The social determinants of health . . . understanding how health is shaped
Everything—from our income and neighbourhoods to our jobs and education—affects our health. Michael Hingston explains their influence:
We may want to have a better job, but if work is scarce or we are short on skills, it’s hard to move up the ladder. We may want to eat healthy food, but if buying fresh fruit and vegetables means we can’t pay the electricity bill, then what? Such factors are called the social determinants of health and are powerful influences on the health and well-being of all Albertans.
Positively changing social determinants of health goes beyond the realm of individual actions. Our communities, businesses, governments and institutions all have an important role in developing and supporting public policies that can make good health a real possibility for Albertans of all ages.
Political ideals also play a role. For example, in developed countries around the world, liberal or left-leaning national governments are more often associated with lower child poverty rates and higher social spending than conservative or right-leaning governments.
Income and income distribution
The more money we have, the better our chances for good health. And the less we have, the worse those chances. More money translates into better access to health services, safer neighbourhoods and better maintained housing. It also makes credit more affordable, transportation reliable and efficient and gives us more chances for recreation and leisure. The income gap between the rich and the poor affects everyone’s health. In Alberta, that gap has grown faster in recent years than anywhere else in the country.
Employment and working conditions
We spend much of our lives at our jobs, so the safety and health of our workplaces will influence our health. Many factors at work can affect our physical and mental health, including stress, the physical demands of the job, our control over our work and our pay, vacation time and benefits.
Education is like income—the more you have, the better it is for your health. More education means a better chance at understanding health and the health-care system, making a higher income, keeping a job and having a healthy workplace. Basic literacy is essential too; about 40 per cent of adult Albertans can’t participate fully in civic life because of low reading and writing skills.
All social determinants of health affect human biology and genetics. Our genes and body respond to our surroundings and experiences—poverty, poor nutrition or toxic stress, for example—and can make us sick or increase our likelihood of being sick. Stressful environments limit healthy options and change us regardless of the choices we make.
Times are changing for Canada’s Aboriginal Peoples: almost half of aboriginals 25 to 64 years old have post-secondary education. But aboriginals as a whole have lower incomes and education than other Canadians. This means they experience inequalities in health and economic well-being that are rooted in colonization, colonialism, racism and the loss of land and culture.
Early childhood development
What happens to us in the first few years of life affects health for a lifetime. Children need supportive, nurturing relationships with parents and other adults in their lives as well as food, shelter and clothing to build a foundation for learning, health and reaching their full potential.
Being an active part of a community is important to good health. It leads to increased physical activity, stronger social skills and feelings of belonging. The Mayo Clinic says having family, friends and peers you can talk with is a way of reducing stress and improving mental well-being. Poverty, discrimination, illiteracy or low education, and unequal political influence by those with more money and power can also exclude people from mainstream society.
Those who struggle to afford enough nutritious food for themselves and their families are at greater risk for poor health. Nearly one in 10 households in Alberta is food insecure, meaning at least someone in the house can’t get the variety, quality or quantity of food they need because of a lack of money.
Based on our gender (male, female, gender-diverse or transgendered), society has different roles and expectations of us. These affect our health as well as our relative power and autonomy in society, job prospects and income, poverty levels, leisure time and the likelihood of discrimination and social exclusion.
To stay healthy, we need safe, clean and reliable places to live. Yet cities across the province are dealing with expensive housing and overcrowded homeless shelters. Without proper housing, we have more health problems and need more health-care services.
Social exclusion and isolation affect the health of many different ethnic groups. New and recent Canadians of colour face higher unemployment rates (related to discrimination in hiring practices) and earn less than those of European descent, in part because languages barriers and professional credentials are not always recognized.
Unemployment and employment security
Whether or not we have a steady job affects our health. Coping with the stress of unemployment can lead to substance abuse, depression and a host of illnesses. Part-time and temporary jobs, which are on the rise, are also sources of added stress and fatigue.
Like housing, health care is a basic human right as well as a social determinant of health. Canada’s universal system is designed to improve the health of all citizens, especially those who can’t afford services and treatment. Access to healthcare services and providers is important to all Canadians.
Retrieved from: http://www.applemag-digital.com/applemag/summer_2015#pg45
Social determinants of health advisors: Gary Bloch, Nairne Cameron, Joe Ceci, Cheryl Currie, Stasha Donahue, Lesley Dyck, Nicole Eshkakogan, Suzanne Galesloot, Bart Goemans, Trevor Hancock, Tara Hanson, Deena Hinshaw, Darrell Howard, Tracy Kaczanowski, Jong Kim, Donna Koch, Brian Ladd, Lindsay McLaren, Ryan Meili, Richard Musto, Candace Nykiforuk, Ann Phillips, Dennis Raphael, Cristabel Sosa, Jane Springett, JamesTalbot, SuzanneTough, AlyshaVisram