Intro to Social and Physical Determinants of Health:
What is Health?:
Health is the state of complete physical, social, and mental well being and not simply an absence of
disease or infirmity. Social well being likely involves social cohesion and inclusion, a sense of belonging,
and connection.
Illness is caused largely by social status and circumstances more so than biology. 50% of health is
determined by social determinants such as income, race, gender, and minority status.
Determinants of Health, an Interconnected Web:
“Genetics loads the gun and environment pulls the trigger” The pressures individuals are put under play
roles in how health variables affect them. Health is determined by several factors including:
- Social and economic environment
- Physical environment
- Biology and Behavior
Levels of Health determinants:
Individual:
Biological or genetic; age; parity; birth order; education; employment; decision-making; marital status
Household:
The social and economic status of the household within the community; the household’s access to
resources.
Community:
Level of development
National:
Size of country; population; type of governance; structure of health system; dependence on global
market; nature of health policies
International:
Global economic scenario and dominant economic ideologies; balance of power between various geo-
political forces; health sector reform; international human rights regime.
SD’s have complex relationships with one another and can compound to impact health positively or
negatively.
Intro to Research Methods:
Experts’ opinions are no longer sufficient. Evidence is now the gold standard and research should be
done properly and without bias.
CORRELATION DOES NOT EQUAL CAUSATION
, Causation is defined as:
1. a strong association to rule out other factors
2. Must be demonstrated repeatedly
3. The cause should occur before the effect
4. Increased exposure should increase the magnitude of effect
5. Must be plausible
6. Must not contradict other knowledge
7. Is verifiable by experiment
Interventions to Improve Health:
There are two main types of intervention:
- Downstream: Treats diseases after they have manifested (hospitals)
- Upstream: Addresses the root issue to prevent future disease (welfare)
Healthy Individuals vs Healthy Populations:
Interventions have different levels of benefit at the individual and population levels. This means that
different interventions are needed depending on the size of those who need it.
Societal factors play a huge impact on individuals health. An individual’s risk of illness cannot be
considered in isolation from the disease risk of the population they belong to.
Health-related behaviors arise from individual choices and societal norms. (Ex. Poor people often have
multiple SES disadvantages and engage in riskier behavior)
Socio-Economic Status as a Determinant of Health:
What is Socio-Economic Status?
SES is a ranking of a person’s position within society. This can be determined by geography or other
groupings, including gender or occupation.
SES is a relative measure as there is no number that indicates SES. Instead, it is a ranking that compares
one individual or group to another. Absolute measures such as income have numbers attached to them
that definitively put one individual above or below others.
Measures of SES:
Income:
Income is often measured as a yearly salary. Because of this, it often doesn’t include measures such as
government funding or social programs that are essential to determining SES.
Household Income:
The combined income of those living in one grouping (usually a family unit)
Education:
What is Health?:
Health is the state of complete physical, social, and mental well being and not simply an absence of
disease or infirmity. Social well being likely involves social cohesion and inclusion, a sense of belonging,
and connection.
Illness is caused largely by social status and circumstances more so than biology. 50% of health is
determined by social determinants such as income, race, gender, and minority status.
Determinants of Health, an Interconnected Web:
“Genetics loads the gun and environment pulls the trigger” The pressures individuals are put under play
roles in how health variables affect them. Health is determined by several factors including:
- Social and economic environment
- Physical environment
- Biology and Behavior
Levels of Health determinants:
Individual:
Biological or genetic; age; parity; birth order; education; employment; decision-making; marital status
Household:
The social and economic status of the household within the community; the household’s access to
resources.
Community:
Level of development
National:
Size of country; population; type of governance; structure of health system; dependence on global
market; nature of health policies
International:
Global economic scenario and dominant economic ideologies; balance of power between various geo-
political forces; health sector reform; international human rights regime.
SD’s have complex relationships with one another and can compound to impact health positively or
negatively.
Intro to Research Methods:
Experts’ opinions are no longer sufficient. Evidence is now the gold standard and research should be
done properly and without bias.
CORRELATION DOES NOT EQUAL CAUSATION
, Causation is defined as:
1. a strong association to rule out other factors
2. Must be demonstrated repeatedly
3. The cause should occur before the effect
4. Increased exposure should increase the magnitude of effect
5. Must be plausible
6. Must not contradict other knowledge
7. Is verifiable by experiment
Interventions to Improve Health:
There are two main types of intervention:
- Downstream: Treats diseases after they have manifested (hospitals)
- Upstream: Addresses the root issue to prevent future disease (welfare)
Healthy Individuals vs Healthy Populations:
Interventions have different levels of benefit at the individual and population levels. This means that
different interventions are needed depending on the size of those who need it.
Societal factors play a huge impact on individuals health. An individual’s risk of illness cannot be
considered in isolation from the disease risk of the population they belong to.
Health-related behaviors arise from individual choices and societal norms. (Ex. Poor people often have
multiple SES disadvantages and engage in riskier behavior)
Socio-Economic Status as a Determinant of Health:
What is Socio-Economic Status?
SES is a ranking of a person’s position within society. This can be determined by geography or other
groupings, including gender or occupation.
SES is a relative measure as there is no number that indicates SES. Instead, it is a ranking that compares
one individual or group to another. Absolute measures such as income have numbers attached to them
that definitively put one individual above or below others.
Measures of SES:
Income:
Income is often measured as a yearly salary. Because of this, it often doesn’t include measures such as
government funding or social programs that are essential to determining SES.
Household Income:
The combined income of those living in one grouping (usually a family unit)
Education:
