Hi and welcome to this video on the social determinants of health. This is a very important concept to understand because its impact on the health of individuals and of populations. We'll be taking a look at what it is, how it impacts health, and a useful framework to understand it.
Take a look around you, your family, friends, and other people around you. What's clear is that health is quite variable, not just between individuals, but also across different population groups. Let's take an example.
In 2015, the life expectancy of a child born in Sierra Leone was 50 years, whereas in Australia it was 83 years, a difference of 33 years. But there are differences even within countries. For example, in Australia, the life expectancy of indigenous people is about 10 years lower.
than that of non-indigenous people. Within a population, health is also influenced by social status. People with higher income, a higher level of education, and a better occupation have better health and a greater life expectancy. Health status can change as well.
For example, studies of migrants have shown that the type of diseases, health behaviors, and risk factors are different in migrants compared to those in their country of origin. So why is there so much variability? To answer that question, we must understand the factors that can influence health.
Let's have a look. A person's health is influenced by a range of factors called determinants of health. These include who they are, individual factors such as age, sex, and genetic makeup, and also what they do.
This includes their health behaviors such as smoking, physical activity, alcohol use, and diet. Health is also largely influenced by the conditions in which people are born, grow, live, work, and age. These include their social and community networks, the socio-economic, cultural, and environmental conditions that people live in, and also health systems. These are collectively called the social determinants of health.
The social determinants of health are ultimately shaped by the distribution of money, power, and resources at an international, national, and local level. They have a marked influence on health inequities, which is the unfair and avoidable health differences between different groups of people within countries or between countries. Now, there are many different social determinants of health, working across many levels and with complex interactions between them. So, to understand and explain how these determinants influence and interact with each other to affect health and well-being, Several models or frameworks have been proposed. There are many different frameworks that do this.
But let's have a look at one useful framework developed by the World Health Organization. According to this framework, there are two broad types of health determinants that influence health and can lead to health inequities. These are structural determinants and intermediary determinants. Structural determinants refer to the socio-economic and political context in which a person is born into and lives in. These include governance, how society organizes itself to make and implement decisions, economic, social and public policies, and also the social and cultural values that communities place on health.
These factors can determine and lead to the unequal distribution of material and monetary resources which shapes a person's socioeconomic position. The socioeconomic position is the position of a person's socioeconomic position. position describes a person's place in society which can affect their exposure, vulnerability, and outcomes to conditions that have an impact on their health.
The socioeconomic position is determined by a number of factors such as education, occupation, income, gender, race or ethnicity, and social class. The socioeconomic position in turn affects the intermediary determinants of health. These include material circumstances like the quality of housing, the financial means to buy healthy food, clothing or other requirements for healthy living, and also the work environment. Psychosocial circumstances, like stressful living circumstances, relationships and social support. Behavioral and biological circumstances.
In addition to these, health systems have an impact on the type and quality of health care available to people. It also determines how easy it is for people to access health services and receive the health care they need. Social cohesion and social capital are factors that bridge the structural and intermediary determinants.
They describe the willingness of people living in a community to make sacrifices and to cooperate with each other for a wider benefit. Intermediary determinants influence health and health inequities. It's also important to know that the links between these different factors are not always linear, but are complex and can go in both directions.
For example, poor income and education can impact health and also poor health can limit opportunities for people to participate in the workforce or receive education also if population is affected by a lot of disease it can have a broader impact on the socio-economic and political context so how can we change or influence these determinants addressing the social determinants of health is not an easy task It involves identifying the structural and intermediate determinants of health and taking appropriate actions to improve them. To do this requires actions across all sectors of society and at all levels, including local, national, and international. The actions will depend on the existing socioeconomic and political context, resources that are available, and commitment for action.
And that's a quick introduction to the social determinants of health. We've had a look at what it is, how it impacts health, and a useful framework to understand it.