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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