SOCIAL DETERMINANTS And their contribution to the variation in health status of Australians

What are social determinants of health? Open textbook to page 65

SOCIO-ECONOMIC STATUS There are 3 factors which determine socio-economic status: 1) Income 2) Occupation 3) Education All 3 factors interrelate. For example, a person with a low level of education is more likely to have a lower paying job, therefore generating less income. Socioeconomically disadvantaged people are: Less likely to take notice of health promotion messages (education/knowledge) More likely to smoke and be obese due to poor nutrition and lack of physical activity (knowledge) Experience overcrowding housing conditions (income)

EMPLOYMENT The type of work that people do can have either positive or negative effects on health: Ill-health caused by work related stress Quality of relationships with workmates, superiors or the public can enhance or detract from social health Financial position of the company. A company struggling to generate income may make workers redundant (?) which can increase stress levels and affect mental health Job status may increase self esteem and improve mental health Physical environment may affect physical health. E.g. UV exposure (skin cancer) heavy lifting (back injuries) operating machinery (accidents/injuries) These can account for a difference in mortality rates. For instance workers in manual jobs experience higher rates of death than managerial/office workers

UNEMPLOYMENT “The unemployed have a higher chance of dying and more illnesses than those of similar age who are employed” (AIHW) Unemployed people have higher rates of: Suicide Lung cancer Cardiovascular disease Mental health problems such as stress There is a two way relationship between level of health and unemployment. Ill-health may cause unemployment (injury/illness) or for others unemployment may cause ill health (such as stress/depression)

Social exclusion “ Is the segregation that people experience if they are not adequately participating in the society in which they live” The causes and results of social exclusion are often similar. They are: - poor physical and mental health - disability - family breakdown - homelessness - lack of education and skills - low income - poverty

stress Stress can cause a number of health conditions such as: Infections Diabetes High blood pressure Heart attack Stroke Depression Aggression

Food security Food supply will affect what you eat: A shortage of food products can lead to deficiency diseases (iron deficiency anaemia) Food plenty (too much food) will result is people eating too much and putting themselves at risk of diet related diseases such as diabetes, obesity and CVD Difficulty accessing foods will lead to people being forced to by cheaper, processed foods, with high levels of added fat, salt and sugar. These additives also increase the risk of diet related diseases Low income families are forced to purchase healthy options due to processed foods often being cheaper. Healthier foods are more expensive and harder to access in disadvantaged areas (supermarket fruits) Low SES groups may also experience constraints associated with transport and knowledge of healthy foods Rural and remote areas are affected by a lack of supply of nutritious foods, increasing their risk of diet related diseases

HOUSING Because people spend a lot of time in the home, housing is a determinant of health which can lead to various health outcomes: Overcrowding: People need their own space and being surrounded by others all the time can lead to feelings of anxiousness, depressions and stress, leading to mental health problems. Many people living under the one roof can put extra strain on facilities in the home such as the bathroom, kitchen and laundry. Unhygienic conditions are more common therefore leading to the spread of infectious diseases. A noisy household will affect sleeping conditions Lack of security (safe locks) will increase anxiousness and affect MH Pollution in the home such as smoking and pet hair can lead to respiratory conditions such as asthma and bronchitis REFER TO PAGE 74 FOR MORE EXAMPLES OF OVERCROWDING

Access to health care Access to health care services promote good health. Access to these services can be influenced by: Cultural barrier (language, values/beliefs) Geographical location Easy access to health services can promote good health by: Decreasing mortality rate and increasing life expectancy due to early detection and treatments Decreased morbidity due to education Reduced rate of low birth weight babies

TRANSPORT EARLY LIFE EXPERIENCES