Social Determinants of Health (SDH): How to Reduce Health Inequalities

Social Determinants of Health (SDH):  How to Reduce Health Inequalities.

Social Determinants of Health or SDH can be defined as a set of conditions, systems, and policies in which we are born, nurture, grow, play, learn, work, earn, live, age, and die. 

The broader sets of conditions, drives, systems, and policies create the conditions of our daily lives and create inequalities in health status.

These include financial policies and systems, political systems, social norms and policies, and other environmental conditions.

Social Determinants of Health.
Image source-Wikipedia.

Our health is influenced by the conditions of both internal and external environmental forces. It is time to be aware of those Social Determinants seriously. 

All responsible people should take part to create a healthy environment, for minimizing the inequalities of health distribution.  

1. Concept of Social Health

👉Some people understand health as a happy physical posture, while others think health means the absence of any major disease.

  

👉In reality, health refers to overall well-being, which includes physical, mental, and social health. It is important to understand the concept of social health.

👉Social health begins with our home, our family members, and the internal environment of the home. Social health is determined by the external environment.

👉We often say health is wealth, but do not realize how worthy is our health. We never thought about the social and economic value of an individual's health. The main source

 of any society's wealth are human resources- the quality people- people with good health.

👉Good health depends on some key factors, such as a well-balanced diet, regular exercise, adequate sleep, and a healthy state of mind. A healthy state of mind is dependent substantially on social norms and conditions. The above factors are the primary determinants of health and wellbeing.

👉Our present and future status of health depend, to a great extent, on the socio-economic environments in which we exist. These environmental conditions and forces determine people's health by influencing their lifestyles in a variety of ways.

2. Example of  Social Determinants

👉Social Determinants are factors that have significant impacts on our lives. The socio-economic conditions and availability of resources to enhance the quality of human life can have a substantial influence on health.

👉These resources include availability, quality, safety, protection, affordability, and accessibility of certain important things, including essential and luxurious, physical, and non-physical stuff.

👉Social Determinants of health can influence the health of any individual, group, or community, either in positive ways or negative ways. Some examples of the SDH are listed below for a better understanding.

• Earning opportunity and protection, social security
• Food security, availability, and quality
• Residential security, the quality of housing
• Clothing and garments, the trend of fashion, availability, affordability
• Transportation/traveling
• Education and training
• Employment and job opportunity
• Health care services
• Recreation and entertainment
• Public Safety
• Social  Norms,
• Language/literacy
• Social media
• Political environment
• Government policies
• Community resources
• Technological development
• Globalization
• Gender inequality, Racism, Caste discrimination.

The list is very long, let it ends here.

3. Reasons for Health Disparities/Inequalities

The primary reasons for health disparities that can be expanded further are mentioned below:

• Community's health awareness
• Health-promoting policies of the government
• Health services
• Availability of resources to lead a healthy life
• Distribution of income & wealth
• Political ideologies.

The distributions of social determinants are sometimes formed by public policies that reflect the dominant political ideologies of the specific region /area.

According to The World Health Organization, "This unequal distribution of health-damaging experiences is not in any sense a 'natural' phenomenon but is the result of a toxic combination of poor social policies, unfair economic arrangements [where the already well-off and healthy become even richer and the poor who are already more likely to be ill become even poorer], and bad politics."

4. Available Mechanism to Understand How Social Determinants Affect Health

Two Fundamental mechanisms for understanding how social determinants influence health are -

• analysis of cultural practices and behavioral choices. 
• analysis of material conditions of human life.

4.1. Through analysis of cultural practices and behavioral choices

👉We often notice that people get sick due to poor diet, smoking, consumption of alcohol, etc. 

In this method, people's behavioral preferences and cultural characteristics are thought to be 

responsible for the development of various diseases.

👉But behavioral preferences are determined by the material condition of the individual or group of people. In most cases, behavioral preferences are the outcomes of internal and external environmental conditions.

4.2. Through the analysis of human material life

👉This system emphasizes the condition of human material life. These conditions include the availability of resources for access to life benefits, working conditions and sources of income, and the quality of food and accommodation available among others.

👉When a person is sick due to malnutrition, the behavioral analysis will explain that the wrong eating habits of that person are responsible for the sickness.

 

👉But if we analyze material life, it may be revealed that he cannot afford to buy nutritious food due to his limited income. So in this case income is his social determinant.

👉However, it is possible to know the extent of the effect of social determinants on health only by analyzing the first method and then verifying by the second mechanism.

👉Why people smoke, drink alcohol, adopt a weak diet and, reduces physical movement, sleeps late at night, and woke up late? These all are influenced by the environment.

👉The reason for late-night sleep, tobacco use, excessive alcohol intake, consumption of diet dense with carbohydrate & fat, etc is to deal with challenging conditions.

5. Latest Mechanism to Analyze How Social Determinants Influence Health

Three frameworks are available to explain how social determinants influence health. These frameworks through which you can analyze the influence of social determinants on health are described below.

• materialist approach.
• neo-materialist approach. 
• psychosocial comparison. approach  

(A) The materialist approach

The materialist outlook demonstrates how living conditions and the SDH that compose these living conditions or situations can shape your health.

 

Material conditions of life determine health by affecting the essence of individual evolution, interaction with family members, and neighborhood surroundings.

The materialist approach attempts to understand how these social determinants happen.

(B) The neo-materialist approach

👉The advancement of the materialist perspective is that it asks, analyzes, and explains how these living conditions transpire. 

👉The neo-materialist approach emphasizes how economic and other resources are distributed among the population of the nation that can vary widely from area to are, 

region to region, and country to country. 

👉The neo-materialist view focuses on both the social determinants of health and the 

societal factors responsible for the distribution of these social determinants.

(C) The psychosocial comparison approach

👉Psychosocial comparison analysis considers whether you compare yourself to others, 

and how these comparisons influence your health.

👉The social comparison approach aims attention to the psychosocial effects of public policies, that undermine the social determinants of health

 

👉The social comparison approach thinks that the social determinants of health play their role through citizens' interpretations of their positions in the social regime.

6. Final Words

The socio-economic conditions of a nation determine the health of its population. 

That's a powerful indicator of the wealth of that nation. 

Social Determinants of Health is one of the most challenging issues of most countries in the world, including developed countries.

The massive participation of citizens to create health awareness is essential. An effective policy framework from the Government is needed to minimize the negative impact of social determinants of health as well as health inequalities.

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