scholarly journals Closing the Gap: A Human Rights Approach towards Social Determinants of Health

2016 ◽  
Vol 23 (5) ◽  
pp. 510-524 ◽  
Author(s):  
Brigit Toebes ◽  
Karien Stronks
Keyword(s):  
Human Rights ◽  
Social Determinants Of Health ◽  
Health Inequalities ◽  
Social Determinants ◽  
Public Perception ◽  
Determinants Of Health ◽  
Policy Makers ◽  
The Public ◽  
Health Related ◽  
The Right

Social determinants of health are major contributors to population health as well as health inequalities. The public perception that health inequalities that arise from these social determinants are unjust seems to be widespread across societies. Nevertheless, there is also scepticism about the progress in the implementation of actual policies to reduce health inequalities. Scholars, activists and policy makers from various disciplinary backgrounds increasingly stress the value of the human rights approach to support policies addressing health inequalities, and to hold actors in policies to address social determinants accountable for these inequalities. The ‘right to health’, in conjunction with the other health-related human rights, captures most elements of social determinants of health, and makes clear appeals to the governmental authorities at all levels to take action when social injustices occur. Existing judicial and non-judicial cases show us how human rights can be instrumental in addressing inequalities in health.

Bridging human rights and social determinants of health: Argentina, Chile, Paraguay, and Uruguay

2019 ◽  
Vol 13 (1) ◽  
pp. 3-17
Author(s):  
Juan Smart ◽  
Alejandra Letelier
Keyword(s):  
Human Rights ◽  
Health Status ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Right To Health ◽  
Determinants Of Health ◽  
Human Right ◽  
Content Type ◽  
Health And Human Rights ◽  
The Right

Purpose The purpose of this paper is to do a systematic assessment and testing of identified human rights norms alongside social determinant approaches in relation to identified health issues of concern in four Latin American countries (Argentina, Chile, Paraguay and Uruguay) to show how social determinants and human rights frameworks improve population health. Design/methodology/approach To do so, in the first part the authors analyze the inequalities both between and within each of the selected countries in terms of health status and health determinants of the population. Then, in the second section, the authors analyze the level of recognition, institutionalisation and accountability of the right to health in each country. Findings From the data used in this paper it is possible to conclude that the four analysed countries have improved their results in terms of health status, health care and health behaviours. This improvement coincides with the recognition, institutionalisation and creation of accountability mechanisms of human rights principles and standards in terms of health and that a human rights approach to health and its relation with other social determinants have extended universal health coverage and health systems in the four analysed countries. Originality/value Despite of the importance of the relation between human rights and social determinants of health, there are few human right scholars working on the issues of social determinants of health and human rights. Most of the literature of health and human rights has been focussed specific relations between specific rights and the right to health, but less human right scholar working on social determinants of health. On the other hand, just a few epidemiologists and people working on social medicine have actually started to use a universal human rights frame and discourse. In fact, according to Vnkatapuram, Bell and Marmot: “while health and human rights advocates have from the start taken a global perspective, social medicine and social epidemiology have been slower to catch up”.

Addressing Social Determinants of Health through Medicaid: Lessons from Oregon

2019 ◽  
Vol 44 (6) ◽  
pp. 919-935
Author(s):  
Jonah Kushner ◽  
K. John McConnell
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Medical System ◽  
Determinants Of Health ◽  
Related Services ◽  
Policy Makers ◽  
Health Related ◽  
Reducing Costs ◽  
State Plan ◽  
And Control

Abstract States and policy makers have expressed a strong interest in using Medicaid to address social determinants of health (SDOH). While this approach holds promise for improving outcomes and reducing costs, using Medicaid to pay for services outside the medical system creates challenges. This article examines efforts to address SDOH in Oregon, which, as part of its 2012 Medicaid waiver, incorporated health-related services that lacked billing or encounter codes and were not included in Oregon's Medicaid state plan as a strategy to improve outcomes and control costs. We examine the varieties of health-related services that were used and describe the specific challenges in deploying and paying for these services. We conclude with lessons from Oregon that can help states and the federal government as they work to address SDOH.

scholarly journals Exploring the local policy context for reducing health inequalities in children and young people: an in depth qualitative case study of one local authority in the North of England, UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eleanor Holding ◽  
Hannah Fairbrother ◽  
Naomi Griffin ◽  
Jonathan Wistow ◽  
Katie Powell ◽  
...  
Keyword(s):  
Child Health ◽  
Social Determinants Of Health ◽  
Health Inequalities ◽  
Social Determinants ◽  
Qualitative Case Study ◽  
Determinants Of Health ◽  
Local Policy ◽  
Inequalities In Health ◽  
The North

Abstract Background Improving children and young people’s (CYP) health and addressing health inequalities are international priorities. Reducing inequalities is particularly pertinent in light of the Covid-19 outbreak which has exacerbated already widening inequalities in health. This study aimed to explore understandings of inequality, the anticipated pathways for reducing inequalities among CYP and key factors affecting the development and implementation of policy to reduce inequalities among CYP at a local level. Methods We carried out a qualitative case study of one local government region in the North of England (UK), comprising semi structured interviews (n = 16) with service providers with a responsibility for child health, non-participant observations of key meetings (n = 6 with 43 participants) where decisions around child health are made, and a local policy documentation review (n = 11). We employed a novel theoretical framework, drawing together different approaches to understanding policy, to guide our design and analysis. Results Participants in our study understood inequalities in CYP health almost exclusively as socioeconomically patterned inequalities in health practices and outcomes. Strategies which participants perceived to reduce inequalities included: preventive support and early intervention, an early years/whole family focus, targeted working in local areas of high deprivation, organisational integration and whole system/place-based approaches. Despite demonstrating a commitment to a social determinants of health approach, efforts to reduce inequalities were described as thwarted by the prevalence of poverty and budget cuts which hindered the ability of local organisations to work together. Participants critiqued national policy which aimed to reduce inequalities in CYP health for failing to recognise local economic disparities and the interrelated nature of the determinants of health. Conclusions Despite increased calls for a ‘whole systems’ approach to reducing inequalities in health, significant barriers to implementation remain. National governments need to work towards more joined up policy making, which takes into consideration regional disparities, allows for flexibility in interpretation and addresses the different and interrelated social determinants of health. Our findings have particular significance in light of Covid-19 and indicate the need for systems level policy responses and a health in all policies approach.

scholarly journals Making equal rights to health an election issue in NZ local body elections

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Stone ◽  
D e b Leyland
Keyword(s):  
Public Health ◽  
Social Media ◽  
Human Rights ◽  
New Zealand ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Inequity ◽  
Equal Rights ◽  
The Public ◽  
Local Body

Abstract In New Zealand there are 20 district health boards (DHBs) with local elections every 3 years. There is low voter turnout for these, we suspect because the public has low cognizance of the role DHBs have in governing their health and disability system. Good governance ensures everyone whatever ethnicity, gender or sexual proclivity, from birth to old age, able or disabled, mentally well or unwell, drugfree or addicted, has equal rights of dignified access to healthcare. Without public engagement in DHB elections, the community risks having candidates elected that also don't understand their role through a preventative public health framework or human rights lens. The United Community Action Network (UCAN) developed a human rights framework and Health Charter for people driven into poverty by the costs of staying well in NZ. The framework outlines 6 social determinants of health needing protection through policy, to ensure all enjoy their rights to health. UCAN and the Public Health Association of New Zealand (PHA) partnered to raise public and the candidates' awareness during 2019 elections, of these social determinants causing inequity in health outcomes. A series of short explainer-videos were created for sharing through social media during the election build-up period, helping to promote PHA Branches' public Meet the Candidates events. Post-election, a longer film was produced to send to the elected DHB members. Our theory of change centred on spotlighting health inequity for voters, so that they would elect DHB members who had the greatest understanding and commitment to addressing this issue. With shareable videos we aimed to attract audience, raise awareness and debate the policy solutions to health inequity with candidates, enabling more informed choice amongst the voting public. Post-election, we maintain supportive relationships with the elected DHB members that promised their commitment to our Health Charter during their campaigns. Key messages Using videos and social media, local body elections provide an opportunity to promote everyone’s right to affordable healthcare, supporting and informing voter decision-making. UCAN's Health Charter is an advocacy resource for raising awareness of the social determinants of health inequity and poverty for people with mental illness, addiction and disability.

scholarly journals Dynamics of Health Among Adults in South Africa

2020 ◽  
Author(s):  
Usengimana Shadrack Mutembereza
Keyword(s):  
South Africa ◽  
Social Determinants Of Health ◽  
Health Inequality ◽  
Social Determinants ◽  
National Income ◽  
Determinants Of Health ◽  
Health Campaigns ◽  
Health Selection ◽  
Policy Makers ◽  
The Poor

Abstract BackgroundThis paper estimates trend of health mobility in South Africa using National Income Dynamic Study (NIDS) and investigate whether the patterns of health mobility differs within socioeconomic groups created by income and gender. Health is measured by SRHS, which correlates with mortality and morbidity; thus, it is the best measure of health. MethodsUsing five waves of NIDS and various econometric models, this research estimates health mobility in the period between 2007 and 2017. This study will use transition matrix as descriptive analysis of health mobility and Conditional Maximum Likelihood Estimations to analyse health mobility, trend of health mobility and relationship between health mobility and health inequality within NIDS. ResultsThe study shows that, among poor males, health mobility neither follows a health selection or health constraint mobility trend; the high health mobility with ambiguous trends has not decreased health inequality. Among the poor females, a negative health mobility trend is observed; this research also found that health inequality has not creased. Among the non-poor males, it is found that health mobility follows a gradient constraint trend which has decreased health inequality. Among non-poor females, it is found that health mobility follows a health selection trend which has not decreased health inequality. The results suggest that policy makers should target both social determinants of health and health campaigns to deal with health inequality among the poor males. ConclusionsThe trend of health mobility among poor females suggest that policy makers should target the social determinants of health to combat health inequality. The trend of health mobility among the non-poor males suggests that health mobility will eliminate health inequality. Lastly, the trend of health mobility suggests that policymakers should target health campaigns to deal with health inequality.

scholarly journals Pushing poverty off limits: quality improvement and the architecture of healthcare values

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Polly Mitchell ◽  
Alan Cribb ◽  
Vikki Entwistle ◽  
Guddi Singh
Keyword(s):  
Quality Improvement ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Deprivation ◽  
Ethical Dilemmas ◽  
Determinants Of Health ◽  
Ethical Challenges ◽  
The Social ◽  
Significant Burden ◽  
Health Related

Abstract Background Poverty and social deprivation have adverse effects on health outcomes and place a significant burden on healthcare systems. There are some actions that can be taken to tackle them from within healthcare institutions, but clinicians who seek to make frontline services more responsive to the social determinants of health and the social context of people’s lives can face a range of ethical challenges. We summarise and consider a case in which clinicians introduced a poverty screening initiative (PSI) into paediatric practice using the discourse and methodology of healthcare quality improvement (QI). Discussion Whilst suggesting that interventions like the PSI are a potentially valuable extension of clinical roles, which take advantage of the unique affordances of clinical settings, we argue that there is a tendency for such settings to continuously reproduce a narrower set of norms. We illustrate how the framing of an initiative as QI can help legitimate and secure funding for practical efforts to help address social ends from within clinical service, but also how it can constrain and disguise the value of this work. A combination of methodological emphases within QI and managerialism within healthcare institutions leads to the prioritisation, often implicitly, of a limited set of aims and governing values for healthcare. This can act as an obstacle to a genuine broadening of the clinical agenda, reinforcing norms of clinical practice that effectively push poverty ‘off limits.’ We set out the ethical dilemmas facing clinicians who seek to navigate this landscape in order to address poverty and the social determinants of health. Conclusions We suggest that reclaiming QI as a more deliberative tool that is sensitive to these ethical dilemmas can enable managers, clinicians and patients to pursue health-related values and ends, broadly conceived, as part of an expansive range of social and personal goods.

scholarly journals Social inequalities and access to health: challenges for society and the nursing field

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Regina Celia Fiorati ◽  
Ricardo Alexandre Arcêncio ◽  
Larissa Barros de Souza
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Inequalities ◽  
Determinants Of Health ◽  
Critical Hermeneutics ◽  
Access To Health ◽  
The Social ◽  
Dialectical Relationship ◽  
The Right ◽  
The Life Course

Objective to present a critical reflection upon the current and different interpretative models of the Social Determinants of Health and inequalities hindering access and the right to health. Method theoretical study using critical hermeneutics to acquire reconstructive understanding based on a dialectical relationship between the explanation and understanding of interpretative models of the social determinants of health and inequalities. Results interpretative models concerning the topic under study are classified. Three generations of interpretative models of the social determinants of health were identified and historically contextualized. The third and current generation presents a historical synthesis of the previous generations, including: neo-materialist theory, psychosocial theory, the theory of social capital, cultural-behavioral theory and the life course theory. Conclusion From dialectical reflection and social criticism emerge a discussion concerning the complementarity of the models of the social determinants of health and the need for a more comprehensive conception of the determinants to guide inter-sector actions to eradicate inequalities that hinder access to health.

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