Determinants of health

2021 ◽  
pp. 83-92
Author(s):  
Matthew Fisher ◽  
Belinda Townsend ◽  
Patrick Harris ◽  
Ashley Schram ◽  
Fran Baum
Keyword(s):  
Public Health ◽  
Public Policy ◽  
Indigenous Health ◽  
Health Inequities ◽  
Determinants Of Health ◽  
Environmental Determinants ◽  
Policy Action ◽  
Main Factors ◽  
And Gender ◽  
Public Health Literature

The determinants of health are the biological, psychological, behavioural, social, economic, and environmental factors that determine the health of individuals and populations. Socially or politically conditioned inequalities in the distribution of determinants lead to inequities in health within or between countries. The ways that determinants act on health are complex, involving interactions between factors and effects occurring over differing timespans. These complexities present challenges for research and public policy, to understand and take action on determinants, to improve population health, and/or to reduce health inequities. In this chapter we review the four main categories of biological, behavioural, social, and environmental determinants. We then discuss the topic of social determinants of health in more detail and review a number of the main factors identified in contemporary public health literature; from education, employment, and gender to determinants of Indigenous health, and commercial determinants of health. In a later section of the chapter (‘The complexity of determinants and their interactions’) we look at some of the challenges raised by the complex, multifactorial nature of determinants of health for research, health practice, and policy action. In the final section, we discuss two particular political challenges facing governments and international bodies seeking to take action on determinants of health and health equity.

Transforming a global order in New Zealand to reduce health inequities in service provision

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Rawson
Keyword(s):  
Public Health ◽  
New Zealand ◽  
Indigenous Knowledge ◽  
Best Practice ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Health Inequities ◽  
Medical Emergency ◽  
Major Work ◽  
Health Initiatives

Abstract St John has been providing service in New Zealand for nearly 140 years since its arrival. It has now close to 4000 staff and nearly 20000 Members and over 8500 volunteers. In New Zealand the major work of St John is its Ambulance service providing front line first responders to crash, medical emergency and other life-threatening situations. St John New Zealand also provides a number of 'Community Health' initiatives focused on strengthening communities and prevention. In recent years St John has recognised that they have not engaged well with Indigenous communities and that their organisation in New Zealand must become skilled and relevant in addressing the needs of the Indigenous people of New Zealand, as they suffer the greater burden of disease and illness than any other population in the country. St John NZ Community and Health Services are embarking on a process of transformation through re-orienting its culture and practice by adopting Public Health approaches and an equity lens over all its programmes. They also have committed to understanding and using Indigenous knowledge to support this re-orientation to most effectively engage and implement programmes that will reduce Indigenous health inequities. This presentation will describe the process by which they will be implementing their strategy for change and highlight best practice for working with Indigenous communities. Key messages Indigenous Knowledge is key to addressing Indigenous Health inequities. Mainstream Public Health can learn from Indigenous Public Health approaches.

scholarly journals Students’ Perspectives: How Will COVID-19 Shape the Social Determinants of Health and Our Future as Public Health Practitioners?

2020 ◽  
Vol 47 (6) ◽  
pp. 850-854
Author(s):  
Eliyas K. Asfaw ◽  
Emily S. Guo ◽  
Sarah S. Jang ◽  
Swathi R. Komarivelli ◽  
Katherine A. Lewis ◽  
...  
Keyword(s):  
Public Health ◽  
Health Inequities ◽  
The United States ◽  
Determinants Of Health ◽  
Next Generation ◽  
Public Health Professionals ◽  
The Social ◽  
Health Practitioners ◽  
To Come ◽  
Public Health Practitioners

We are the next generation of public health practitioners. As public health students, we acknowledge that the COVID-19 (coronavirus disease 2019) pandemic will continue to fundamentally alter the field that we are preparing to enter. We will be the first wave of public health professionals whose education is being shaped by this pandemic. For decades to come, we will be working to address the impacts of this pandemic. In this commentary, we are lending our voice to discuss and highlight the importance of considering the intersections of various determinants of health and COVID-19, including education, food insecurity, housing instability, and economic hardship. We provide a discussion on what is being done across the United States in attempts to reduce the growing health inequities. As the next generation of public health leaders, we believe that only by investing in these issues can we begin to address the social and economic impact of the COVID-19 pandemic.

Socially Constructed Determinants of Health: The Case for Synergies to Arrive at Gendered Global Health Law

2020 ◽  
Vol 13 (1) ◽  
pp. 16-28 ◽  
Author(s):  
Sarah Hawkes ◽  
Kent Buse
Keyword(s):  
Health Inequities ◽  
Well Being ◽  
Determinants Of Health ◽  
Health Law ◽  
Socially Constructed ◽  
And Gender ◽  
Gender Neutrality ◽  
The Relationship ◽  
Health And Well Being ◽  
Improve Health

Abstract Both gender and the law are significant determinants of health and well-being. Here, we put forward evidence to unpack the relationship between gender and outcomes in health and well-being, and explore how legal determinants interact and intersect with gender norms to amplify or reduce health inequities across populations. The paper explores the similarities between legal and health systems in their response to gender—both systems portray gender neutrality but would be better described as gender-blind. We conclude with a set of recommendations to address both law and gender in implementing the work of the Lancet Commission on the legal determinants of health to improve health outcomes for all, irrespective of gender.

scholarly journals Explaining the Health Gap Experienced by Girls and Women in Canada: A Social Determinants of Health Perspective

2009 ◽  
Vol 14 (5) ◽  
pp. 1-13 ◽  
Author(s):  
Cecilia Benoit ◽  
Leah Shumka ◽  
Kate Vallance ◽  
Helga Hallgrímsdóttir ◽  
Rachel Phillips ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Inequities ◽  
Safety Net ◽  
Determinants Of Health ◽  
Health Determinants ◽  
Sex And Gender ◽  
The Social ◽  
Health Gap ◽  
And Gender

In the last few decades there has been a resurgence of interest in the social causes of health inequities among and between individuals and populations. This ‘social determinants’ perspective focuses on the myriad demographic and societal factors that shape health and well-being. Heeding calls for the mainstreaming of two very specific health determinants - sex and gender - we incorporate both into our analysis of the health gap experienced by girls and women in Canada. However, we take an intersectional approach in that we argue that a comprehensive picture of health inequities must, in addition to considering sex and gender, include a context sensitive analysis of all the major dimensions of social stratification. In the case of the current worldwide economic downturn, and the uniquely diverse Canadian population spread over a vast territory, this means thinking carefully about how socioeconomic status, race, ethnicity, immigrant status, employment status and geography uniquely shape the health of all Canadians, but especially girls and women. We argue that while a social determinants of health perspective is important in its own right, it needs to be understood against the backdrop of broader structural processes that shape Canadian health policy and practice. By doing so we can observe how the social safety net of all Canadians has been eroding, especially for those occupying vulnerable social locations.

scholarly journals Step-by-step process of making the case for sustainable investment in wellbeing and health equity

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Dyakova ◽  
K Ashton ◽  
A Stielke ◽  
M A Bellis
Keyword(s):  
Public Health ◽  
Health Equity ◽  
Essential Element ◽  
Monitoring And Evaluation ◽  
Determinants Of Health ◽  
Policy And Practice ◽  
Policy Action ◽  
Sustainable Solutions ◽  
Knowledge To Action ◽  
Business As Usual

Abstract Issue Urgent action is needed to address the growing health, inequity, economic and planetary challenges that threaten the wellbeing of present and future generations. Business as usual has proven unsustainable with high human, social, economic and environmental costs. Coordinated policy action on the determinants of health combined with well-designed and implemented governance and innovative investment approaches can have a dual effect: a) reducing the health gap; and b) improving overall population health. Description The WHO Collaborating Centre on Investment for Health and Wellbeing has developed a practical step-by-step guide, outlining the process of how to synthesise, translate and communicate public health and economics evidence into policy and practice, in order to make the case for investment in wellbeing and health equity. It aims to: 1) prevent disinvestment in health; 2) increase investment in prevention / public health; and 3) mainstream cross-sector investment to address the wider determinants of health and equity, driving prosperity for all. Building on the Knowledge-to-Action framework and an extensive international multi-disciplinary consultation, four key phases are described: 1) Project scoping and planning; 2) Evidence gathering, synthesis and design; 3) Dissemination and communication; and 4) Monitoring and evaluation. Key messages, different products and a number of practical tools and tips are highlighted. An essential element is using health economics approaches and tools to build the case, showing the burden of inaction in parallel with available sustainable solutions, which can bring ‘social return on investment’. Results/Lessons The result of the above-described process is the development of evidence-informed, context-tailored advocacy documents and tools, enabling healthy policy- and decision-making across different sectors, levels of government and country settings.

scholarly journals Through a Critical Lens: Expertise in Epidemiology for and by Indigenous Peoples

2019 ◽  
Vol 45 (6) ◽  
pp. 1142-1167
Author(s):  
Erica Prussing
Keyword(s):  
Public Health ◽  
Public Policy ◽  
Indigenous Peoples ◽  
Science And Technology Studies ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Public Health Research ◽  
Ethnographic Study ◽  
Social Worlds ◽  
Aotearoa New Zealand

Epidemiology for and by Indigenous peoples uses quantitative and statistical methods to better document Indigenous health concerns, and is oriented around providing data for use in advocacy to promote Indigenous health equity. This advocacy-oriented, technoscientific work bridges the often distinct social worlds of Indigenous communities, professional public health research, and public policy-making. Using examples from a multisited ethnographic study in three settings (Aotearoa New Zealand, Hawai’i, and the continental United States), this paper examines the forms of expertise that researcher/practitioners enact as they conduct research that simultaneously harnesses epidemiology’s persuasive power in social worlds like public health and public policy, while also critically challenging legacies of colonialist erasures and misrepresentations of Indigenous health in population statistics. By demonstrating how these continual translations across multiple social worlds enact expertise, this analysis offers a new integration of discussions about both coloniality and expertise within science and technology studies (STS). By focusing on the experiences of technoscientific professionals themselves, this study’s findings also pose new questions for broader STS conversations about how activism is shaping the production of knowledge about health in the twenty-first century.

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