social determinant of healthcontents.kocw.net/kocw/document/2014/chungang/hankihye/7.pdf ·...

Social Determinant of Health

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Social Determinants of Health

SDH

http://www.youtube.com/watch?v=_11xLlwKgWc



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• Poverty, social exclusion, poor housing

and poor health systems are among the

main social causes of ill health.

SDH examples

Source: WHO, Social Determinants of Health, Fact File.

http://www.who.int/features/factfiles/sdh/01_en.html


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• Differences in the quality of life within

and between countries affect how long

people live.

• A child born in Japan has a chance of

living 43 years longer than a child born

in Sierra Leone.

SDH examples

Source: World Health Report 2006 http://www.who.int/whr/2006/en/

http://www.who.int/whr/2006/en/


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• The probability of a man dying between

the ages of 15 and 60 is

8.2% in Sweden,

48.5% in the Russian Federation, and

84.5% in Lesotho.

SDH examples

Source: World Health Report 2006 http://www.who.int/whr/2006/en/



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• In Australia, there is a 20-year gap in

life expectancy between Australian

Aboriginal and Torres Strait Islander

peoples, and the Australian average.

SDH examples



http://www.humanrights.gov.au/aboriginal-and-torres-strait-islander-social-justice


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• Low- and middle-

income countries

account for 85% of

the world’s road

deaths.

• In 2002, nearly 11

million children died

before reaching their

fifth birthday – 98%

of these deaths

were in developing

countries.

SDH examples




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• Inequality in income

is increasing in

countries that

account for more

than 80% of the

world’s population.

• Few governments

have explicit policies

for tackling socially

determined health

inequalities.

SDH examples




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HTTP://SI.EASP.ES/EIS2011/WP-CONTENT/UPLOADS/2011/04/NEW-SDH-CONCEPTUAL-FRAMEWORK-

GRANADA-2011.PDF

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Social Determinant of Health

Source: Norway 2006 & WHO 2011

SDH

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Contextualizing Risk Factors

• How do people come to be exposed to

individually-based risk factors (diet,

cholesterol, lack of exercise, high blood

pressure, smoking, ect..)?

• What is it about people’s lives that shapes

their exposure to individual risk factors?

• What is the social process that leads to

exposure?

Contextualizing factors

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Pathways from Context to

Health Outcomes• Social contexts create social stratification and

assign individuals to different social positions.

• Social stratification in turn engenders differential

exposure to health-damaging conditions and

differential vulnerability, in terms of health conditions

and material resource availability.

• Social stratification likewise determines differential

consequences of ill health for more and less

advantaged groups (including economic and social

consequences, as well differential health outcomes

per se).

Contextualizing factors

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Why Do Top People Live Longer?

• “I’ve been poor, and I’ve been rich. Rich

is better.” – Sophie Tucker

• We know poverty is ‘bad for you.’

• Yet, there are large differences in health

status not just on the basis of poverty,

but across well-defined groups.

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What are ‘social determinants’?

• Expands on the concepts of poverty (income)

• Focus on basic material needs for food, clothing,

shelter, and sustainable livelihoods, physical

environments, and health systems.

• Emphasizes human development as essential to

health and hence the need for education,

supportive communities, and participatory

political structures.

• Focus on inequality and injustice in access and

distribution of material and social resources.

SDH

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Burning questions for the SDH framework

1. Where do health differences among

social groups originate, if we trace

them back to their deepest roots?

2. What pathways lead from root causes

to the stark differences in health status

observed at the population level?

SDH framework

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Question 1:

Where do health differences among social groups

originate, if we trace them back to their deepest roots?

Answer: Health inequities flow from the systematically unequal

distribution of political power, prestige and resources among

groups in society.

SDH framework

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Question 2:

What pathways lead from root causes



Intermediate Determinants• The structural determinants operate through a series of what we term

intermediary social factors, or social determinants of health in a more

restricted sense.

• Intermediary factors flow from the configuration of underlying social

stratification and, in turn, determine :– differences in exposure to health-compromising conditions;

– differences in vulnerability, in terms of health conditions and material resources available; and

– differences consequences social, economic and over health.

• Main categories of intermediary determinants of health:1. material circumstances;

2. psychosocial circumstances;

3. behavioral and/or biological factors; and

4. the health system itself as a social determinant

SDH framework

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Answer: Pathways from root causes to observed inequities in health,

operate through a set of what we call intermediary determinants of health

and unequal distribution of them (through differential exposure and

vulnerability) that shape health outcomes.

SDH frameworkQuestion 2:

What pathways lead from root causes



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http://www.who.int/social_determinants/final_report/csdh_finalreport_200

8_execsumm.pdf

Commission on Social Determinants of Health. (2008).

Closing the gap in a generation. Geneva: WHO.

http://www.who.int/social_determinants/final_report/csdh_finalreport_2008_execsumm.pdf

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Gender Equity

Commission on Social Determinants of health FINAL REPORT, page 23

Closing the Gap in a Generation

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Education



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Fair Employment and Decent Work



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Fair Employment and Decent Work



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Universal Health Care



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Equity from the start



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Health Equity in All Policies, Systems,

and Programmes



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Questions

Comments

Thoughts

Suggestions

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Discussion Questions

1. Define the Social Determinants of

Health.

2. Describe one health inequity in Korea,

along with social determinants of health

which are related to the health inequity

issue.

Discussion Questions

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