Professionalism and social justice: the next step?
Jill Thistlethwaite, John Spencer in Professionalism in Medicine, 2018
It is impossible for all human beings to be equally healthy. Genetic conditions, chronic disease and accidents mitigate against this at the present time. However, a condition of equity is that patients in similar circumstances are treated in similar ways. Is it possible to treat all people equally within a health service? It certainly does not seem possible within most societies. The research literature shows that the richer one is, the longer and healthier one’s life is. The Black Report demonstrated this a quarter of a century ago.6 This is not just a question of access to a doctor or other health professional, the number of doctors being trained, the distance to secondary care facilities or the availability of state-of-the-art medical equipment. The main determinants of health are gender, culture, genetic make-up and social determinants, such as education, social organisation, income, diet and the environment.7 Of course some of these are not amenable to manipulation. However, the social determinants of health affect morbidity and mortality across the spectrum of disease (both acute and chronic), and these social determinants are largely related to wealth. Quality of and access to education depend on government policies. How may health professionals influence this? The American philosopher Norman Daniels has proposed four conditions which, once achieved, will help to eliminate injustices in health outcomes (seeBox 12.2).8
Public Health and Viruses
Patricia G. Melloy in Viruses and Society, 2023
Social determinants of health include all the factors in a person’s environment that can affect his or her health. These factors include economic status, occupation, educational background, housing situation, access to healthcare providers and facilities, and other aspects of community such as support from friends and family (ODPHP 2022). The Office of Disease Prevention and Health Promotion, a part of the Department of Health and Human Services in the U.S. government, has launched the Healthy People 2030 initiative to reduce health disparities arising from differences in social environment. For example, disparities in access to healthy foods, good healthcare providers, clean water and air, and other factors can contribute to different health outcomes (ODPHP 2022). People of color are more likely to experience health inequities linked to differences in these social determinants (CDC 2022f).
An Interdisciplinary View of Health
Deborah Fish Ragin in Health Psychology, 2017
A second critique suggests that the model overlooks environmental factors known to influence well-being. Part of the problem here may be the definition of environmental. For some, social environmental variables such as family, community, and culture represent environmental determinants of health. For others, however, they do not. For example, some researchers who study the effects of environments on health focus on air and water quality, toxic waste sites, or other pollutants as the principal physical environmental determinants of health status. Indeed, many would agree that poor air quality can cause breathing and other respiratory problems that may result in adverse health outcomes (see Chapter 4, Theories and Models of Health Behavior Change). The point here is that for many researchers, environmental determinants of health refer to the physical not social environment, and the biopsychosocial model does not address physical environmental determinants.
Supernatural beliefs, religious affiliations, and HIV testing among recently arrived Asian-born men who have sex with men in Australia
Published in AIDS Care, 2023
Stephen W. Pan, Christopher K. Fairley, Eric P.F. Chow, Ying Zhang, Warittha Tieosapjaroen, David Lee, Jason J. Ong
Recent empirical research with MSM in East Asia suggests that belief in supernatural determinants of health are associated with poor uptake of healthcare services, including HIV testing (Pan, Carpiano, et al., 2020; Pan, Smith, et al., 2020). (Determinants of health can be characterized as factors and circumstances that influence individual health outcomes and the health of populations (World Health Organization, 2017)). There are several mechanisms by which belief in supernatural determinants of health can directly impact HIV testing. First, belief in supernatural determinants of health implies that health status is partially influenced by an external locus of control that transcends laws of the natural world, which can undermine motivation to test for HIV if individuals question their self-efficacy in influencing their future health outcomes (Straughan & Seow, 1998). Second, individuals who believe in supernatural determinants of health may initially seek out supernaturally mediated health interventions over biomedical interventions. Prayer and appeals to supernatural forces to intervene on behalf of one’s health is common throughout many parts of Asia (Anwar et al., 2012; Arthur, 2019; Widayanti et al., 2020), and may delay HIV testing.
Developing a Canadian framework for social determinants of health and well-being among children with neurodisabilities and their families: an ecosocial perspective
Published in Disability and Rehabilitation, 2021
Angela M. Filipe, Aline Bogossian, Rosslynn Zulla, David Nicholas, Lucyna M. Lach
Social determinants of health is a conceptual framework that has typically been used to better understand factors that influence the presence/absence of disease and health conditions in the general population. Children and youth who have a neurodisability associated with diagnoses such as autism spectrum disorder, cerebral palsy, or global developmental delay, already have a “health condition.” Therefore, one way of thinking about how social determinants of health applies to this population is to consider it from a “causes of ill-health” perspective, where consideration is given to the correlation of social factors, such as poverty, with rates of neurodisability [1]. Alternatively, a “consequences of ill-health” perspective would have us examine how neurodisabilities may be considered as a determinant of other physical health conditions such as obesity or oral health issues [2].
Prevalence and treatment of neurological and psychiatric disorders among tertiary hospitals in Pakistan; findings and implications
Published in Hospital Practice, 2020
Tanveer Ahmed Khan, Shahzad Hussain, Aamer Ikram, Sidra Mahmood, Humayun Riaz, Ayesha Jamil, Amina Amin, Yaseen Ghulam Haider, Marva Sandhu, Atifa Mushtaq, Corrado Barbui, Chris F. Johnson, Brian Godman
We are aware that many factors that combine together to affect the health of individuals and communities. The determinants of health include social, economic, and physical environments as well as people’s individual characteristics and behaviors [52]. We are also aware that marital relationship is also an important component of family and social support, and failure to reach or maintain a marriage can go against social norms and expectations in a number of countries including Pakistan, which may influence the extent of especially psychological conditions [53–55]. Consequently, we considered the income status, family history including patients’ stress conditions, and marital status of patients in our study. We also included family history because conditions including ADHD, Alzheimer’s disease, epilepsy, Parkinson’s Disease and OCD may run in families [56]. We also looked further at smoking habits [57,58], alcoholic intake [46,47], and drug misusers [47,59], in view of their potential impact on neurological and psychiatric disorders.
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