Social Determinants of Health

Importance

• Significant impact on individual and population health.
• Illustrates variability in health within and across populations.

Examples of Variability

• Global differences:
  • Life expectancy in 2015: Sierra Leone (50 years), Australia (83 years).
• Within-country differences:
  • Life expectancy of indigenous vs. non-indigenous people in Australia (10 years lower for indigenous).
• Social status influence:
  • Higher income, education, and occupation lead to better health and higher life expectancy.
• Migrants:
  • Different diseases, health behaviors, and risk factors compared to country of origin.

Determinants of Health

• Individual Factors:
  • Age, sex, genetic makeup.
• Health Behaviors:
  • Smoking, physical activity, alcohol use, diet.
• Conditions of Living:
  • Social and community networks.
  • Socio-economic, cultural, and environmental conditions.

Social Determinants of Health

• Shaped by distribution of money, power, and resources.
• Influence health inequities (unfair and avoidable differences in health).

Framework by WHO

• Structural Determinants:

  • Socio-economic and political context.
  • Governance, economic, social, and public policies.
  • Social and cultural values impacting health.
  • Unequal distribution of resources shaping socioeconomic position.

• Socioeconomic Position Factors:

  • Education, occupation, income, gender, race/ethnicity, social class.

• Intermediary Determinants:

  • Material circumstances (quality of housing, ability to buy healthy food).
  • Psychosocial circumstances (stressful living, relationships, social support).
  • Behavioral and biological circumstances.
  • Health systems (type and quality of care, accessibility).

• Social Cohesion and Capital:

  • Cooperation and sacrifices for community benefits.

Complexity and Interaction

• Intermediary determinants influence health and inequities.
• Links between factors are complex and bidirectional.
  • Example: Poor income affects health, poor health affects economic opportunities.

Addressing Social Determinants

• Requires actions across sectors and at all societal levels.
• Dependent on socio-economic, political context, and available resources.
• Commitment and action needed at local, national, and international levels.

---

This summary provides an overview of the social determinants of health, their impact, and a framework to understand them as discussed in the lecture.