SOCIAL DETERMINANTS OF HEALTH

INDIVIDUALSOCIETY It is an organized group. COMMUNITY Total Organization of social life with a limited area. - Ogburn and Mimkuff - Ogburn and Mimkuff

Health "The state of being free from illness or injury". - Google dictionary - Google dictionary Health was defined as "a state of complete physical, mental, and social well- being and not merely the absence of disease or infirmity“. “Socially and economically productive life” - WHO - WHO

Biological Socio-cultural Behavioural Environmental Science and technology Information and communication Healthy system Socio-economic Equity and social justice Aging of the population Gender Famalies Individuals Communities Societies Families Individuals Health Human rights Biological Behavioural Biological Behavioural

Biological determinants The physical and mental traits of every human being to sum extent determined by the nature of genes at the movement of conception. Positive health – a person should be able to express as completely as possible the potentialities of his genetic heritage. - WHO - WHO

BEHAVIOURAL AND SOCIO CULTURAL LIFE STYLE – the way of people live  social values  Attitudes  activities

ENVIRONMENT Disease to environment - Hippocrates - Hippocrates Concept of disease – environment association - Pettenkofer - Pettenkofer

Internal External physicalbiological Psycho social ENVIRONMENT

INTERNAL Each and every component part, every tissue, organ and organ- system and their harmonious functioning with in the system. EXTERNAL OR MACRO ENVIRONMENT All that witch is external to the individual human host.

Socio economic conditions Economic status Education Occupation Political system Nutrition Housing

HEALTH SERVICES PURPOSE To Improve The Health Status Of The Population

AGING OF THE POPULATION A major concern of rapid population aging is the increased prevalence of chronic disease and disabilities both being conditions that tend to accompany the aging process and deserve special attention.

GENDER  Women’s health OTHER FACTORS  Information and communication  Science and technology

Why Emphasize Social Determinants? Social determinants of health have a direct impact on health Social determinants of health have a direct impact on health Social determinants structure other causes of health: Social determinants structure other causes of health: – Environment – Behaviour – Services The ‘causes of the causes’ The ‘causes of the causes’

SOCIAL FACTOR INFLUNCING THE HEALTH OF PEOPLE DEMOGRAPHICECONOMICPOLITICALLEGALRELIGIOUSEDUCATIONALTECHONOLOGICALCOMMUNICATIONSMIGRATIONURBANIZATION LIFE EXPECTANCY MARRIAGEFERTILITY ROLE OF WOMEN ECOLOGICAL PREDISPOSITIONS (community values, socially prescribed roles, life style, sub-cultural behaviour patterns,etc.) CURRENT CIRCUMSTANCES (income, family life, housing employment, Stresses and crises, social support, etc) INDIVIDUAL PREDISPOSITIONS (inheritance, prenatal events, previous accidents or illness, upbringing, childhood nutrition, etc.) OPPORTUNITIES/SITUTIONS (access to health services, expousure to pathogens, availability of education, food, sanitation, alcohol, drugs, marriage partners, etc.) HEALTH

FRAMEWORK OF THE CATEGORIES AND PATHWAYS OR DETERMINANTS SOCIOECONOMIC SOCIOECONOMIC POLITICAL POLITICAL CONTEXT CONTEXT Social Policies Labour market, Housing, land Culture and societal value Macroeconomic policies Public policies, Education, health, Social protection Governance Socioeconomic Position Social Class Gender Ethnicity (racism) Education Occupation Income Material Circumstances (Living and Working, Conditions, Food Availability, etc) Behaviors and Biological Factors Psychosocial Factors IMPACT ON EQUITY IN HEALTH AND WELL-BEING STRUCTURAL DETERMINANTS OF HEALTH INEQUITIES INTERMEDIARY DETERMINANTS OF HEALTH Health System Social cohesion & Social Capital

Addressing the social determinants of health Involves the medical care and public health systems, but clearly extends beyond these Involves the medical care and public health systems, but clearly extends beyond these Requires collaboration with multiple sectors outside of health, including education, housing, labor, justice, transportation, agriculture, and environment Requires collaboration with multiple sectors outside of health, including education, housing, labor, justice, transportation, agriculture, and environment

Addressing the social determinants of equity Involves monitoring for inequities in exposures and opportunities, as well as for disparities in outcomes Involves monitoring for inequities in exposures and opportunities, as well as for disparities in outcomes Involves examination of structures, policies, practices, norms, and values to answer, “How are these inequities being maintained?” Involves examination of structures, policies, practices, norms, and values to answer, “How are these inequities being maintained?” Requires intervention on societal structures and attention to systems of power Requires intervention on societal structures and attention to systems of power

We need to do both Address the social determinants of health, including poverty, in order to achieve large and sustained improvements in health outcomes Address the social determinants of health, including poverty, in order to achieve large and sustained improvements in health outcomes Address the social determinants of equity, including racism, in order to achieve social justice and eliminate health disparities Address the social determinants of equity, including racism, in order to achieve social justice and eliminate health disparities

Building Health & Health Equity Diseases of Public Health Impute Early Child Development Women + Gender Equity Urban Settings Social Exclusion Employment Conditions Globalization Health systemsMeasurement KNOWLEDGE NETWORK THEMES

Ten Tips for Staying Healthy 1. Don't be poor. If you can, stop. If you can't, try not to be poor for long. for long. 2. Don't have poor parents. 3. Own a car. 4. Don't work in a stressful, low paid manual job. 5. Don't live in damp, low quality housing. 6. Be able to afford to go on a foreign holiday and sunbathe. 7. Practice not losing your job and don't become unemployed. 8. Take up all benefits you are entitled to, if you are unemployed, retired or sick or disabled. 9. Don't live next to a busy major road or near a polluting factory. 10. Learn how to fill in the complex housing benefit/ asylum application forms before you become homeless and destitute. Dave Gordon, 1999