencing Health

Top images from around the web for Economic and Social Factors Influencing Health

• 

  The Community Cure for Health Care | Bridgespan View original

  Is this image relevant?

• 

  Frontiers | Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging View original

  Is this image relevant?

• 

  Frontiers | Impact of Social Determinants of Health on the Emerging COVID-19 Pandemic in the ... View original

  Is this image relevant?

• 

  The Community Cure for Health Care | Bridgespan View original

  Is this image relevant?

• 

  Frontiers | Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging View original

  Is this image relevant?

1 of 3

Top images from around the web for Economic and Social Factors Influencing Health

• 

  The Community Cure for Health Care | Bridgespan View original

  Is this image relevant?

• 

  Frontiers | Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging View original

  Is this image relevant?

• 

  Frontiers | Impact of Social Determinants of Health on the Emerging COVID-19 Pandemic in the ... View original

  Is this image relevant?

• 

  The Community Cure for Health Care | Bridgespan View original

  Is this image relevant?

• 

  Frontiers | Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging View original

  Is this image relevant?

1 of 3

• Socioeconomic status (SES) combines economic status (income), social status (education), and work status (occupation)
• Lower SES correlates with poorer health outcomes (higher mortality, morbidity, and disability rates)
• Bidirectional relationship between SES and health
  • Poor health reduces earning capacity, leading to lower SES
  • Lower SES limits access to resources and healthcare, resulting in poor health
• SES impacts health through multiple pathways
  • Access to healthcare
  • Exposure to environmental hazards (air pollution, unsafe housing)
  • Health behaviors (diet, exercise, smoking)
  • Chronic stress

The Social Gradient and Policy Implications

• Social gradient in health describes incremental improvement in health outcomes as socioeconomic position improves
• Absence of threshold effect emphasizes importance of addressing inequality across all socioeconomic levels
• Policies addressing income inequality significantly impact population health outcomes
  • Progressive taxation
  • Social welfare programs (universal healthcare, unemployment benefits)
  • Education subsidies
• Examples of successful interventions
  • Nordic countries' comprehensive social welfare systems correlate with better health outcomes
  • Earned Income Tax Credit in the US associated with improved maternal and infant health

Education and Health-Seeking Behaviors

Health Literacy and Education

• Education level strongly correlates with health literacy
• Health literacy enables individuals to obtain, process, and understand basic health information and services
• Higher education levels associated with increased health-seeking behaviors
  • Preventive care utilization (regular check-ups, vaccinations)
  • Adherence to medical advice (medication compliance, follow-up appointments)
  • Adoption of healthy lifestyle practices (balanced diet, regular exercise)
• Low health literacy linked to poorer health outcomes
  • Increased hospitalizations
  • Lower use of preventive services (cancer screenings, flu shots)
  • Higher healthcare costs

Mechanisms and Interventions

• Education influences health behaviors through multiple mechanisms
  • Increased knowledge about health risks (understanding the dangers of smoking)
  • Improved problem-solving and decision-making skills (evaluating treatment options)
  • Enhanced self-efficacy (confidence in managing chronic conditions)
• Relationship between education and health partially mediated by income
  • Higher education often leads to better-paying jobs
  • Increased resources for health maintenance (healthier food options, gym memberships)
• Interventions to improve health literacy
  • Simplified health communications (easy-to-read pamphlets, visual aids)
  • Patient education programs (diabetes management classes, prenatal education)
  • Digital literacy training (navigating online health resources, using health apps)

Gender Inequalities and Healthcare Access

Gender-Specific Barriers to Healthcare

• Gender inequalities in healthcare access manifest in various forms
  • Disparities in health insurance coverage
  • Quality of care received
  • Health-seeking behaviors
• Women often face unique barriers
  • Higher rates of poverty
  • Greater caregiving responsibilities (childcare, eldercare)
  • Gender-based discrimination in healthcare settings (dismissal of symptoms)
• Cultural norms and gender roles restrict women's healthcare autonomy
  • Requiring male permission for medical procedures
  • Limited mobility to seek care independently
• Maternal health particularly affected by gender inequalities
  • Disparities in access to prenatal care
  • Limited availability of skilled birth attendance
  • Inadequate postpartum care

Impact on Diverse Gender Identities

• Men's health negatively impacted by gender norms
  • Masculinity stereotypes discourage health-seeking behaviors (reluctance to seek mental health support)
  • Lower rates of preventive care utilization (delayed cancer screenings)
• Transgender and non-binary individuals face significant barriers
  • Discrimination in healthcare settings
  • Lack of provider knowledge about gender-affirming care
  • Limited insurance coverage for transition-related treatments
• Addressing gender inequalities requires multifaceted approaches
  • Policy changes (anti-discrimination laws in healthcare)
  • Provider education (training on gender-sensitive care)
  • Community-based interventions (challenging harmful gender norms)

Social Exclusion vs Health Disparities

Mechanisms of Social Exclusion

• Social exclusion systematically disadvantages individuals or groups
• Prevents full participation in society, including healthcare systems
• Marginalized groups experience higher rates of social exclusion
  • Racial and ethnic minorities
  • LGBTQ+ individuals
  • People with disabilities
  • Immigrants
• Social exclusion leads to chronic stress
  • Linked to negative health outcomes (cardiovascular disease, mental health disorders)
  • Weakens immune function

Barriers and Intersectionality

• Excluded groups face multiple barriers to healthcare access
  • Discrimination (racial profiling in medical settings)
  • Language barriers (lack of interpreters)
  • Lack of culturally competent care (misunderstanding cultural health practices)
  • Geographic isolation (limited healthcare facilities in rural areas)
• Intersectionality crucial in understanding compounded health disparities
  • Multiple, overlapping forms of social exclusion
  • Example: A low-income, immigrant woman of color may face barriers related to poverty, language, gender, and race simultaneously
• Social capital mitigates effects of social exclusion on health outcomes
  • Networks and relationships facilitate cooperation within communities
  • Example: Community health workers from marginalized groups improving healthcare access

Interventions and Policy Approaches

• Policies and interventions promoting social inclusion reduce health disparities
  • Anti-discrimination laws (protecting against healthcare discrimination)
  • Cultural competency training for healthcare providers
  • Community engagement initiatives (health fairs in underserved neighborhoods)
• Examples of successful interventions
  • CLAS Standards (Culturally and Linguistically Appropriate Services) in the US
  • Community Health Worker programs in low and middle-income countries
  • Health Equity Impact Assessments in policy-making processes