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Social Determinants of Health

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Social Determinants of Health <[log in to unmask]>
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Tue, 14 Sep 2004 10:20:00 +1000
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Social Determinants of Health <[log in to unmask]>
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Michael West <[log in to unmask]>
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I would add to the originating injustices or fault lines - sexuality or
heterosexism; a robust and multi-culturally sanctioned form of
discrimination that is currently being explicitly named by a global &
transformative rights movement. Like class is it subject to a rigorous
silence.

As to the question: what is the source of inequality and what type of
action leads
to institutional and social change, beyond treating the consequences of
the
inequality?

For me the source of inequality is the maintenance of power
(knowledge), and when we talk of sub groups within populations
(Indigenous, queer, migrant, women) specific performances of this power
(homophobia, misogyny, xenophobia, colonisation) need to be
contextualised if we are to understand the currency of social exclusion.


What is the type of action that leads to change? Bravery and belief as
obdurate resistence; meandering discussions that reveal people aren't
isolated, that despite the many differences that separate individuals -
the common experience(s) of the effects of inequities (stigma, violence,
rejection + isolation) across communities/networks means that a voice of
change for a population group may be identified, may be used to contest
sites of power.

The question - where's the spider? Is an interesting one. Perhaps there
is no spider other than multifarious humanity. Our need to find a spider
is intriguing as this locates responsibility for the maintenance of the
web elsewhere.

Regards,
Michael



Michael West
Acting Manager & Health Access
HIV & Sexual Health Promotion Unit
Northern Sydney Health

37 Fourth Ave, Eastwood N.S.W 2122

pH 02 9858 7606 / 0402 892 058
Fax 02 9858 7987
[log in to unmask]

>>> [log in to unmask] 09/14/04 06:26am >>>
I think it's also important to recognize that prior to the social
determinants are the originating injustices--class, racism, and
sexism.
These are not just another part of a laundry list among many. As Nancy
Krieger reminds us, in a different context, there are hundreds of
"factors"
(here determinants) in the web of causation, but where's the spider?
Class
relations and social hierarchies imply a specific type of power
structure
that influence the character of the determinants. Epidemiologists and
public
health folks can't do this work alone. For the work that I do, a
central
question is: what is the source of inequality and what type of action
leads
to institutional and social change, beyond treating the consequences of
the
inequality?



Richard Hofrichter, PhD
Senior Analyst, Health Equity
National Assoc of County & City Health Officials
1100 17th Street, NW
Washington, DC  20036
Tel: 202-783-5550 x211
Fax: 202-783-1583
email: [log in to unmask]


-----Original Message-----
From: Robb Travers [mailto:[log in to unmask]]
Sent: Monday, September 13, 2004 03:26 PM
To: [log in to unmask]
Subject: Re: Policy & Law as a determinant of health


Colleagues......It's heart-warming to see such an interest!  To quote
a
colleague - Toba Bryant - from the York Centre for Health Studies at
York University in Toronto - these determinants 'didn't fall from the
sky...they're man-made'.  Well put in relation to poorly contrived
health and social policies - especially those of the neo-liberal
variety.

Robb





Robb Travers
Director of Research
Wellesley Central Health Corporation
471 Jarvis St. Suite 201
Toronto, ON, M4Y 2G8
t: 416 545 7498
f: 416 921 7228
e: [log in to unmask]
www.wellesleycentral.com




-----Original Message-----
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf
Of
Ana Natale-Pereira
Sent: Monday, September 13, 2004 3:11 PM
To: [log in to unmask]
Subject: Re: Policy & Law as a determinant of health

I also agree, and would be interested in knowng what work is going on
to
address this.

Ana Natale-Pereira, MD
Assistant Professor of Medicine
Division of Academic Medicine, Geriatrics, and Community Programs
Medical Director
Focus Community Health Center
449 Broad Street
Newark, New Jersey 07102
973-972-0980
973-972-0984 Fax

[log in to unmask]




>>> [log in to unmask] 9/13/2004 2:19:48 PM >>>
Coming to this from a structural health & social change perspective, I
absolutely agree with you - do you know of any work being done in this
area?

***************************************
Christina McLennan BSW MSW (Candidate)
Volunteer Coordinator
Women North Network
Phone: 250-967-0208
Cell: 250-617-5629
Email: [log in to unmask] or [log in to unmask]
***************************************
-----Original Message-----
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf
Of
Barbara Starfield
Sent: Monday, September 13, 2004 10:56 AM
To: [log in to unmask]
Subject: Re: [SDOH] Discussion paper on Class and Health in NEJM

The MOST ignored determinant of health, however, is what is never
addressed---societal determinants in the form of policies, laws, and
regulations.  It's time we started to think about populations rather
than individuals as the object of our attention!

Barbara Starfield, MD

*******************************************************
Barbara Starfield, MD, MPH
University Distinguished Professor
Johns Hopkins University & Medical Institutions
624 North Broadway, Room 452
Baltimore, Maryland 21205
Phone 410-955-3737
Fax 410-614-9046
[log in to unmask]
*******************************************************
-----Original Message-----
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf
Of
Alex Clark
Sent: Monday, September 13, 2004 1:22 PM
To: [log in to unmask]
Subject: [SDOH] Disussion paper on Class and Health in NEJM


Useful paper on class and health in the US from the latest addition of
theNew England Journal of Medicine

Issacs, SL and Schroeder SA (2004) Class - The Ignored Determinant of
the Nation's Health. New England Journal of Medicine 351: 1137-1142

See link:
http://content.nejm.org/cgi/content/short/351/11/1137?query=TOC


************************************************************************
'
Dr Alex Clark

4th Floor Clinical Sciences Building
Faculty of Nursing
University of Alberta
Edmonton, AB.
Canada T6G 2G3
Tel: (780) 492 8347
Fax: (780) 492 2551

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