Determinants of Health

Social determinants of Health is one of the most important topics that is discussed in the field of public health. Currently, there are 14 SDHs that are defined within the Canadian health system.(Canada Public Health Association, 2022) These includes:

• Income and Income Distribution

• Education

• Unemployment and Job Security

• Employment and Working Conditions

• Early Childhood Development

• Food Insecurity

• Housing

• Social Exclusion

• Social Safety Network

• Health Services

• Aboriginal Status

• Gender

• Race

• Disability

These determinants provide great insights by dissecting health, an extremely complex subject, into many components that are often hidden or undiscovered in the lens of clinical medicine. More than just genetic determinants that are responsible for diseases, societal factors play a great role in one's vulnerability to certain illnesses.

Social determinants of health such as employment status, occupation, education, housing, and household income not only affect people’s health and health experiences but also their access to healthcare, outcomes of care, and engagement with health protection activities. (Moscrop A, 2020) .

Multiple epidemiological evidence have indicated how each SDHs lead to poorer health outcome. Social determinant of health is like a domino, when one determinant is affected, they eventually all become affected in a sequential manner.

Aboriginal status play a great role as first nations and other indigoes groups tend to over-represent in poorer health outcomes across different diseases.

Canadian indigenous population have been victim of past colonial history where loss of connectivity to land has become one of the most influential factor that prevent them to holistic health.

Indigenous individual has a greater chance to be in a foster care, where a poor childhood exposure occurred and affected not only mental but physical and emotion aspects. Eventually, this individual would have received poor educational and dropped out of school, which category him/her in low social class. With poor housing condition and social network, lack of support system might lead to mental illnesses and substance abuse, that leads to social exclusion, poor food security and virtually no access to health services. Finally, this person is most likely to suffer from substance abuse and a wide range of mental and chronic disorders. This example has illustrate how each of the determinants are strongly inter-related and affect each other in a great manner.

It is evident that population who belongs to low income class, poorer educational level, unemployed with poor early childhood tend to develop poorer health outcome. (Mikkonen, J., 2022). Women are exposed to higher domestic violence but men are more likely to be a victim of violence. People who live in poor neighbourhood with lack of access to health services tend to reflect poorer health outcomes. (Bryant T. 2011)

Nevertheless, social determinants of health is an important topic in pioneering future health policy in high risk and vulnerable groups. By getting insight in the determinants, we will be able to shift the over reliance on clinical medicine to social medicine which will be getting better in explaining many degenerative health phenomena that are yet to happen.

Reference

Canada Public Health Association (2022). What are the social determinants of health? Retrieved from https://www.cpha.ca/what-are-social-determinants-health

Moscrop A., Ziebland S., Bloch G., Iraola J R., (2020). If social determinants of health are so important, shouldn’t we ask patients about them? BMJ 2020; 371 :m4150 doi:10.1136/bmj.m4150

Mikkonen, J., Social determinants of health, (2022). Canadian Electronic Library. Retrieved from https://policycommons.net/artifacts/1204147/social-determinants-of-health/1757256/ on 15 Jun 2022. CID: 20.500.12592/mm0nz9.

Raphael, D. (2006). Social Determinants of Health: Present Status, Unanswered Questions, and Future Directions. International Journal of Health Services, 36(4), 651–677. https://doi.org/10.2190/3MW4-1EK3-DGRQ-2CRF

Gore, D., Kothari, A. (2012). Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis. Int J Equity Health11, 41. https://doi.org/10.1186/1475-9276-11-41

Bryant T., Raphael D., Schrecker T., Labonte. R. (2011)

Canada: A land of missed opportunity for addressing the social determinants of health,

Health Policy, Volume 101, Issue 1, Pages 44-58, ISSN 0168-8510,

https://doi.org/10.1016/j.healthpol.2010.08.022