The list of social determinants varies among authors. The list provided here is one being utilized throughout Washington state in the public health sector. As work takes place on the social determinants, consideration for the way “isms” have given many unfavorable experiences is crucial. Discrimination and biases toward different groups can have a profound impact on their quality of life. For example, single women with children sometimes have difficulty renting a house or apartment.
SOCIAL DETERMINANTS OF HEALTH DEFINITIONSHealth Equity (Health Inequity): Health equity concerns those differences in population health that can be traced to unequal economic and social conditions and are systemic and avoidable – and thus inherently unjust and unfair. (source: Unnatural Causes)
Health equity is the concept that all people have an equal right to the conditions and resources that assure optimal health and safety. Poor health is not confined to those worst off. At all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health. Where systematic differences in health are judged to be avoidable by reasonable action, they are unfair. The interchangeable use of the terms “health disparities” and “health inequities” seems to be a source of confusion. They both can mean differences in the health of populations, but more consistently the term “health equity” encompasses the concept that the differences are unjust and unfair and traces the source of the differences in health being due to differences in socioeconomic circumstances.
Health Disparity: Differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups. (source: National Institute of Health)
Health disparities exist among racial and ethnic minorities, residents of rural areas, women, children, the elderly, persons with disabilities, etc. Because health disparities are comparative in nature, they do not take into account social gradients in health. Also, health disparities don’t necessarily imply the disparities are unjust.
Social Determinants of Health: Factors (i.e., determinants) in our social and economic environment that research has found to negatively (or positively) affect health.
Research shows the remarkable sensitivity of humans to these socioeconomic factors. Traditional medical and public health practice have not significantly ventured into these realms. The poor health of groups within society, the social gradient in health, and the marked health inequities between countries are caused by the unequal distribution of power, income, goods, and services, the consequent unfairness in the immediate, visible circumstances of people’s lives–i.e., access to health care, schools, and education, their conditions of work and leisure, their homes communities–and the chances of leading a flourishing life. Together, the structural determinants and conditions of daily life constitute the social determinants of health and are responsible for a major part of health inequities.
The following is an example of a list of the social determinants of health:
Factors that contribute to health equity
Access to healthy food
Access to safe, affordable, housing for all people
Supportive neighborhoods
Access to safe, clean, and quality indoors or outdoors, such as parks, trees, and playgrounds
Early childhood development services and community supports
Job training and jobs that provide all residents a livable income
Community economic development that supports local homes, businesses, buildings and land
Public safety that includes fire, police, emergency medical services, and code enforcement
Law and justice system that provides equitable access and fair treatment for each person
Transportation that provides everyone with safe, efficient, affordable, convenient, and reliable transportation
Health and human services that are high quality, affordable, and culturally appropriate
Organizations routinely assess and eliminate all forms of intentional or unintentional policies or practices that have negative impacts related to race, gender, ethnicity, people with low income, people with disabilities, national origin, sexual orientation or gender identity
Other (describe)
Full Department of Health example list WA State Department of Health, Office of Health Communities. Jan. 2014.
Social Gradient: Reflects an individual or population group position in society and different access to, and security of, resources such as education, employment and housing, as well as different levels of participation in civic society and control over life.
The higher the social position, the better the health. Life expectancy is shorter and most diseases are more common the further down the social ladder you are. Both material and psychological causes contribute to these differences and their effects extend to most diseases and causes of death.
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