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Social Determinants Of Health Research

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During the past few years, the health community and public sector has been drawn upon the attention towards social determinants of health. This social determinants of health circle evolves around the factors except those belonging to medical care that can be influenced by shaping health and influencing social policies in much powerful ways. According to World Health Organization, social determinants of health is defined as “the conditions in which people are born, grow, live, work and age” (SLAWOMIRSKI, 2006). Social determinants induces the health related factors coupled with socioeconomic factors like education, income, unemployment and wealth. The social determinants of health are responsible for health inequalities. The essay is a broad …show more content…

Pakistan is a signatory to the Alma Ata Agreement that sets the Millennium Development Goals (Ministry of Planning of Pakistan, 2012). However, health conditions are affected by many social determinants and underlying inequalities in the society. Lack of clean water, housing, adequate nutrition, sanitary conditions, education, unequal distribution of income and gender inequalities are associated with low economic development and bad health conditions.
Education and its proper distribution is being featured as the major factor in the population’s health and epidemiology. Education makes the public aware of basic sanitation and hygiene and decreases the chances of an individual to get sick. A good educational structure can allow the users to undertake regular health checkups by making them aware of the importance of regular health scrutiny (Sabates & Feinstein, 2006). Education helps in enhancing the demand for preventative health services as …show more content…

It is related to health in three ways i.e. through gross national product of the country, income of individuals and income inequality between rich and poor among geographic areas. The inequality between poor and rich gives rise to bad health conditions. According to Marmot (2010), for Canadian middle income group ($30,000-$50,000) the mortality rate was 1.6 times of the top income group. Similarly another study done by Deaton (2002) showed the increase in probability of dying with the decreasing income levels. Not only income, but egalitarian distribution of income is mandatory for attaining better health environment. Pakistan lies in those countries that have highly skewed income distribution with higher rate of poverty which reduces per capita consumption of the poor. Number of hungry people and malnourishment has increased in Pakistan due to income inequality. In case of Pakistan, the unequal income distribution worsens the health of public by increasing infant mortality rate and by reducing the life expectancy rate. The Gini coefficient of Pakistan (measure of income inequality within a society) is 30 (a value of 0 means perfect equality and a value of 100 means perfect inequality) (Ministry of Planning of Pakistan, 2012).
Housing, lack of clean water and poor sanitation are also an indicator of healthier society. The figure below shows that the most prevalent

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Before we look at the different Social/Psychological Determinants of Health it is important firstly to define what a social determinant of health is. According to the World Health Organization (2017) “The social determinants of health are the conditions in which people are born, grow, live, work and age.” These conditions are as a result of a wide range of factors that are ultimately governed by the way in which money, power and specific resources are shared at different levels including those at global, national and local levels. We have all been a part of and will experience different social determinants of health throughout our lives but it is the standard at which we experience these determinants that will ultimately lead onto them affecting our health or ultimately leaving us unaffected. The Social Determinants of Health which I am going to examine include • Education • Unemployment • Stress • Living Conditions • Cultural Norms.

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Social Determinants of Health Shelly Clavis Rutgers University School of Nursing Social Determinants of Health Defined Health concerns is an issue that most organizations have formed a pact to safely deal with the challenge. The main agenda focuses on the eradication of health inequalities that may exist in most countries. It is best suited that social determinants are accorded the much-needed attention since they affect a number of people. In assessing the factors that affect one’s health, genetic disposition, personal behaviors, ability to obtain healthcare and the overall environment in which an individual resides are to be considered. Social determinants of Health are issues that deals with the conditions that people have found constructed in a society and acts as a parcel in their lives, such as; growth, age and some of the more complex systems that construct a society which include economic policies and their systems that include social norms, development goals and the basic political system that they are indulged under (World Health Organization, 2008).

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Healthcare is important because it enables people to be physical, mentally, and physically fit. It ensures that people have a good quality of life and are productive individuals in the society. However, the dream of high-quality healthcare for all is still a mirage. The discussion aims to examine the racial and the socioeconomic inequalities and examine their effect on the delivery of healthcare in the society.

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The term social determinants of health, can be defined as a ‘set of conditions in which people are born, grow up, live and work.’ These conditions include housing, education, financial security and the environment along with the healthcare service. (http://www.rcn.org.uk/__data/assets/pdf_file/0007/438838/01.12_Health_inequalities_and_the_social_determinants_of_health.pdf) These factors are affected by the amount of money, power and resources that are available at a global, national and local level. Social determinants of health are linked to health inequalities according to the World Health Organisation, health inequalities are ‘the unfair and avoidable differences in health status seen within and between countries.’

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Health outcomes among people depend upon the resources that people have to live a quality life. The variations with the money distribution and power derive such circumstances and induce inequalities in health at domestic and global levels where they have become unavoidable at present (Vega & Frenz, 2013). It has been stated that income, housing as well as environment are the major categories undermining all the factors of social determinants as mentioned earlier. Individuals, groups and communities are negatively influenced by these factors in their health status. Governments of all nations have undertaken several measures to tackle the risks arising from these conditions (Chapman, 2010).

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We are surrounded in a community where everyone is encountered by disparities of many types; for example, gender, cultural, religious, socio-economic, plus opinion. All these disparities create the main structure of our society, where one society is distinguished from another because of these disparities. These disparities amid people create our society both active and inactive. Out of all the disparities, gender inequality is still seen in less-developed countries like Syria, Pakistan, Yemen and many more; with Pakistan ranked 141 out of 142, second to last in global gender inequality according to the annual Gender Gap Index by the Geneva-based World Economic Forum. Pakistani women nevertheless face the world’s worst inequality in access to participation in political agencies, education and the imposition of social rules.

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These factors are known as the Social Determinants of health. “The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system” (WHO). Dalgren & Whitehead (1991) image of the social determinants of health aims to show the relationship between the person, their environment and their health. The modifiable factors, people’s age, gender and race lie in the centre surrounded by non modifiable factors like profession, housing, education and public policy. There is a direct relationship between people’s environment and their health, e.g. people who live in damp housing have a higher incidence of respiratory health problems (Farell et al.

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Health inequalities are preventable and unjust differences in health status experienced by certain population groups. People in lower socio-economic groups are more likely to experience chronic ill-health and die earlier than those who are more advantaged. Health inequalities are not only apparent between people of different socio-economic groups – they exist between different genders and different ethnic groups (“Health inequalities,” n.d.). The situation in which people are born, grow, develop, work and age are affected by social, economic, environmental and most importantly political factors.

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The approach focuses on the influencing the environment to change in order to make healthy choices simple. As stated by the universal human right act that everyone has the right to standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing, and medical care and necessary social services and the right to security in the event of unemployment, sickness, disability, widowhood, old age, or other lack of livelihood in circumstances beyond his control (Naidoo et al., 2009). HPP incorporate all major areas that consider social determinant of health which address the policy around employment, welfare, education, transport, food, health and social services. HPP as an approach to health promotion has advantages such as recognition of the multiple socioeconomic environmental determinants of health and the necessity to change these determinants in order to promote health (Naidoo et al., 2009). Aside these, the approach also has commitment to reducing inequality in health and promoting equity.

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Income inequality is one of the big issues in 21st century. Unequal distribution of income in society is considered to be an obstacle to economic growth. The income allocation of a country’s population can be measured by a Gini coefficient. The value of Gini coefficient can be between 0 and 1 and used to define the income gap between the rich and the poor. The value 0 shows perfect equality and value 1 illustrates perfect inequality.

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The Gini coefficient ranges between 0 to 1, with 0 being the perfect distribution and 1 being the worst. Huzaima Bukkhari and Dr Ikramul Haq report that as specified by US State Report Pakistan's GINI Coefficient was 0.63 in 2006. This proves that the major part of the total income was acquired by a few people and the distribution was hightly inequal. (As cited in Huzaima Bukhari and Dr Ikramul Haq) Figure 1 shows the income distribution of Pakistan in 2008. The GNI per capita being $4110.

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What happens when any country has high income inequality? If the separation of nation’s wealth is based on the rule where a little group of people keeps the majority of a nation’s capital, the balance of pоwer in this state is skewed or deformed. Therefore, low and middle classes of society have less access to capital and less access to nation’s resources, consequently, they have low chance for breaking out the cycle of poverty. While economists all over the world think on what optimal wealth distribution actually is, many inhabitants of different countries agree that the Gini index is the most real indicator of the health and vitality of a country.

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