Professional Documents
Culture Documents
Determinants of
Health
Goal 3
Promote healthy lives and wellbeing at all ages for all
10 – Equity
17 – Means of implementation
list of social determinants of health.
• Initial list: nutrition, education, employment, living environment
• Some dominant in the literature: education , housing and or living environment, income and its
distribution , stress, early life, social exclusion, work, unemployment, social support, addiction, food,
transport.
• Recent additions: health system, gender, sexual orientation, social safety net, culture or social norms ,
media, stigma and discrimination, social capital, conflict, rule of law, racism, racialized legal status ,
immigration , family, religion , colonialism, and marginalization
• NEW: “time” as a social determinant of health, as healthy behavior, accessing health services, resting,
and caring all require time. The amount of time one can use for health-related activates is socially
patterned and could therefore be a source of health inequalities.
• economic sanctions as a social determinant of health.
• access to broadband internet service .
• Social determinants of specific conditions are Ex depression, contraceptive use, and oral health.
Social determinants
• Social determinants of health are conditions or circumstances in which people are born,
grow, live, work, and age (WHO).
• The quality, quantity, and distribution of these resources with equity and equality (ex:
education, a healthy living environment, nutrition, healthcare and employment),
determine citizen's health and well-being.
• These conditions are shaped by political, social, and economic forces .
• Poor policies and programmes, unfair economic arrangements and bad governance may
lead to unfavorable conditions.
WHAT are structural determinants of health?
• Determinants of health which are responsible for major part of health inequalities between and
within countries.
• Determinants of health which are responsible for major part of health inequalities between and
within countries.
• Structural Determinants are the ‘root causes’ of health inequities, because they shape
the quality of the Social Determinants of Health experienced by people in their
neighbourhoods and communities.
• Structural determinants include the governing process, economic and social policies
that affect pay, working conditions, housing, and education.
• The structural determinants affect whether the resources necessary for health are
distributed equally in society, or whether they are unjustly distributed according to race,
gender, social class, geography, sexual identity, or other socially defined group of people.
SOCIAL
FORCES
POLICIES
GOVERN
PUBLIC
ANCE
and
Adopted by Dr
Neelamani
Determinants
environmental External
determinants that
environment (e.g.,
influence of
parents/friends),
Tertiary:
Headman, elders,
religious leaders...
Meso Level:
Service delivery
organisations
11/25/2013 36
Equity Vs Equality
Administrators
role
• Continually increasing the understanding of
the professionals of the role of the health
• Helping identify unseen determinants
(Factors)
• Selecting factors to address
• Suggesting interventions
• Encouraging appropriate assessment of
results
• Sharing knowledge and providing feedback
throughout
Working with
determinants
• Identifying determinants
• Analyzing determinants
• Selecting factors to address
• Measuring change
• Modifying on the basis of
ongoing findings
Referance
• Last JM, editor. Dictionary of epidemiology. 4th
ed. New York: Oxford University Press; 2001. p.
61.
• Cates W. Epidemiology: Applying principles to
clinical practice. Contemp Ob/Gyn 1982;20:147–
61.
• Greenwood M.Epidemics and crowd-diseases:
an introduction to the study of epidemiology,
Oxford University Press; 1935.