The social determinants of health, care ethics and just health care

2013 ◽  
Vol 13 (2) ◽  
pp. 149-167 ◽  
Author(s):  
Daniel Engster
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
O. Pearson ◽  
◽  
K. Schwartzkopff ◽  
A. Dawson ◽  
C. Hagger ◽  
...  

Abstract Background Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented. Methods The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed. A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings. Results Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes. Conclusions This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


2020 ◽  
Author(s):  
Odette Pearson ◽  
Kate Schwartzkopff ◽  
Anna Dawson ◽  
Christina Hagger ◽  
Agape Karagi ◽  
...  

Abstract Background: Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented. Methods: The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed . A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings. Results: Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes. Conclusions: This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


2019 ◽  
Vol 13 ◽  
Author(s):  
Carolina Gabriele Gomes da Rocha ◽  
Ivonete Heideman Teresinha Schulter Buss Heidemann ◽  
Pamela Camila Fernandes Rumor ◽  
Fabiano Oliveira Antonini ◽  
Michelle Kuntz Durand ◽  
...  

Objetivo: conhecer como são trabalhados os Determinantes Sociais da Saúde na consulta de Enfermagem do pré-natal na Atenção Primária à Saúde. Método: trata-se de um estudo qualitativo, descritivo, exploratório, com 15 enfermeiras, mediante a realização de entrevistas semiestruturadas, prosseguindo-se com a análise temática dos dados. Resultados: limita-se a compreensão sobre os Determinantes Sociais da Saúde a fatores relacionados à situação socioeconômica e à rede familiar da gestante. Revelou-se a atuação da equipe multiprofissional e enfatizou-se a necessidade de envolver ações intersetoriais. Identificaram-se limites e dificuldades relacionados à atuação dos enfermeiros sobre os determinantes e condicionantes que interferem na vida das gestantes. Conclusão: revela-se que, apesar de os enfermeiros não compreenderem o conceito de modo amplo, a atuação mostra-se como uma realidade durante o pré-natal. Acrescenta-se, no entanto, que são múltiplas as barreiras enfrentadas pelas gestantes e são muitos os limites e dificuldades encontrados pelos profissionais para atuar amplamente sobre os Determinantes Sociais de Saúde. Descritores: Promoção da Saúde; Determinantes Sociais da Saúde; Atenção Primária à Saúde; Enfermagem; Cuidado Pré-natal; Equidade em Saúde.ABSTRACTObjective: to know how the Social Determinants of Health are dealt with in the Prenatal Nursing consultation in Primary Health Care. Method: this is a qualitative, descriptive, exploratory study, with 15 nurses, through semi-structured interviews, continuing with the thematic analysis of the data. Results: the understanding about the Social Determinants of Health is limited to factors related to the socioeconomic situation and the pregnant woman's family network. The performance of the multiprofessional team was revealed and the need to involve intersectoral actions was emphasized. Limits and difficulties related to the performance of nurses on the determinants and conditions that interfere in the lives of pregnant women were identified. Conclusion: it is revealed that, although nurses do not understand the concept broadly, acting is a reality during prenatal care. However, there are multiple barriers faced by pregnant women and there are many limits and difficulties encountered by professionals to act broadly on the Social Determinants of Health. Descriptors: Health Promotion; Social Determinants of Health; Primary Health Care; Nursing; Pré-natal Care; Health Equity.RESUMENObjetivo: conocer cómo se abordan los Determinantes Sociales de la Salud en la consulta de Enfermería Prenatal en Atención Primaria de Salud. Método: estudio cualitativo, descriptivo, exploratorio, con 15 enfermeras, a través de entrevistas semiestructuradas, continuando con el análisis temático de los datos. Resultados: la comprensión de los Determinantes Sociales de la Salud se limita a factores relacionados con la situación socioeconómica y la red familiar de la mujer embarazada. Se reveló el desempeño del equipo multiprofesional y se enfatizó la necesidad de involucrar acciones intersectoriales. Se identificaron los límites y las dificultades relacionadas con el desempeño de los enfermeros sobre los determinantes y las condiciones que interfieren en la vida de las mujeres embarazadas. Conclusión: se revela que, aunque los enfermeros no entienden el concepto en general, la actuación es una realidad durante la atención prenatal. Sin embargo, las mujeres embarazadas enfrentan múltiples barreras y los profesionales enfrentan muchos límites y dificultades para actuar ampliamente sobre los Determinantes Sociales de la Salud. Descriptores: Promoción de la Salud; Determinantes Sociales de la Salud; Atención Primaria de Salud; Enfermería; Atención Prenatal; Equidad en Salud.


2020 ◽  
Author(s):  
Odette Pearson ◽  
Kate Schwartzkopff ◽  
Anna Dawson ◽  
Christina Hagger ◽  
Agape Karagi ◽  
...  

Abstract Background Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented.Methods The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed. A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings.Results Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes.Conclusions This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


2020 ◽  
Vol 35 (2) ◽  
pp. 56-67
Author(s):  
Jeannette Y. Wick

Increasingly, public policy makers, professional organizations, and academics are discussing social determinants of health—the conditions in which people live, work, and age. The impetus for the discussion is a growing awareness that medication and any type of health care is a poor substitute for improving a patient's living conditions. Health care is a necessary but insufficient intervention when people develop chronic disease. Addressing the social determinants of health that include poverty, food insecurity, health literacy, neighborhoods, and the environment is essential if we are to improve an individual's overall health. This is the focus of population health, and to address social determinants of health adequately, the medical team needs to expand to give all team members overlapping duties. It also needs to include social workers and legal representatives. Pharmacists may wonder how the theories associated with social determinants of health can be incorporated into their practices. This article discusses a number of different approaches.


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