Social determinants of Health

Mrs.Mayakutty M.Sc (N)

Asst. professor KVCN
 What are the Social Determinants of Health?

• Social Determinants of Health are all factors

that influence the state of health of the
population, without necessarily being the
direct causes of particular problems or
diseases. The Social Determinants of Health are
associated with individual and collective
behaviors, living conditions, and environments.
 According to the WHO definition
• the Social Determinants of Health are the
“personal, social, economic and
environmental factors that determine the
state of health of individuals or populations”.
• In 2007, some organizations proposed a list of
12 Social Determinants of Health. They are,
• Income Level and Social Status
• Social Support Networks
• Education and Literacy
• Employment and Working Conditions
• Social Environments
• Physical Environments
• Personal Health Habits and Adaptability
• Early Childhood Development
• Biological and Genetic Heritage
• Health services
• Gender
• Culture and ( food fads likes and dislikes, in
some culture men eat first and women eat last
with small quantity leading to malnutrition)
• Religious factors
• Traditional factors
• Food production and distribution
• Lifestyle habits(cooking practices, child rearing
practices, alcoholism
 1. Income Level and Social Status

• The level of income of individuals, households, or the family

was the classic indicator used in the first investigations on social
inequalities and their effect on health, however, several studies
have discredited its validity to sufficiently explain this
relationship. Some studies show that, after a certain level of
average income per person, increases in income do not seem to
improve the health level of the population, at least significantly.
• Social status determines significant health inequalities in the
population. These inequalities are often evident, especially in
clinical practice. However, defining and measuring these
inequalities is not always easy. Social status can be defined as
access to power, prestige, wealth, etc.
 2. Social Support Networks

• The social environment, the support of

relatives and family, and the help of friends
make it possible to overcome health-related
difficulties and thus contribute to better health.
• A quite influential area is that of the family. A
person with family problems tends to be more
emotionally unstable, as well as people with
few, less sociable friends who live in toxic
relationships.
 3. Education and Literacy

• Education is another widely used material factor for the study

of health inequalities. The educational level has direct and
indirect repercussions on people’s health status, by operating
as an element of reinforcement and protection throughout
their lives.
• As a reinforcement, education contributes to the choice of
lifestyles and behavior favorable to health and,
simultaneously, it enables access to better jobs and life
opportunities that protect people from health risks.
• Education is a relatively easy factor to measure through
indicators such as the number of complete years of study, the
maximum level of study achieved, or the degrees obtained.
 4. Employment and Working Conditions

• The fourth material factor used is the occupation of the people, that is, the
position of the individual within the social structure, which contributes to
protect him from certain occupational risks, facilitates access to health
resources, contributes to producing different levels from psychological
stress and can influence their behavior or the adoption of healthy lifestyles.
• In advanced societies, occupation is the main criterion to explain the social
stratification and categorization of the different socioeconomic groups,
where esteem and social approval depend, to a large extent, on the type of
work that people have, as well as on their professional training and
achievements.
• However, the certain analytical utility of this determining factor, its
measurement faces difficulties to consider in all research work, among
others: classifying those who are engaged in domestic work or are in
retirement condition and and also, the existing differences in the
compensation paid for the same job and often due to gender or race.
 5. Social Environments

• People with an unfavorable socioeconomic position are in poorer health than

people whose socio-economic position is favorable.
• Since the mid-nineteenth century, numerous investigations revealed the significant
impact that the conditions of the environment where they live, study, work, or age
have on the health of individuals, which they concern elements such as access to
basic services in the field of sanitation, clean water, and waste disposal.
• To measure environmental factors, a very broad set of useful indicators is used
such as measures related to air quality (quantity of suspended particles of lead,
ozone, or carbon dioxide, for example), water quality (from access to piped water
to measurement of the turbidity or pH of the liquid); the number of road accidents
and mortality from this cause, an average value of homes, number of cases of
family violence, percentages of unemployed in the study area, among others.
• It is also related to the socio-economic factor since it is said that unemployment
and poverty can cause social disintegration, which would increase the risk of
suffering stress, depression, and anxiety.
 6. Physical Environments

• The good health of a population depends on the quality of

the air, water, homes and infrastructure, and public roads.
Physical factors encompass everything that refers to the
environment that surrounds a person to pollution. Among
them we can mention the following:
• The use of aerosols.
• Noise: a factor that is not considered, but has a relevant
influence e.g. the excessive presence of noise, whether at
work or home, can cause stress, anxiety, insomnia, and,
consequently, hearing problems.
• Atmospheric pollution.
7. Personal Health Habits and Adaptability

• Although it is not taken as something so necessary, physical exercise is very

important since it not only prevents obesity but also protects cardiovascular
health.
• Therefore, the general recommendation is to lead an active lifestyle, not
only incorporating exercise routines, but increasing movement, both in the
workplace and at home.
• In the same way, eating unhealthy foods (such as saturated fat) could
increase the risk of heart problems.
• People with risky behavior (tobacco, alcohol, drugs, etc.) are at risk of
developing more disease and have poorer health than people without risky
behavior.
• People with coping skills in the face of stressful situations and/ or obstacles
in life enjoy better health than people without good coping skills.
 8. Early Childhood Development

• The development of the child and the situations lived or not, have
repercussions on the state of health of the adult person.
• The study by stages of life, more than a dimension, is a useful
approach for the investigation of social inequalities since it covers
social facts outside the individual, which can affect their health
condition throughout life, for example, the effect of socioeconomic
status during childhood, the presence of specific health conditions
upon reaching adulthood.
• It is obvious that this approach requires very extensive studies, with
a great variety of indicators and, above all, precise and continuous
monitoring of the data. The usefulness of the results of this type of
work concerns the design of public policies that can influence the
future of the health of individuals.
 9. Biological and Genetic Heritage

• Biological factors are inherent to each individual being and in most cases
cannot be controlled. They can make an individual more or less prone to
presenting a certain disease and are considered to influence up to 20% in
the general state of health.
• Genetics heritage is one of the most difficult to change, since it is directly
related to each individual, so it is different in each case.
• While it is true that there are factors that predispose to suffering a disease,
lifestyle also influences. Specifically, it is about 20%; therefore, it is very
important to maintain a good diet and exercise.
• The healthier you try to be, the less risk there is of suffering from any
ailment.
 10. Health Services

• People with easy access to health services have better health than people
with difficult access to health services.
• In recent years, barriers to access to health services appear as one of the
causes of greater explanatory interest about the differences in health
between social groups, mainly because to eliminate them, consistent public
policies are established.
• Although the level of income is adequate, one has sufficient knowledge and
lives in a healthy environment, the effect of access gaps is true, if medical
services are not available or these are deficient when diseases appear.
• Not only will social groups see their good health diminish, but they will also
live in an environment much more risky for life.
• The indicators used are the number of doctors and nurses available in the
study area, as well as the number of countable beads or the percentage of
social security beneficiaries.
 11. Gender

• Men and women are not subject to the same risk of disease
depending on their age. Beyond the specific ailments of each
gender, common diseases do not always occur equally if the
person is of one or the other sex. Neither drugs have to act the
same in a man as in a woman.
• Recent research has revealed the crucial differences between
men and women in cardiovascular disease, cancer, liver
disease, osteoporosis, and in the area of ​pharmacology.
• Medical science still knows very little about gender-specific
differences in disease, particularly when it comes to symptoms,
their link to social and psychological factors, and the
implications of these differences for treatment and prevention.
 12. Culture and Lifestyle

• Cultures, customs, traditions, and beliefs influence values ​and feelings

about health. The behavior of people throughout their lives, faced with
different risks to their health, is one of the most studied determining
factors since the second half of the 20th century. Smoking, consuming
alcohol, eating poorly nutritious food, or maintaining low levels of physical
activity are practices that directly damage the health and life perspective
of individuals and that they freely choose, hence the importance of their
knowledge in predicting the future state of their health and the
implementation of appropriate prevention and cure policies.
• This factor is usually measured through indicators such as consumption or
not of cigarettes or alcohol, the number of cigarettes or the daily amount
of drink consumed, the level of caloric consumption, or the time devoted
to physical activities. And it is said that leading a healthy lifestyle is
individual and, accounts for approximately 45% of the factors.
 Assignment
Draw pictorial representation of social determinants
• Thank you