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INDIVIDUAL INDIVIDUAL
SOCIETYSOCIETY
It is an organized group.It is an organized group.
COMMUNITY COMMUNITY
Total Organization of social life with a limited Total Organization of social life with a limited area.area.
- Ogburn and Mimkuff- Ogburn and Mimkuff
HealthHealth
"The state of being free from illness or injury"."The state of being free from illness or injury".
- Google dictionary- Google dictionary
HealthHealth was defined as "a state of was defined as "a state of complete physical, mental, and social complete physical, mental, and social well-being and not merely the well-being and not merely the absence of disease or infirmity“.absence of disease or infirmity“.
““Socially and economically productive Socially and economically productive life”life”
- WHO - WHO
Biological
Socio-cultural
Behavioural
Environmental
Science and technology
Information and communication
Healthy system
Socio-economic
Equity and social justice
Aging of the population
Gender Famalies
Individuals
Communities
SocietiesFamilies
Individuals
Health
Humanrights
Biological
Behavioural
Biological
Behavioural
Biological determinantsBiological determinants
The physical and mental traits of every human The physical and mental traits of every human being to sum extent determined by the nature being to sum extent determined by the nature of genes at the movement of conception.of genes at the movement of conception.
Positive health – a person should be able to Positive health – a person should be able to express as completely as possible the express as completely as possible the potentialities of his genetic heritage. potentialities of his genetic heritage.
- WHO - WHO
BEHAVIOURAL AND SOCIO CULTURALBEHAVIOURAL AND SOCIO CULTURAL
LIFE STYLE – the way of people liveLIFE STYLE – the way of people live social valuessocial values AttitudesAttitudes activitiesactivities
ENVIRONMENTENVIRONMENT
Disease to environmentDisease to environment
- Hippocrates- Hippocrates
Concept of disease – environment Concept of disease – environment associationassociation
- Pettenkofer- Pettenkofer
INTERNALINTERNAL
Each and every component part, every tissue, Each and every component part, every tissue, organ and organ- system and their harmonious organ and organ- system and their harmonious functioning with in the system.functioning with in the system.
EXTERNAL OR MACRO ENVIRONMENTEXTERNAL OR MACRO ENVIRONMENT
All that witch is external to the individual All that witch is external to the individual human host.human host.
Socio economic conditionsSocio economic conditions
Economic status
Education
Occupation
Political system
Nutrition
Housing
HEALTH SERVICESHEALTH SERVICES
PURPOSEPURPOSE
To Improve The Health Status Of The To Improve The Health Status Of The PopulationPopulation
AGING OF THE POPULATIONAGING OF THE POPULATION
A major concern of rapid population aging is A major concern of rapid population aging is the increased prevalence of chronic disease the increased prevalence of chronic disease and disabilities both being conditions that tend and disabilities both being conditions that tend to accompany the aging process and deserve to accompany the aging process and deserve special attention.special attention.
GENDERGENDER
Women’s healthWomen’s health
OTHER FACTORSOTHER FACTORS Information and communicationInformation and communication Science and technologyScience and technology
Why Emphasize Social Why Emphasize Social Determinants?Determinants?
Social determinants of health have a direct Social determinants of health have a direct impact on healthimpact on health
Social determinants structure other causes of Social determinants structure other causes of health:health:– EnvironmentEnvironment– BehaviourBehaviour– ServicesServices
The ‘causes of the causes’The ‘causes of the causes’
SOCIAL FACTOR INFLUNCING THE HEALTH OF PEOPLESOCIAL FACTOR INFLUNCING THE HEALTH OF PEOPLE
DEMOGRAPHICDEMOGRAPHICECONOMICECONOMICPOLITICALPOLITICALLEGALLEGALRELIGIOUSRELIGIOUSEDUCATIONALEDUCATIONALTECHONOLOGICALTECHONOLOGICAL
COMMUNICATIONSCOMMUNICATIONSMIGRATIONMIGRATIONURBANIZATIONURBANIZATIONLIFE EXPECTANCYLIFE EXPECTANCYMARRIAGEMARRIAGEFERTILITYFERTILITYROLE OF WOMENROLE OF WOMEN
ECOLOGICAL PREDISPOSITIONS(community values, socially prescribed roles,life style, sub-cultural behaviour patterns,etc.)
CURRENT CIRCUMSTANCES(income, family life, housing employment,
Stresses and crises, social support, etc)
INDIVIDUAL PREDISPOSITIONS(inheritance, prenatal events, previous accidents or illness, upbringing, childhood nutrition, etc.)
OPPORTUNITIES/SITUTIONS(access to health services, expousure to pathogens,
availability of education, food, sanitation, alcohol, drugs, marriage partners, etc.)
HEALTH
FRAMEWORK OF THE CATEGORIES AND PATHWAYS OR FRAMEWORK OF THE CATEGORIES AND PATHWAYS OR DETERMINANTSDETERMINANTS
SOCIOECONOMIC SOCIOECONOMIC
POLITICALPOLITICAL
CONTEXTCONTEXT
Social PoliciesLabour market,Housing, land
Culture andsocietal value
Macroeconomic policies
Public policies,Education, health,Social protection
Governance
Socioeconomic Position
Social Class Gender
Ethnicity (racism)
Education
Occupation
Income
• Material Circumstances(Living and Working,
Conditions, Food Availability, etc)
• Behaviors and Biological Factors
•Psychosocial Factors
IMPACT ON EQUITY IN HEALTH
AND WELL-BEING
STRUCTURAL DETERMINANTS OF HEALTH INEQUITIES
INTERMEDIARY DETERMINANTS OF HEALTH
Health System
Social cohesion & Social Capital
Addressing the social Addressing the social determinantsdeterminants
of health of health
Involves the medical care and public Involves the medical care and public health systems, but clearly extends health systems, but clearly extends beyond thesebeyond these
Requires collaboration with multiple Requires collaboration with multiple sectors outside of health, including sectors outside of health, including education, housing, labor, justice, education, housing, labor, justice, transportation, agriculture, and transportation, agriculture, and environmentenvironment
Addressing the social Addressing the social determinantsdeterminants
of equity of equity
Involves monitoring for inequities in Involves monitoring for inequities in exposures and opportunities, as well as for exposures and opportunities, as well as for disparities in outcomesdisparities in outcomes
Involves examination of structures, policies, Involves examination of structures, policies, practices, norms, and values to answer, practices, norms, and values to answer, “How are these inequities being “How are these inequities being maintained?”maintained?”
Requires intervention on societal structures Requires intervention on societal structures and attention to systems of powerand attention to systems of power
We need to do bothWe need to do both
Address the social determinants of Address the social determinants of health, including poverty, in order to health, including poverty, in order to achieve large and sustained achieve large and sustained improvements in health outcomesimprovements in health outcomes
Address the social determinants of Address the social determinants of equity, including racism, in order to equity, including racism, in order to achieve social justice and eliminate achieve social justice and eliminate health disparitieshealth disparities
Diseases of Public
Health Impute
Early ChildDevelopment
Women + GenderEquity
Urban Settings
Social Exclusion
EmploymentConditions
Globalization
Health systems
Measurement
Building Health & Health Equity
KNOWLEDGE NETWORK THEMES
Ten Tips for Staying Healthy Ten Tips for Staying Healthy 1.1. Don't be poor. If you can, stop. If you can't, try not to be poorDon't be poor. If you can, stop. If you can't, try not to be poor for long.for long.2.2. Don't have poor parents.Don't have poor parents.3.3. Own a car.Own a car.4.4. Don't work in a stressful, low paid manual job.Don't work in a stressful, low paid manual job.5.5. Don't live in damp, low quality housing. Don't live in damp, low quality housing. 6.6. Be able to afford to go on a foreign holiday and sunbathe.Be able to afford to go on a foreign holiday and sunbathe.7.7. Practice not losing your job and don't become unemployed.Practice not losing your job and don't become unemployed.8.8. Take up all benefits you are entitled to, if you are unemployed, Take up all benefits you are entitled to, if you are unemployed,
retired or sick or disabled.retired or sick or disabled.9.9. Don't live next to a busy major road or near a polluting factory.Don't live next to a busy major road or near a polluting factory.10.10. Learn how to fill in the complex housing benefit/ asylum Learn how to fill in the complex housing benefit/ asylum
application forms before you become homeless and destitute.application forms before you become homeless and destitute.
Dave Gordon, 1999