Social and Economic Determinants of Health
Social and Economic Determinants of Health
Human health is a comprehensive issue that both the government and the people must always be aware of. There are many factors that are combined together that directly influence the community health and the individuals themselves. Whether or not these individuals are healthy, they are being determined by various circumstances as well as the environment. On a broader view, determinants of health, such as the place where we live, the status of our environment, population’s income, genetics, level of education, and even the relationships between friends and families have substantial effects on health. Relatively, these are viewed as health determinants to which this paper will discuss. There are two major determinants of health. The first one is the economic determinants and the second one is the social determinants. The purpose of this writing is to analyze these health determinants based on the written evidence pertaining to the relevance of both the social and economic aspects to the people’s health.
Social Determinants of Health
Prior discussing the social determinants themselves, it is better to understand the global characterization of the term. In definition, health determinants in a social aspect are the conditions, which individuals are born, grow, live, and work (WHO 2013). These are also the conditions of the society to which people age. These situations are also formed by the circulation of money, resources, and power at local, national, and global levels. In addition, the social determinants of health are commonly responsible why health inequalities happen on many places. There is an unfair and preventable difference in terms of people’s health status, which is seen within as well as between these nations.
Member states of the World Health Organization embraced the “Rio Political Declaration” during the World Conference in 2011 (WHO 2013). It was identified that there are five critical issues that must be acted upon in relation to resolving health inequality using social determinants. These are the adoption of improved health governance, promotion of participation when it comes to policy-making, health sector’s reorientation towards health promotion; strengthen global collaboration and governance, and the extensive monitoring of progress including the increase in accountability.
There have been some different movements so as to identify the various social health determinants. Richard Wilkinson and Michael Marmot (2003) identified some of these social determinants of health. First, they say that social gradient defines the society’s health status using the life expectancy, which means that such expectancy is shorter and illnesses are more common as we go lower down the social status of each group in the society (Wilkinson & Marmot, 2003). In which case, health policies of the governments must further discuss both the economic and social determinants of health. Second, stress is another social determinant of health to which various stressful situations potentially make people worried. Thus, they become more anxious, making them incapable to cope with life’s challenges. It is known that these situations may negatively affect people’s health and could lead to early death.
Third, individual’s early life is also another health determinant of the society (Wilkinson & Marmot, 2003). If an individual has a good start in his or her life, or experienced a good bonding between a mother and her child, will have a better health impact during the developmental and educational stage, which will lasts a lifetime (Wilkinson & Marmot, 2003). Therefore, a good foundation of health will help an individual to have a healthy life as he or she grows older.
Another determinant that was identified by Wilkinson and Marmot (2003) is the social exclusion. It was discussed by the authors that a person’s life may be shorter if such life holds a poor quality. Due to social exclusion; hardships, resentment, and poverty cause discrimination that normally cost lives (Wilkinson & Marmot, 2003). That is because poverty, deprivation, and exclusion from the society have major impacts on human health and early death. In relation, poverty is related to being lack of basic needs of life, which continue to exist in many parts of the world. Knowing the social determinants of health can be similar to looking at the different social status of the people. We may identify how healthy these people are based on the society they belong to and how their social status directly affects their health.
Michael Marmot (2005) also suggests that besides the reality that poverty and health inequality as the social determinants of health, there are roots behind these causes being determinants. Since most everything in our surroundings affects our health, they also serve as the determinants themselves. It was also added that social determinants of health includes work, social support, unemployment, food, addiction, and transport.
Work as a determinant is related to stress as it is common that a person experiences stress within the workplace and as we all know, the more we get stressed, the more chances we are at risk of many diseases. When it comes to unemployment as a determinant of health, having a secured job means that a person has the potential to have an increased quality in health, well-being, and even job satisfaction. In contrast, higher unemployment rates may cause illness and worse, premature death Marmot, 2005). Moreover, the interaction with families, co-workers, and other people that contributes to a person’s experiences within the community are also social determinants of health (Sheridan, n.d., Marmot et al., 2012). This arguments states that every person and social factors such as social support, norms, employment and living conditions are significant to determining the social health. Relatively, it was also reported that other social circumstances also serve as the social determinants of health (Currie et al., 2012). As a result, social inequalities occur in many places around the world. The authors also added that the WHO says that majority of health inequalities in terms of health are preventable. One group that can use in identifying the social determinants of health is the younger people, which show that they are one of the most affected groups when it comes to health inequalities. Therefore, this group can be a basis when it comes to their health. The essence of social determinants to the young individuals’ health, development, and well-being is clear. Young people being the determinants of health are similar to a world of countless opportunity in terms of health, occupation, education, discovery, social engagement, and fulfillment.
The social determinant of health is vast issue to which great factors are involved so as to identify each and every determinant that we can think of. However, this approach will be more feasible through using the whole community as the basis of health determinants. Syme (2004) suggests that both the community empowerment and partnerships are also one of the social determinants of health. In relation this, knowing the community’s disease risk factors can be used to further identify the determinants of health, which is quite difficult (Syme, 2004).
Relatively speaking, these risks are associated with the people’s behavior as one of the primary reasons why health diseases occur. Thus, looking at the overall public health’s challenge is another thing that can be set as a determinant of social health. The goal of determining these social health factors can also be done through focusing on each risk factor and disease. We can link the health risk factors and people’s behavior in order to further understand what really affects the people’s well-being within the society.
It may not enough to know what the social determinants of health are. Thus, it is better to understand the causes as to why these determinants occur in the first place. For example, mortality rate due to different cases is a social health determinant (Braveman & Gottlieb, 2014). The reason is quite clear; mortality rate may increase due to the occurrence and increase of different health illnesses. However, the reason as to why such illnesses increase may not have been presented enough. That is why; identifying the social determinants of health must be accompanied by the underlying reasons, which will also identify the root causes these determinants’ presence.
Economic Determinants of Health
Economic determinants of health are related to the social determinants as they both encompass the people who are the main subject as to why determinants transpire. The public health system’s performance may also be formed by the system’s organization including how the resources are being structured. One essential characteristic of this structure is the public health system size (Mays et al., 2006). Large systems may be able to realize the scale of economies in terms of activities such as the surveillance of diseases as well as the spreading of health education. In this sense, the economic determinants of health may referred to as the effectiveness of the approaches use to inform the public about their health.
Additionally, many economists justify the determinants of health based on equity and efficiency grounds (WHO, 2013). The traditional well-being economics creates a conceptual difference between the equity and efficiency aspect. Therefore, in relation to the economic determinants of health, both of these two aspects affect the government’s economic approach to the society’s health.
Another economic determinant of health is the people’s financial status (LA County Dept. of Health, 2013). This is in relation to their finances; the society’s economic hardships are used to determine how their health may be improved or otherwise. Generally, economic hardships are influenced by various factors such as crowded housing, percentage of people living below the poverty level, and household’s income per capita (LA County Dept. of Health, 2013). In an economic point of view, each family’s income and number of household member affects their capacity to support their health needs.
Economic determinants of health are one of the major factors when it comes to identifying the health status of an identified population (National Health Committee, 1998). As such, these economic factors such as poverty and health inequality may have something to do with the overall status of the nation’s economic growth. This scenario serves a cause and effect theory to which a country’s economy has an impact towards the people through various influencing factors. Additionally, economic development itself has a direct impact towards the health of the people (Eckersely, Dixon, & Douglas, 2001). That is because economic development supports health restoration, effects, and the improvement of people’s health.
In an economic context, the socio-economic status is regarded as one of the major determinant of life expectancy and health in overall aspect. That is, lower incomes are unambiguously bad for health (UCL Institute, 2012). Since it is one of the major determinants (healthypeople.gov), it encompasses various stakeholders such as the social factors, individuals’ behavior, policymakers, and the overall health services being provided to the people.
References
Braveman, P., Egerter, S., & Williams, D. R. (2014). The Social Determinants of Health: Coming of Age. The Annual Review of Public Health, 32, 381-398.
Braveman, P., & Gottlieb, L. (2014). The Social Determinants of Health: It’s Time to Consider the Causes of the Causes. Diversity, Disparities, and Social Determinants, 129, 19-28.
Currie, C., & World Health Organization. (2012). Social determinants of health and well-being among young people: Health behaviour in school-aged children (HBSC) study : international report from the 2009/2010 survey. Copenhagen: World Health Organization, Regional Office for Europe.
Eckersley, R., Dixon, J., & Douglas, R. M. (2001). The social origins of health and well-being. Cambridge, UK: Cambridge University Press.
Healthy People. (n.d.). Determinants of Health | Healthy People 2020. Retrieved from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health
Los Angeles County Department of Public Health. (2013). How Social and Economic Factors Affect Health. Social Determinants of Health, 2-23.
Marmot, M. (2005). Social determinants of health inequalities. International Center for Health and Society, 365, 1099-1104.
Marmot, M., Allen, J., Bell, R., Bloomer, E., & Goldblatt, P. (2012). WHO European review of social determinants of health and the health divide. Epidemiology and Public Health, 380, 1011-1028.
Mays, G. P. (2006). Institutional and Economic Determinants of Public Health System Performance. American Journal of Public Health, 96(3).
National Health Committee. (1998). The Social, Cultural and Economic Determinants of Health in New Zealand: Action to Improve Health. National Advisory Committee on Health and Disability.
Sheridan, L. (n.d.). Social and Economic Determinants of Health. Greater London Authority, 31-36.
Syme, S. L. (2004). Social Determinants of Health: The Community as an Empowered Partner. Preventing Chronic Disease, 1(1).
UCL Institute of Health Equity. (2012). Economic context | The King's Fund. Retrieved from http://www.kingsfund.org.uk/time-to-think-differently/trends/broader-determinants-health/economic-context
Wilkinson, R. G., & Marmot, M. G. (2003). Social determinants of health: The solid facts (2nd ed.). Copenhagen: World Health Organization, Regional Office for Europe.
World Health Organization,. (2013). The economics of the social determinants of health and health inequalities: a resource book. Luxembourg: Publication of the World Health Organization.
World Health Organization. (2013, May 7). Social determinants of health. Retrieved from http://www.health.state.mn.us/strategies/social.pdf
