Social Determinants of Health

Introduction

• Importance of understanding social determinants and their impact on health
• Variability in health between individuals and populations

Life Expectancy Example

• Sierra Leone (2015): Life expectancy of a child was 50 years
• Australia (2015): Life expectancy was 83 years
• Difference of 33 years
• Within Australia: Indigenous populations have a life expectancy about 10 years lower than non-Indigenous populations

Factors Influencing Health

• Social status influences health outcomes:
  • Higher income, education, and occupation correlate with better health
• Migrant health status varies based on country of origin (different diseases, health behaviors, and risk factors)

Determinants of Health

• Influences on health are called determinants of health:
  • Individual Factors: Age, sex, genetic makeup
  • Health Behaviors: Smoking, physical activity, alcohol use, diet
  • Living Conditions: Social and community networks, socioeconomic, cultural, and environmental conditions, health systems
• Collectively known as social determinants of health

Health Inequities

• Social determinants shape the distribution of money, power, and resources
• Lead to health inequities: unfair and avoidable health differences between groups

Frameworks for Understanding Health Determinants

• Several models proposed to explain interactions of determinants, focusing on two broad types:
  1. Structural Determinants:
     • Socioeconomic and political context
     • Governance, societal organization, policies, social and cultural values
  2. Intermediary Determinants:
     • Material circumstances (housing quality, financial means)
     • Psychosocial circumstances (stress, relationships, social support)
     • Behavioral and biological factors
     • Impact of health systems on care quality and accessibility

Socioeconomic Position

• Affected by factors such as education, occupation, income, gender, race, ethnicity, and social class
• Socioeconomic position influences intermediary determinants

Social Cohesion and Capital

• Bridge structural and intermediary determinants
• Community willingness to cooperate for wider benefit

Complex Interactions

• Not always linear; can go in both directions:
  • Poor income and education affect health, while poor health can limit workforce participation and education
  • Disease prevalence can impact socioeconomic and political context

Addressing Social Determinants

• Challenging task:
  • Requires identifying and improving structural and intermediary determinants
  • Involves action across all sectors and levels (local, national, international)
  • Actions depend on existing contexts and commitment to change

Conclusion

• Summary of social determinants of health and their impact
• Importance of frameworks for understanding and addressing health determinants.