Determinants of Health
- Cynthia Yuen
- Nov 30, 2022
- 2 min read
I remember there was a time when my friend Jane and I volunteered in a soup kitchen; it was Jane's first time serving meals to homeless people. We sat down for coffee after, and she was all puzzled and asked me, "why would people choose to be homeless?" and "why would they eat so much unhealthy food until they get diabetes?". I felt Jane was very ignorant and judgemental to ask such questions, but I did not know how to answer her questions then; I did not know the determinants of health could be the explanation.
The Government of Canada (2022) states that "Determinants of Health" are the broad range of personal, social, economic and environmental factors that determine individual and population health. The main determinants of health are:
Income and social status
Employment and working conditions
Education and literacy
Childhood experiences
Physical environments
Social supports and coping skills
Healthy behaviours
Access to health services
Biology and genetic endowment
Gender
Culture
Race/Racism
World Health Organization (WHO, n.d.) defines Social Determinants of Health (SDH) as the non-medical factors influencing health outcomes. Examples of SDH are early child development, unemployment and job insecurity and access to affordable health services of decent quality, etc.
What are "Health Inequalities"?
Public Health Agency of Canada. 2019. Health Inequalities in Canada.
Health inequalities refer to the differences in the health status of individuals and groups; these differences can be due to genetics or by choice (Government of Canada, 2022). For instance, someone with Type I diabetes was caused by genetics. People's health choices and behaviours can be affected by social-economic factors. For example, a patient with Type I diabetes has never received education on insulin injections or is unable to afford the insulin injections due to low income.
The next video of Making The Connections: Our city, Our Society, Our Health explains that the social determinants of health are interconnected; one determinant affects another, like a big complex web. One small positive change can trigger a ripple effect that positively impacts the community.
Wellesley Institute. 2012. Making The Connections: Our City, Our Society, Our Health.
Braveman & Gottlieb (2013) suggests that clinical providers can develop more effective treatment plan by considering social factors that influence health-related behaviour and health status. Clinical providers can also develop health-promotion strategies that reach beyond individual clinical and social services to communities, to influence living and working conditions, as these are generally the strongest determinants for many (Braveman & Gottlieb, 2013).
If I were to answer Jane's questions today, I would not only explain to her the social determinants of health; but also discuss the inequalities and positive changes to reduce the inequalities. Just like the "ripple effect" I mentioned above, I think triggering positive changes can start as small as making a dialogue.
Reference:
Alberta Health Services. 2022. Alberta Community Hub.
Braveman, P., & Gottlieb, L.(2013). The Social Determinants of Health: It's Time to Consider the Causes of the Causes. Public Health Reports.
Government of Canada. 2022. Social Determinants of Health and Health Inequalities.
Public Health Agency of Canada. 2019. Health Inequalities in Canada.
Wellesley Institute. 2012. Making The Connections: Our City, Our Society, Our Health.
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