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

Social Determinants of Health

What is health? How do we measure the health of a society? Is it merely the clinical outputs of each individual patient or are these numbers impacted by environmental and social factors such as access to healthcare facilities? The answer is yes. Research surrounding health and social services shows a correlation between health outcomes and the environment, calling this junction the Social Determinants of Health (Bradley, et al., 2011; Bradley, et al., 2016; Woolf, et al., 2015). This includes a combination of factors that impact the health of an individual such as: access to food, income, education, physical activity, and proximity to care. This, in turn, impacts outcomes such as life expectancy and prevalence of disease. Reducing negative health outcomes has long-term, positive economic impacts. Healthcare costs related to preventable diseases, such as diabetes and obesity, could be reduced if individuals had access to resources that improve overall health. This improves the overall well-being of citizens; targeting such programs to vulnerable populations could have long term, positive impacts on community members’ health and the economy

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

Water, sanitation and hygiene interventions for acute childhood diarrhea: a systematic review to provide estimates for the lives saved tool

Background: In the Sustainable Development Goals (SDGs) era, there is growing recognition of the responsibilities of non-health sectors in improving the health of children. Interventions to improve access to clean water, sanitation facilities, and hygiene behaviours (WASH) represent key opportunities to improve child health and well-being by preventing the spread of infectious diseases and improving nutritional status.Methods: We conducted a systematic review of studies evaluating the effects of WASH interventions on childhood diarrhea in children 0–5 years old. Searches were run up to September 2016. We screened the titles and abstracts of retrieved articles, followed by screening of the full-text reports of relevant studies. We abstracted study characteristics and quantitative data, and assessed study quality. Meta-analyses were performed for similar intervention and outcome pairs.Results: Pooled analyses showed diarrhea risk reductions from the following interventions: point-of-use water filtration (pooled risk ratio (RR): 0.47, 95% confidence interval (CI): 0.36–0.62), point-of-use water disinfection (pooled RR: 0.69, 95% CI: 0.60–0.79), and hygiene education with soap provision (pooled RR: 0.73, 95% CI: 0.57–0.94). Quality ratings were low or very low for most studies, and heterogeneity was high in pooled analyses. Improvements to the water supply and water disinfection at source did not show significant effects on diarrhea risk, nor did the one eligible study examining the effect of latrine construction.Conclusions: Various WASH interventions show diarrhea risk reductions between 27% and 53% in children 0–5 years old, depending on intervention type, providing ample evidence to support the scale-up of WASH in low and middle-income countries (LMICs). Due to the overall low quality of the evidence and high heterogeneity, further research is required to accurately estimate the magnitude of the effects of these interventions in different contexts

The Importance of Pediatric Provider Awareness of Social Determinants of Health and the Impact on Health Outcomes: An Integrative Review

Social determinants of health have become a global concern over the past several years. Efforts to reduce negative health outcomes related to social determinants of health are of high priority. Awareness of this issue by providers, especially pediatric providers, must be considered to help combat this major concern. A researcher seeks through an integrative review to determine provider perspective on social determinants of health, impact of social determinants of health on outcomes, and ways of integrating social determinants into prescriptive practice. The integrative review will inform stakeholders about the importance of pediatric provider assessment of social determinants of health and the impact on health outcomes. By using nursing science and research as a foundation, this review will serve as a call to action for the healthcare community

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