Patient as storyteller: Determinants of health
Anna-leila Williams in Integrating Health Humanities, Social Science, and Clinical Care, 2018
According to the World Health Organization (n.d.), The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels.Social determinants of health are equivalent to the Healthy People 2020 category, Social and Physical Environment. Social factors, like family, culture and religion, neighbors, and the larger community, affect a person’s health by encouraging or deterring social engagement and one’s sense of security and safety. In addition, these factors determine one’s susceptibility to the consequences of discrimination and racism. Factors from the physical environment similarly entwine with health. One’s physical environment most directly correlates with economic status. The higher one’s income, the more likely one is to live in a home free of environmental toxins, and in a neighborhood free of crime and violence. In the United States, neighborhood dictates access to public education, public transportation, variety and quality of food, and response times of public safety and emergency personnel. In addition, the physical environment affects quality of life by encouraging socialization and physical activity by the presence of streetlights, sidewalks, bike lanes, parks and ball fields, community centers, libraries, trash pick-up, and adaptations for people with disabilities (Center for Disease Control and Prevention, 2018).
Population Health and Systems of Neurological Care
Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw in Hankey's Clinical Neurology, 2020
Social determinants of health may be defined as the social conditions that we are born and live in, interact with, and work in. Such factors include, but are not limited to, education, income, employment, working conditions, race/ethnicity, and access to health care and social support, and they are believed to be the single most important determinant of one's health. Social determinants of health, however, may be impacted by allocation of financial resources (e.g. spending on social programs). In addition, the following key health indicators are predicted by where one lives (e.g. region, state, zip code): Life expectancyHealthy life expectancyMortality ratesYears of life lost due to premature mortality
Health Equity and Women's Health in Underserved Communities
Michelle Tollefson, Nancy Eriksen, Neha Pathak in Improving Women's Health Across the Lifespan, 2021
The social determinants of health (SDOH) are defined by the Centers for Disease Control and Prevention (CDC) as “the conditions in the places where people live, learn, work, and play.” Examples of the social determinants of health include food insecurity, access to safe and affordable housing, issues with transportation, educational attainment, environmental exposures (including air pollution and exposure to lead, among others), employment, and access to greenspace.3 Yet societal perceptions of minority communities experiencing unmet social needs are, ironically, shaped by the very political structures which created them. SDOH are the result of systemic racism and years of unjust policies that adversely affect racial and ethnic minority communities.4
Upstreaming occupational therapy: reflections on sustaining contextual relevance in a globalising world
Published in World Federation of Occupational Therapists Bulletin, 2021
Madeleine Duncan, Kit Sinclair, Jennifer Creek
In this paper, we propose that occupational therapy is facing a paradigm crisis precipitated by rapid global social change and that upstreaming occupational therapy is a potentially effective strategy for ensuring a socially responsive profession that strives to serve the occupational needs of local populations. We recommend two actions that may be taken towards advancing appropriate responses by the profession to the current paradigm crisis. The first action addresses 15 dimensions of occupational therapy that require continuous adjustments to promote contextual relevance. The second action points back to the basics of the profession’s ontology, epistemology, axiology and methodology, with recommendations for future actions aligned to the needs of people affected by a world in perpetual flux. We argue for extending the role of the profession beyond ill, diseased or disordered individuals towards building socially inclusive communities, with a particular focus on mitigating the social determinants of health that impact human occupation. Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning and quality of life outcomes (Bloom et al., 2018).
Defining a framework for medical teachers’ competencies to teach ethnic and cultural diversity: Results of a European Delphi study
Published in Medical Teacher, 2019
Rowan Hordijk, Kristin Hendrickx, Katja Lanting, Anne MacFarlane, Maaike Muntinga, Jeanine Suurmond
We also found that the teaching of specific knowledge about ethnic and social determinants of health was seen as essential. The social determinants of health are the circumstances under which people live that affect their health and life chances. Factors related to health outcomes are, for example, educational attainment, occupational status, income status, access to health care services and discrimination. This competence describes that medical teachers should have knowledge about social and ethnic determinants of health for the most common and/or most vulnerable groups in the community or society. Martinez and colleagues have provided 12 tips to teach social determinants of health in medical schools (Martinez et al. 2015). They provide medical teachers with concrete examples of how to teach social determinants of health, but also stress the importance of teaching students self-reflection and awareness about e.g. their own cultural background and the ability to recognize their stereotypes and unconscious biases.
Health assessment and the capability approach
Published in Global Bioethics, 2019
Rodrigo López Barreda, Joelle Robertson-Preidler, Paula Bedregal García
Health status depends on personal factors, such as individual predisposition and lifestyle, health care, and the social determinants of health, or “the conditions in which people live their daily lives and the structural influence on these conditions that ultimately reflect the distribution of power and resources” (World Health Organization, 2012, p. 9). Among the most commonly cited social determinants of health are structural determinants, such as political institutions, and intermediate determinants, such as income, educational level, housing, neighbourhood, and working conditions (World Health Organization, 2012). These determinants have been organized in many different models, aiming at identifying links between social determinants and health inequalities (Borrel, Malmusi, & Muntaner, 2017). These models range from linear in shape (Mosley & Chen, 1984) to more organic and complex in structure (House & Williams, 2003; Kim & Saada, 2013), including those taking into account geographical and temporal variables (Marmot, 2010). The similarities between the concepts of the social determinants of health and the aforementioned social and environmental conversion factors lead to the idea that through the analysis of the social determinants of health is possible to assess health as a capability (Hall, Taylor, & Barnes, 2013).
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