The Social determinants of health are the conditions that individuals are born, grow, age, work and live plus the forces and the systems that shape the terms of the daily life. They can be classified as the social and the economic conditions including their distributions among the global populations. They are the health promoting factors that are found in the living situation of the individuals like the wealth, power, and the income but not the risk factors that influence the risk for the diseases.
The primary factors that shape the health of the individuals globally are not only the medical treatments or the lifestyles choices but also the living conditions they are experiencing (De, 2005). These conditions of life including the environment that the individuals live have come to be known as the social determinants of health. The systems that shape these determinants are the development agendas, social norms, political systems and the social policies.
Public policy is considered the major influence in embracing the transparent and the participatory model of the policy development. It looks at the factors that lead to the continued health inequalities for the indigenous people and the solutions to these factors. Most of the health and the human services around the globe include the social determinants on their model of the population health with the primary mission of strengthening the policies that have the best knowledge and the evidence in the field (Kronenfeld, 2013).
The government is upholding the affordable health care act while ensuring that the money allocated to the health sector is sufficient and could benefit the individuals who are less fortunate in the society. The affordable health care benefits the individuals through the Obamacare, affordable insurance and the medical bills and sufficient and efficient technologies in health centres. All the three factors ensure that there is quality of the health care given to individuals.
Housing is a major social determinant of health around the globe. Few people live in well-furnished houses compared to those individuals residing in the shanties and ghettos. Well, furnished rooms are only found in places where the social amenities are of high quality. Therefore, the people living in these areas have an opportunity to get quality services (Kronenfeld, 2013). The individuals who live in poorly furnished houses tend to be more vulnerable to the diseases due to the coldness and the poor social amenities around the place. The hospitals and other medical facilities may be of low quality also.
Access to the health and the health care is a social factor that influences the health of the individuals. The best and the quality health services promote good life through minimizing the diseases. Even in the wealthiest states, there is inequality in accessing the excellent health services between the poor and the rich (De, 2005). The unequal distribution of the wealth leads to the unequal access to the services by the individuals living in the state.
Access to the health care is essential for the equitable health, and it is preferred to be common more rather than the market commodity. The individuals who access safe and quality health care services tend to live the good life with less vulnerability to the disease. On the other hand, the individuals who do not access the quality health care are very vulnerable to the diseases (Kronenfeld, 2013). The wealthy individuals are more likely to access the quality health services as compared to the needy individuals.
The social support networks like language are significant social determinants in healthcare. Language for instance attaches an individual to the community and peaople around. Understanding and comprehending the language helps the individuals to convey the problems well; it aids in the times of need and supports one in making healthier behaviour choices. And the individual who is in the foreign land and does not speak the language of that state may feel alone in the place. Social support network benefits health in many ways since it is a source of the reassurance and gives a safe place for and individual to discuss his problems and helps him to cope with the adversity (World Health Organization, 2008). Association between the social ties and the health is significant because the communities establish the collaborative networks that aid in addressing the health concerns.
Education is one of the key determinants of health. It influences other determinants such as employment, housing, and living conditions. People with higher education have access to better employment opportunities and higher income. With higher income, one can afford quality healthcare facilities, balanced diet and live in a good house. In addition, educated people take preventive measures such as physical exercise, vaccines, and fruits to avoid the occurrence of health problems. Therefore, higher education is associated with better health. Low education, on the other hand, is associated with poor health because uneducated persons do not understand the importance of prevention. Such people experience many health problems because they have less income that limits them from accessing good housing and quality health services (Marmot, 2006).
Employment and working conditions is another social determinant of health. Uneducated people earning low income are still the ones vulnerable to poor working conditions. Working conditions can be viewed in five dimensions; self-expression opportunities, working hours, work-related stress, physical conditions and job security. Stress at work predisposes people to anxiety, depression, cardiovascular diseases and high blood pressure. Unemployment or job insecurity also has negative psychological effects because it exposes individuals to a lot of stress and it may escalate to depression. Many unsafe working environments are associated with workplace injuries (Marmot, 2006). For example, people working in the quarries are likely to suffer injuries due to the falling stones or may also suffer from lung infections because of the dust. Employed people enjoy good health because they have adequate income to purchase balanced diet and quality healthcare services.
Food being an important human need forms a key determinant of health. Those experiencing food insecurity do not access the right quality and quantity of food thereby being a great barrier to adequate nutritional intake. Such people consume less serving of vitamins, milk products, vegetables, and fruits. Food insecure households experience dietary deficiencies leading to diseases such as kwashiorkor, marasmus, night blindness, diabetes, heart diseases and food allergies. Food insecurity is still associated with income because people with low income cannot afford enough quantity and quality of food. Food security, on the other hand, is associated with better health because the right kind of food gives the body protection against diseases by boosting immunity (Marmot, 2006).
Gender, roles that men and women assume in the households is another crucial social determinant. Women are more exposed to health problems as compared to men given the greater responsibility they take in raising the children. Childbearing and the associated health complications also put women at a greater risk of health problems. In most households, women perform the household chores, which is an extra work especially for those who are employed. This makes them experience psychological problems such as stress because sometimes they come home when they are already tired, and they are still expected to cook and perform other tasks.
Women and the men have different health and life experience because of the psychological, biological, cultural attributes and the opportunities associated with the being female and male (World Health Organization, 2008). The goal then is to create the optimal outcomes for men and women through the compensation for the social and historical disadvantage, which prevents them from operating on the level playing field. It improves the health of the sub-groups rather than the specific individuals in the populations. Both the women and the men require the health policies that target their specific needs and hence, the gender analysis is utilized to identify the health issues and their behaviours, which are of the particular concern for men and women.
Research also shows that most gays, lesbians, and transgender were being discriminated thus were exposing them to health problems. It was especially common among the adolescence and youth who are trying to come to terms with their identity (Marmot, 2006). In fact, in the past when there were no proper legislations and policies protecting them they were being denied health services just because of their sexual orientation. For example, in 1970's there were no proper policies and legislations for the protection of gays, lesbians, and transgender nor even an organization to fight for their rights.
Disability is also a social issue that affects people’s health. People with mental and physical disability are unable to perform as other people. First, some of them feel discriminated because some schools, offices and healthcare institutions may not have facilities designed to cater for the needs of people with disabilities. Therefore, they suffer emotional stress and even depression. They always feel that other people despise them, and such a low self-esteem is a predisposing factor to health problems (De, 2005). Others especially the mentally ill are exposed to health problems because sometimes you will find some of them eating foods in the dumpsites, which are dirty. They can also hurt themselves because they may get in touch with sharp objects and dangerous chemicals.
In addition, because most people with disabilities are handicapped some of them do not get the privileges of education thus limiting them to good employment opportunities and ability to earn a reasonable income. In countries where there are no social protection and social security legislations such as the Disability Fund and National Insurance schemes people with disabilities are vulnerable to health problems. Because of their limited income, they cannot afford quality healthcare facilities (De, 2005).
Health policy and policy process have led to positive health outcomes among the vulnerable groups. The policies are aimed at ensuring that there is no disparity in healthcare and that the vulnerable groups especially expectant women, children and people with disabilities access healthcare services. The policy process that involves the vulnerable groups in the formulation, implementation and review are more effective because the unique needs of these groups are catered for.
Advance practice nurses have a responsibility in protecting vulnerable groups in the community. For example, they should draft policies for the protection of people with disability and forward them to the legislators. Nurses should also engage in health education of the general population to empower them to protect vulnerable groups in the society such as the women, children, elderly and people with disabilities. In addition, they play an important role in offering healthcare services to the vulnerable groups visiting them and helping them to cope with health challenges including the counselling and vaccination services (De, 2005). Therefore, all nurses should ensure that the government recognize and protect vulnerable groups.
References
De, C. M. (2005). Caring for the vulnerable: Perspectives in nursing theory, practice, and research. Sudbury, MA: Jones and Bartlett.
Kronenfeld, J. J. (2013). Social determinants, health disparities and linkages to health and health care. Bingley: Emerald.
Marmot, M. G., & Wilkinson, R. G. (2006). Social determinants of health. Oxford: Oxford University Press.
World Health Organization. (2008). Building the knowledge base on the social determinants of health: Review of seven countries in the Eastern Mediterranean Region. Albany, NY: Author.
