Understanding perspectives of health, wellbeing and resilience 2.1.2
Social and economic determinants
Personal characteristics: Sex, age, ethnic group, hereditary groups
Sickle cell
Life expectancy
Spain: men- 80.3 yrs women- 86.2 yrs
Poland: men- 71.7 yrs women- 79.7 yrs
UK: men- 79 yrs women- 83 yrs
Health conditions - susceptible to as 17 age
Myself: welsh-female-17 -89yrs
Substance abuse
STI
Car crashes
Ethnic groups its common in: African descents
Group of inherited red blood cell disorders
Health inequalities
1991-2011 - pakistani and bangladeshi women morality 10% higher than white women
2011- white gypsy/ irish traveller groups, mixed black caribbean and black caribbean men, white irish men all higher rates of long term illness than white males
Long term illnesses - men 65 69% of white gypsyand irish traveller men
69% P men and 64% B men compared with 50% of white men
Minority ethnic groups display higher levels of poor health
Hereditary health conditions
Coronary artery disease: hearts blood supply is blocked with a build up of fatty substances in coronary artery
High blood pressure: systolic pressure - higher number which the heart pumps blood around the body
Diastolic pressure - lower number which the resistance to the blood flow in the blood vessels between heartbeats when blood is pumped around your heart (mmHg)
HBP: 140/90 mmHg - pharmacy and gp: 135/85 mmHg when at home
over 80: 150/90mmHg : 145/85 mmHg
Lifestyle factors
lifestyle behaviours that are embedded in life
- diet - smoking - alcohol use - substance abuse - exercise
popcorn, crisps and sweets in front of the television on a Saturday
a roast dinner on a Sunday
a walk with the people you live with on the weekend
swimming once a week
visiting the local park most days
your grandparents coming to your home for dinner every month
an annual family gathering where everyone brings one dish of food
a social gathering involving food after prayers at your place of worship
a cycle ride with friends on the weekend.
Potential social and economic challenges
Economic challenges
Social challenges
Diet (eating well): fruit and vegetables can be expensive
Activity/ exercise: gym, pool and cycling unaffordable
Alcohol: some alcohol is still relatively cheap in the UK - stress is linked to drinking high amouns
Substance misuse: financial costs may lead to inability to buy enough to eat or pay bills
Smoking: limited income is used to pay for cigarettes which means reduced money is available for other household costs
Diet (eating well): there is a higher number of fast food outlets in deprived areas compared to healthy outlets
Activity/ exercise: youth offending, anti social behaviour, unsafe neighbourhoods and air pollution may discourage activities such as running and walking
Alcohol: individuals may not seek help with alcohol dependence due to inadequate services or lack of knowledge as to how access services
Substance misuse: turning to crime to seeks funds, individuals may not seek help, if this is not recognised as a problem or there is a stigma attached
Smoking: an inability to quit smoking is classes as an addiction and individuals is deprived communities may not always seek help or know where to go to get help
Personal and family resilience
Resilience and development through PIES IMPACT
Resilience; Capability to recover quickly from difficulties; toughness
Adversity: hardships, challenges or misfortune (poverty)
Resilience is the ability to draw upon inner resources to weather stress, adversity and challenges during life. Resilience is linked to good health and well-being. Resilience is important to the lives of individuals because adversity and challenges are inevitable in life
Infancy 0-2: Within-child protective factors that strengthen infant and toddler resilience are closely tied to their social and emotional well-being – the ability to form relationships, get their needs met, regulate strong emotions and explore their world.
Childhood 3-12: The single most common factor for children who develop resilience is at least one stable and committed relationship with a supportive parent, caregiver, or other adult. These relationships provide the personalised responsiveness, scaffolding, and protection that buffer children from developmental disruption.
Adolescence 13-19: Developing and fostering opportunities to build resilience in teens may lead to better outcomes in school engagement, pro social behaviour, community participation, positive peer group activity and future aspirations
Adulthood 20-64:
Self-directedness – people with this quality tend to accept responsibility for their mistakes, learn from them, and move on
Cooperativeness – people who are tolerant and able to accept a range of behaviours viewpoints tend to feel less frustrated and this reduces a potential source of stress
Harm avoidance – people who are decisive and less anxious can more easily accept uncertainty and risk and are more confident in making decisions
Persistence – people who have stamina can persevere with a task, set realistic goals, accept their mistakes and learn from them.
Later adulthood over 65: The strongest evidence indicates that mental factors including adaptive coping, optimism, and positive emotions as well as social support/connectedness are necessary aspects of maintaining high resilience and would be critical to an effective intervention.
Adverse childhood experiences:
Children growing up in poverty or in households with significantly lower incomes are more likely to be at risk of ACEs compared to children living in more advantageous social and economic conditions. ACEs are described as stressful events that are experienced in childhood. They can include:
Verbal, physical or sexual abuse or neglect. This can lead to a child being placed on the child protection register. In Wales, this is a confidential list of all children in the local authority area who have been identified as at risk of abuse, neglect or harm.
Parental separation.
Domestic violence.
Household mental illness.
Household substance misuse.
Household incarceration (i.e. members of the family are controlled or prevented from going out).
Ace aware can prevent future health problems such like:
Heart disease
Diabetes
Cancer
Social and health issues
Relationships:
Anger – parents
Anger = scary = normalized
Copy behaviour
Social
Relationships – negative – maintaining – loneliness – social isolation
Tell a teacher: Safeguarding officer – headteacher – speak to parents – social services – home visit
Social and community networks
Social and community activity
Family and wider social circles
Family, friends and communities are part of social and community networks that provide positive relationships which support all aspects of health and well-being. These networks reduce the risk of poor health and well-being caused by loneliness and social isolation. The presence of multiple social and community networks in a person’s life increases their resilience and decreases the risk of a decline in health and well-being.
Social and community networks include access to family and friends. They also include access to enjoyable and meaningful activities such as sports, arts, volunteering opportunities and meeting those with shared values and beliefs or a shared religion.
Infancy – play group/ day group, mother and toddler groups,
Childhood – dance, scouts, duke of Edinburgh, projects church (arts and craft)
Adolescents – leisure, sports, projects locally, cadets, volunteering
Adulthood – religion, planned nature reserved things, gym planned sessions (community), yoga
Later adulthood – religion (Sunday religious days, pilgrimage), everyday planned activities (nature walks, café days out, beach days) (care), bingo
Loneliness is a personal feeling of dissociation, disconnection, detachment or emptiness.
Social isolation is being socially isolated means being separated from social and community networks such as family, friends, neighbours, community involvement or access to services.
Some barriers:
Barrier 1: Poor mental health and wellbeing: Meaning they may not have the social ability to try and get help for their mental health and also may feel lonely from this feeling
Barrier 2: Inability to pay for access to public transport: People may not be able to afford this due to public transport raising prices or may be that its too expensive to get to where they need to be. This makes a lack in socialisation as not being able to get there and feeling of loneliness as wont be able to get to where wanted and feeling lonely of not able to drive or even rely on someone who may need help with transport
Barrier 3: Public transport: may be at risk of crime or fear crime depending on what area you may live in (people with babies and small children, women, disabled people, elderly people, ethnicity)
Barrier 4: inability to pay for broadband, might be living in poverty, not being able to afford phones, internet etc - leading to feeling lonely as not being able to contact anyone and having the inability of "fitting" in with society of technology and not being able to socialise due to not being able to afford anything to contact friends or family online
Barrier 5: poor physical environment : living in poverty which has an increase in criminal behaviour and activity aswell as lack of community cohesion
Living and working conditions
Access and opportunities in relation to
Jobs (income)
Housing
Education
Care services
Good income
Bad income
Good food: healthy, plenty of food
Access to services
Freedom to get things you like
Home: hot water, heating, electric, furniture, internet, washing machine, subscriptions, a garden, choose where to live
Socialise with friends - shopping, food, drink, nights out
Period products
Transportation: cars, insurance
Holidays
Premium quality
Newest gadgets
Private healthcare
Private education
Takeaways
Develop good personal and family resilience: could be that they dont have to work harder
Lack of food
Deprived of necessities
Poor housing: mould, damp, struggle to pay for bills, poor area, lack of choice of where to live
Become malnourished
Lack of clean clothes (cant change for the season)
Inability to clear debt
Resorting to illegal money lenders
Inability to own your own car
Increased risk of poor personal and family resilience: work harder for money
Less high education resulting in low pay job
the benefits of being in work on an individual's resilience and wellbeing PIES
P: being able to afford fitness - gym: helps with the physical side giving you a healthier lifestyle
I: money being able to afford university, a tutor, pirvate education: helps you have an greater wellbeing lifestyle as you'll have opportunities to learn better --- if you didn't have this month you'd experience the resilience of struggling to maybe get the higher pay job you want or need
E: promotes self esteem
S: provides opportunities for social interaction, friendship and sense of community: this helps the social development in work to build on your work with support and advice around you and make work more enjoyable knowing you have people at your workplace that you get along with -- work colleagues can provide support
Socio-economic, cultural and environmental conditions
Factors such as:
Poverty
Disposable income
Language (bi-lingual/ multinilgual)
Ruarality
Availability of work
Poverty
Governments and policy makers identify that whilst some people are able to flourish from their very first day, others are born, into a life of poverty. This is when a person's resources are well below their minimum needs, including the need to be a part of society
The welsh governments defines child poverty as living in a household where there are insufficient resources to afford food, reasonable living circumstances ( such as being in a safe and attractive neighbourhood) and an ability to participate in actvities that are taken from granted by others in society
Individuals experiencing poverty are more likely to need medical and other interventions from services that are funded by tax payers' money which could be spent elsewhere
disposable income
Disposable income is the amount of money available to households for savings and spending after direct taxes such as income tax have been paid
Rurality and availability of work
Large parts of rural wales have a significant number of older people and welsh speakers. In 2017, 21% of the population of wales was aged 65 or over
In 2011, 27% of welsh speakers were based in south east wales, 36% in north wales and 37% in mid and south west wales, according to the welsh government, 76.4% of residents aged three and over in Gwynedd reported being able to speak welsh in 2018
This shows that being a welsh speaker is an essential part of peoples identity in many parts of rural wales. Compared to the diverse job opportunities available in south eat wales, the lower number of job opportunities, the reduced diversity and the lower quality of the jobs available in rural wales means that people are often faced with a difficult choice. That is, to remain in their communities with limited economic opportunities, to commute long distances or to move away completely.
This inequality in circumstances presents a huge dilemma and struggle for people who have strong attachments within their communities, whilst other might welcome the challenge
New job opportunities, perhaps in England or abroad, may mean that an individual cannot communicate in Welsh in the workplace, and this can represent a significant loss in their identity. Commuting or moving away may not be an option for people who have carer responsibilities for older parents, or where children are settled in school. Alternatively, individuals might simply not want to move away from their loved ones. In these circumstances, a lack of employment opportunities means that people experience rural poverty, i.e. they have insufficient resources to meet their living needs. In addition to this, housing in parts of rural Wales can be unaffordable to local people on lower incomes, due in part to the higher house prices that can be paid by people who have retired and moved into the area, or people who have second homes.