Health Determinants of Health – Assessing the Social Environment
The Determinants of Health is a relatively new concept in the world of public health research and policy. Although this concept is still fairly new to the field of public health, it is already making a significant impact on the design of health programs and policies. The key feature of this theory is that the determinants of health do not take into consideration a persons current state of health, or any past state of health. Rather the determinants of health are based upon current conditions of health and what effects those conditions will have on a persons ability to participate in society. The idea is that people in societies with higher levels of social hierarchy and social mobility have higher levels of health risks than people who are economically disadvantaged and have lower levels of social hierarchy and social mobility. This is not an theory about why some groups of people get sicker or die earlier than other groups of people but an explanation about why some conditions of health are associated with particular classifications of people.
Social determinants of health fall into four categories; biological, community, social, and environmental factors. Social factors that are considered as part of the social determinants of health include; the demographics of a community, the level of social interdependence of a community, and the nature of the local environment. A local environment that is rich in physical resources, such as clean air and water, good education, adequate medical services and social support, is believed to promote healthy living. These are all environmental factors. A community that has good medical, educational and other community services is also a good community.
The theory of the Determinants of Health is an attempt to identify how changes in these four factors can affect public health and promote health equity. Changes in these four factors are being studied to try to identify interventions that will reduce health disparities by improving the health of the population as a whole. An intervention can be anything from improving the availability of quality public health services to increasing access to quality education and promoting health behaviour and habits. Studies have shown that interventions that focus on these four areas have the greatest impact on reducing health disparities. This leads to improved quality of life and economic growth.
There are several ways to improve health disparities by identifying and reducing the problem of social disparity
Community interventions are often designed to tackle the problems of gaps in neighborhood social structure, such as low income and lack of good social support, low educational achievement and poor health outcomes. These can include neighbourhood development strategies that involve improved cross-sectional communication and engagement, better recreation opportunities for kids from disadvantaged families, and increased social capital for the poor. Other interventions can include community-based approaches aimed at reducing the burden of chronic diseases such as diabetes and cardiovascular disease.
Some of the interventions aimed at improving the health equity of the population focus on promoting active living. The introduction of active living is an important strategy to address some of the key drivers of chronic disease outcomes. Active living is an approach that considers a range of different strategies to create a healthier lifestyle and get more people living a healthy life. For example, an introduction of a neighbourhood-based active living program that combines exercise, yoga, recreation and social activities has been shown to be effective in creating a safer environment for all.
Another strategy that has the potential to reduce the burden of chronic diseases is the introduction of a universal single-payer national health program. Evidence suggests that a universal program can reduce the burden of diseases by improving health outcomes for those with better access to quality health care. The introduction of a universal single-payer program has been endorsed by prominent medical associations. One of the most recent recommendations of this association, the National Practitioner’s Organization, is that the United States should consider an official single-payer system by 2021. For this reason, the focus of this article is on the role of the state in improving health care outcomes for its citizens.
In reviewing the social determinants of health, attention was given to three broad categories
These categories are occupational, social and physical environment. Occupational settings include the number of hours worked; duration of employment; level of skill attained by the employees; and demographics of the employees. Social conditions include the existence and dynamics of two interacting forces: personal characteristics and social conditions. These include the physical environment which includes the nature and degree of pollution, the availability of public services, the social setting in terms of the existence of social determinants such as race and gender, the history and culture of place of residence, and the general trend of living.
Health is determined by a combination of the determinants identified above. Some of these factors are beyond our control. However, we can improve our health by making appropriate adjustments to the existing socio-economic structure. We can do this by improving the health care system and ensuring access to quality services. These changes will address social determinants of health within the broader context of the health care system and the nation as a whole.