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The Health Gap: Doctors and the social determinants of health - Coggle…
The Health Gap: Doctors and the social determinants of health
The social gradient in health
The social gradient in health - action to improve health and reduce inequalities has to take place at social level, as Individuals’ ability to change is constrained by social circumstances
We have to address the social gradient, not only the issue of poverty and health. Addressing the social gradient means addressing inequality across the whole of society
The social gradient in health runs all the way from top to bottom of society
The failure of health to improve includes the average person, not just the poor
the gradient is getting steeper as the fewer the years of education, the steeper the rise
The causes of death with the sharpest rise: poisonings due to drugs and alcohol, suicide, chronic liver disease largely alcohol-related, and violent deaths.
health inequalities vary across countries as well as over time
All societies have social inequalities but the magnitude varies
The between-country differences in life expectancy are much smaller for people with a university education
Taking action: individual behaviour in social perspective
The problem with prevention advice is that it is unlikely to change behaviour
Example: People do not continue to smoke because of ignorance of the damaging health consequences but for a variety of psychological and social reasons
Instead, we need to address the social determinants of health as they may be the determinants of behaviors and affect people’s lives in other ways, damaging minds and bodies, that affect their health
Action on social determinants of health
six domains of recommendations of what we can do:
Give every child the best start in life
education and lifelong learning
employment and working conditions
everybody should have a minimum income
necessary for a healthy life
healthy and sustainable places to live and work
taking a “causes of the causes” approach to
prevention.
The rise in childhood obesity has stopped in children from higher-income families. By contrast, in children in more deprived areas the rise in obesity continues. As a result, inequalities in obesity are increasing
If we want to solve the obesity problem, we have to solve the inequality problem
Tthe density of fast-food outlets follows the social gradient. The more deprived the area, the greater the density of Mcdonald's, Burger King, KFC, and Pizza Hut
Consumption of fast food is indicative of wider social issues
Declaration of Oslo and doctors for health equity
Seeing the individual in a broader context
Pediatricians acknowledge that early child development is influenced by various factors beyond treating illnesses, including socio-economic conditions
Poor parenting and poverty are both to blame for poor child development reflecting broader political ideologies.
Addressing inequalities in early development is crucial for improving future outcomes, education, employment, income, and overall health
Enhancing the socio-economic status of the most deprived communities can mitigate developmental disparities
Some communities perform better than others at the same level of deprivation by implementing effective policies and practices
Education and training
Education and training needs to happen at every level.
Advocacy
modest redistribution could have dramatic positive effects on the social determinants of health and, hence, on health equity
Working in partnership
The standard narrative focuses on negative aspects while an alternative perspective highlights the impact of historical injustices and systemic destruction of identity and self-worth, leading to a sense of powerlessness and "Spiritual Sickness."
Empowering individuals and communities is crucial for making meaningful progress and there needs to be healthcare partnerships between medical professionals and communities.
Health sector as employer
There are persisting physical and chemical hazards that affect health workers and attacks on health workers in conflict zones
the lower the occupational class, the higher the likelihood of imbalance between effort and reward, and having low control at work. Both of those increase the risk of cardiovascular disease, mental illness, and sickness absence