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Week 2 – Discussion 1
• Based on assigned readings and videos, we will expand on our discussion from last week where we examined the wealth/health gradient and social policy. This week our focus will be on the determinants of health.
• 1. Discuss economic, political, and social structures as determinants of
health. Each of these concepts should be addressed in your response
Social determinants of health are social factors such as the physical conditions where the person is born, lives, works and plays in and their age and where they work at. Examples of this are how safe the area is, how many resources that they have in their community, employment opportunities, quality of their schools and their transportation options. Another example would be that someone lives in a town that has poor air quality and this may put them more at risk to develop asthma.
Political structures as determinants of health could include policy making at the state and federal levels of government. An example of one such policy would be to increase taxes on alcohol and cigarettes, and this may decrease the amount of people who will smoke cigarettes and drink alcohol. Another policy that has been made a huge impact on health has been making it illegal to ride or drive in a care without a seat belt on which has reduced injuries and deaths from car accidents.
Economic structures of determinants of health could include if the patient does not make an adequate income or have access to adequate health insurance, healthy foods, or the means to exercise. If the patient does not have health insurance they are going to have delays in getting the proper care that they need, they would have no access to preventative care such as wellness visits and labs, and would have unnecessary hospitalizations due to this.
Reference:
Healthy People.gov (2020). Determinants of Health. Office of Disease Prevention and Health Promotion. Determinants of Health | Healthy People 2020
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The social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks (Healthy People 2030, ND). Economic structures which affect the SDOH include unemployment, lack of high-quality childcare, and lack of education. Often even people with steady employment do not earn enough to afford to live in better neighborhoods or buy healthier foods. Social structures are also identified in Healthy People 2030 (ND). Having positive relationships with family, friends, and community can improve a person’s health and well-being. Stress and discrimination are just two social structures that decrease a person’s health. Underpinning all the social determinants of health is politics and policy initiatives. As a country we put an emphasis on individual responsibility, but we need to acknowledge all policies impact health care. Where new development happens, taxes, the Affordable Healthcare Act, infrastructure, and climate change are just a few examples of how politics influences the SDOH. It is important that health professionals be educated about governance, lobbying, and policymaking (Mishori, 2019). Caring for our patients, communities, and populations must include thinking outside of the walls of our practice site.
References
Mishori, R. (2019). The social determinants of health? Time to focus on the political determinants of health! Medical Care 57(7). 491-493. doi:10.1097/MLR.0000000000001131
Office of Disease Prevention and Health Promotion (ND) Social Determinants of Health. https://health.gov/healthypeople/objectives-and-data/social-determinants-health