Social determinants of health inequalities

The gross inequalities in health that we see within and between countries present a challenge to the world. That there should be a spread of life expectancy of 48 years among countries and 20 years or more within countries is not inevitable. A burgeoning volume of research identifies social factors at the root of much of these inequalities in health. Social determinants are relevant to communicable and non-communicable disease alike. Health status, therefore, should be of concern to policy makers in every sector, not solely those involved in health policy. As a response to this global challenge, WHO is launching a Commission on Social Determinants of Health, which will review the evidence, raise societal debate, and recommend policies with the goal of improving health of the world's most vulnerable people. A major thrust of the Commission is turning public-health knowledge into political action.https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)71146-6/fulltex

Final Recommendations from the World Health Organisation Commission on the Social Determinants of Health: Nurses, part of the solution? A discussion paper.

Aim This paper suggests that nursing needs a new paradigm for research and practice that recognises the social determinants of health as potentially preventable causes of ill health. It is clear from the recent report from the World Health Organisation Commission on the Social Determinants of Health that nurses are critical to global change through their ability to champion a `social determinants of health` approach with partner agencies. Data Sources Relevant literature searches have been undertaken to inform this discussion paper using the following databases in late 2008/early 2009 including the previous twenty years as relevant (British Nursing Index, Medline and Cinahl). In addition relevant international policy documents have been referred to from 2000 on. Discussion On the publication of this report it is timely for nurses to take stock of how they might be most effective in reducing inequities in health as part of a global work force and resource for health. Many nurses will feel that they already work to promote social justice and poverty reduction yet their scope of action is often limited by their specific sector. Do nurses need a new paradigm for research and practice that focuses on the social determinants of health as potentially preventable causes of ill health? Conclusion Nurses need to strengthen their strategic skills to reaffirm inequities in health as a priority within often complex local circumstances and to enable them and those they care for to influence local and national policy, research and practice development. Key words – health, inequities, nursing practic

Identifying Food Insecurity in a Rural Vermont Primary Care Setting

Recent years have shown an emergence of interest in social determinants of health by healthcare providers, community leaders, and social service organizations alike. Among the social determinants of health, food insecurity has been associated with higher incidences of chronic disease and poor health outcomes as compared to rates among individuals not screening positive for food insecurity. This project aims to compare the effectiveness of screening patients for food insecurity via formal paper questionnaires versus the traditional approach of an open patient-provider dialog guided by provider intuition in identifying food insecure individuals in a primary care setting.https://scholarworks.uvm.edu/fmclerk/1623/thumbnail.jp

Depression, Cognition, & Social Determinants of Health: Assessing Associations in Older African Americans with Diabetes

Social determinants of health have been widely identified as characteristics of one’s social and economic climate that affect one’s health outcomes1. (see Graphic 1) The Alzheimer’s Association indicates that rates of Alzheimer’s disease (AD) and other forms of dementia are two times higher in older African Americans than their white counterparts2. People who have diabetes are also at an increased risk. The prevalence and co-morbidity of depression among older Americans with diabetes (both with and without cognitive impairment) has been well established3. Understanding the effect that social determinants of health have on the onset and progression of dementia and depression in older African American diabetics is important as such an understanding may better inform future health policy and government spending on healthcare intervention(s).https://jdc.jefferson.edu/cwicposters/1038/thumbnail.jp

Health Equity Series: Food Insecurity December 2015

In order to address health equity, it is important to acknowledge the factors that create inequitable health outcomes, such as socioeconomic factors and other inequalities related to race and gender. Although individual responsibility and personal health behaviors have an impact on health outcomes, understanding how the social determinants of health (e.g., education, housing, employment, transportation) play a significant role in both health behaviors and health outcomes is important when attempting to achieve health equity for all Missourians.For the purpose of this report, health equity will be discussed through the examination of Missouri's food system, including how social determinants of health impact food security and food access, as well as the connection between disparities in health outcomes and an inequitable food system

Social Determinants of Malaria in the Working Area of Puput Public Health Services, West Bangka

Background : Malaria is a preventable and curable disease and yet more than one million people die from it each year. It is a disease that significantly affects the poor who have economic, social and educational deprivation. Malaria is also a disease that flourishes in conditions of crisis and population displacement (Oxfam, 2008). The Working Area of Puput Public Health Services is an ​​high malaria-endemic area with API 43.92 ‰ in 2011 and was the highest in the west Bangka district. The purpose of this study was to determine the major social determinants of health as risk factors of malaria occurance in the working area of puput Public Health Services at west Bangka district in 2012. Methods: The design of this study was the unmatched case control with population based case-control and purposive sampling, respondents consisted of 58 cases and 58 controls selected from the reported malaria positive patients based on laboratory test results in puput Public Health Services in 2012. Data processed with SPSS 19 program. The statistical analysis was carried out by the chi-square test and logistic regression: a p-value of less than 0.05 was considered to be statistically significant. Result : Variable that were associated with incidence of malaria is housing conditions (p=<0,001), Environmental conditions (p=<0,001), working conditions (p=0,001), habits going out at night (p=<0,001), malaria prevention behaviors (p=<0,001), health services (p=0,007) and migration (p= 0,004). There was no association between socioeconomic (p=0,266) with incidence of malaria. Logistic regression analysis showed that the variables that are risk factors for malaria is the habit of going out at night (adjusted OR: 6,7; 95% CI: 1,6-28,4), environmental conditions (adjusted OR: 5,6; 95% CI: 1,2-25,5) and malaria prevention behaviors (adjusted OR: 4,1; 95% CI: 1,4-11,9). Conclusion : Improve malaria control with increase education, use of insecticidal nets by people at risk, indoor residual spraying (IRS) with insecticide to control the vector mosquitoes, and policy on the provision of malaria drug to prevention in immigrant population. health insurance that covers immigrants

Social Determinants of Smoke Exposure During Pregnancy: Findings From Waves 1 & 2 of the Population Assessment of Tobacco and Health (PATH) Study

Maternal smoking during pregnancy (MSDP) and secondhand smoke (SHS) exposure are associated with a myriad of negative health effects for both mother and child. However, less is known regarding social determinants for SHS exposure, which may differ from those of maternal smoking during pregnancy (MSDP). To identify social determinants for SHS exposure only, MSDP only, and MSDP and SHS exposure, data were obtained from all pregnant women (18–54 years; N = 726) in waves 1 and 2 of the Population Assessment of Tobacco and Health Study (2014–2015). Multiple logistic regressions were conducted using SAS 9.4. Smoke exposure during pregnancy was common; 23.0% reported SHS exposure only, 6.1% reported MSDP only, and 11.8% reported both SHS exposure and MSDP. Results demonstrate that relationships between smoke exposure during pregnancy and social determinants vary by type of exposure. Women at risk for any smoke exposure during pregnancy include those who are unmarried and allow the use of combustible tobacco products within the home. Those who are at higher risk for SHS exposure include those who are younger in age, and those who are earlier in their pregnancy. Those who are at higher risk for maternal smoking include those with fair/poor mental health status and those who believe that others\u27 view tobacco use more positively. These results suggest the need for implementing more comprehensive policies that promote smoke-free environments. Implementing these strategies have the potential to improve maternal and fetal health outcomes associated with tobacco smoke exposure