By a SDOH listserv member! - dr
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Inequality is Bad for Your Health
Nelson Daily News, Tue 21 Feb 2006
Page: 2, Section: Community
Byline: Helen Lutz
Source: Special to the Daily News
When most people think of the things in their life that help to prevent
disease and maintain health, most respond with diet and exercise, as well
as their prompt and convenient access to health care services,
professionals and equipment. Though these beliefs are widely held, and
strongly touted in traditional medical literature, they are not
necessarily the things that truly keep us healthy. There are other
characteristics of our communities and societies that have considerably
more influence on our health than eating right and seeing the doctor.
Curious?
A great deal of evidence from Canadaand other countries supports the
notion that the social and economic "circumstances of individuals and
groups are equally or more important to health status than medical care
and personal health behaviours such as smoking." These circumstances are
commonly referred to as the "social determinants of health."
According to Health Canada, "social determinants of health are the
socio-economic conditions that influence the health of individuals,
communities and jurisdictions as a whole. These determinants also
establish the extent to which a person possesses the physical, social and
personal resources to identify and achieve personal aspirations, satisfy
needs and cope with the environment." Social determinants of health
determine whether individuals stay healthy or become ill.
According to Dr. Dennis Raphael of York University, "Social determinants
of health are about the quantity and quality of a variety of resources
that a society makes available to its members." What exactly are these
determinants? Dr Raphael considers a number of factors as playing a
critical role in the health and wellbeing of individuals, communities and
society as a whole. These resources include such things as conditions of
childhood, income, availability of food, housing, employment and working
conditions, and health and social services. It also includes issues of
gender, class, racism and other forms of social exclusion.
In terms of the health of larger populations, it is well recognized that
the size of the gap (or disparity) in social and economic status between
groups within a given population has an enormous affect on the health
status of the whole population. The larger this gap, the greater the
affect on the health status of all of us or more simply, a chain is only
as strong as it's weakest link. Taking a social determinants of health
approach to our work in health care and communities is much different than
the traditional focus on the risk factors such as eating habits,
cholesterol levels, tobacco use and exercise.
Making a change towards the social determinants of health approach is
challenging, and inherently political. After all, when we begin to
consider some of the more complicated issues within our community such as
poverty, housing quality, and employment opportunities for example, then
we must shift our attention to how we as community members organize
ourselves and make resources and supports available (or not) to all of us.
In conclusion, if you're still looking for some tips to help improve your
health, here is the social determinants of health perspective (adapted
from Dr. Raphael's book "The Social Determinants of Health", p.13): Don't
be poor. If you can, stop. If you can't, try not to be poor for long.
Don't have poor parents. Own a car. Don't work in a stressful, low paid
manual job. Don't live in damp, low quality housing. Be able to afford to
go on a foreign holiday and sunbathe. Practice not losing your job and
don't become unemployed. Take up all benefits you are entitled to, if you
are unemployed, retired or sick or disabled. Don't live next to a busy
major road or near a polluting factory. Learn how to fill in the complex
housing benefit/asylum application forms before you become homeless and
destitute.
If you are interested in further reading about the importance of these
social and economic forces as predictors of our health, there are
resources available through a "Google" search of "social determinants of
health".
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