scholarly journals Income and Income Inequality as Social Determinants of Health. Do Social Comparisons Play a Role?

2018 ◽  
Author(s):  
Patrick Präg ◽  
Melinda C. Mills ◽  
Rafael Wittek
Keyword(s):  
Income Inequality ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Stratification ◽  
Social Comparisons ◽  
Well Being ◽  
Determinants Of Health ◽  
Individual Level ◽  
Health Differences ◽  
Negative Effect

Two of the most prominent phenomena in the study of social determinants of health, the socio-economic gradient in health and the income inequality–health association, have both been suggested to be explainable by the mechanism of status comparisons. This, however, has rarely ever been tested in a direct fashion. In this article, we explicate and test this mechanism by assessing the role of social comparison orientation. Research has shown that individuals vary in their propensity to engage in social comparisons, and those with a higher propensity are also more likely to be affected by the outcomes of such comparisons. In our analysis, we check whether the tendency to compare one’s income to that of others can contribute to explaining socio-economic disparities in health. Using individual-level data (N = 18,356) from 23 European countries on self-rated overall health and psychological well-being, we show that a high-income comparison orientation neither moderates the negative effect of income inequality on health nor the health differences by relative income. Our findings cast doubt on the crucial role that researchers such as Wilkinson and Pickett (2010) have attributed to the mechanism of status differentiation as the link between social stratification and health outcomes.

scholarly journals How can social enterprises impact health and well-being?

2018 ◽  
Vol 24 (3) ◽  
pp. 697-713 ◽  
Author(s):  
Katy Gordon ◽  
Juliette Wilson ◽  
Andrea Tonner ◽  
Eleanor Shaw
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Enterprise ◽  
Well Being ◽  
Social Enterprises ◽  
Determinants Of Health ◽  
Content Type ◽  
The Social ◽  
The Impact ◽  
Health And Well Being

Purpose The purpose of this paper is to examine the impacts of social enterprise on individual and community health and well-being. It focusses on community food initiatives, their impact on the social determinants of health and the influence of structure on their outcomes. Design/methodology/approach Using an interpretive qualitative approach through case studies focussed on two community food social enterprises, the research team conducted observations, interviews and ad hoc conversations. Findings Researchers found that social enterprises impacted all layers of the social determinants of health model but that there was greater impact on individual lifestyle factors and social and community networks. Impact at the higher socio-economic, cultural and environmental layer was more constrained. There was also evidence of the structural factors both enabling and constraining impact at all levels. Practical implications This study helps to facilitate understanding on the role of social enterprises as a key way for individuals and communities to work together to build their capabilities and resilience when facing health inequalities. Building upon previous work, it provides insight into the practices, limitations and challenges of those engaged in encouraging and supporting behavioural changes. Originality/value The paper contributes to a deeper insight of the use, motivation and understanding of social enterprise as an operating model by community food initiatives. It provides evidence of the impact of such social enterprises on the social determinants of health and uses structuration theory (Giddens, 1984) to explore how structure both influences and constrains the impact of these enterprises.

Informal Recyclers’ Health Inequities in Vancouver, BC

2018 ◽  
Vol 28 (2) ◽  
pp. 321-343 ◽  
Author(s):  
Josie Wittmer ◽  
Kate Parizeau
Keyword(s):  
Environmental Health ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Low Income ◽  
Service Providers ◽  
Health Inequities ◽  
Well Being ◽  
Determinants Of Health ◽  
Access To Health ◽  
Health Related

We explore informal recyclers’ perceptions and experiences of the social determinants of health in Vancouver, Canada, and investigate the factors that contribute to the environmental health inequities they experience. Based on in-depth interviews with 40 informal recyclers and 7 key informants, we used a social determinants of health framework to detail the health threats that informal recyclers associated with their work and the factors that influenced their access to health-related resources and services. Our analysis reveals that the structural factors influencing environmental health inequities included insufficient government resources for low-income urbanites; the potential for stigma, clientization, and discrimination at some health and social service providers; and the legal marginalization of informal recycling and associated activities. We conclude that Vancouver's informal recyclers experience inequitable access to health-related resources and services, and they are knowledgeable observers of the factors that influence their own health and well-being.

Assessing the Strategies of State Offices of Minority Health to Reduce Health Disparities

2017 ◽  
Vol 32 (1) ◽  
Author(s):  
Aaron J Diehr ◽  
Timothy Jordan ◽  
James Price ◽  
Jiunn-Jye Sheu ◽  
Joseph Dake
Keyword(s):  
Health Disparities ◽  
Best Practices ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Minority Health ◽  
Determinants Of Health ◽  
Individual Level ◽  
State Office ◽  
Percent Response ◽  
Percent Response Rate

Researchers suggest focusing on social determinants of health might have greater impact atreducing health disparities than individual-level approaches. The goal of this research was to compareperceived best practices to reduce racial and ethnic health disparities with the actual activities of stateoffi ces of minority health. Persons in charge of each state office of minority health responded to an onlinequestionnaire (N = 41, 82 percent response rate). Officers believed addressing social determinats of healthwould have greatest impact at reducing disparities yet devoted most resources to individual-level variables.Though state offices of minority health are under-resourced, officers must continue identifying innovative,collaborative methods to intervene on social determinants of health.

Abstract P882: A Multi-Level Exploration of the Social Determinants of Health in Florida: Initial Findings From the Transitions of Care Stroke Disparities Study

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Antonio Bustillo ◽  
Hannah Gardener ◽  
Kefeng Wang ◽  
Chuanhui Dong ◽  
Anny Rodriguez ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Statistical Tests ◽  
Stroke Care ◽  
Determinants Of Health ◽  
Transitions Of Care ◽  
Stroke Severity ◽  
Post Discharge ◽  
Stroke Incidence ◽  
Individual Level

Introduction: Social determinants of health (SDH) are major contributors to stroke incidence and disparities, yet their relationship with severity and disability is relatively unexplored. The purpose of this study is to provide preliminary findings on SDH measures at the individual- and ZIP code-level across outcomes of stroke severity and disability. Methods: We used data from 344 stroke patients from the ongoing Transitions of Care Stroke Disparities Study (TCSDS) enrolled 2018-2020 from sites throughout Florida. TCSDS aims to identify disparities in hospital-to-home transition of stroke care. Individual-level SDH were collected by a trained interviewer at discharge; ZIP-level SDH data were obtained from a contracted data company. Outcomes included stroke severity at admission measured by the NIH Stroke Scale (NIHSS; Mild: 0-4; Moderate: 5-14; Severe: ≥15) and obtained from the AHA Get with the Guidelines-Stroke program; and disability at discharge measured by the modified Rankin Scale (mRS; 0-1; 2-5). Non-parametric statistical tests were used to compare individual- and ZIP-level SDH by NIHSS and mRS scores. Results: Most patients were older (median age 62 years, IQR: 19), male (58%), non-Hispanic White (39%) or Hispanic (35%) and suffered mild strokes (median NIHSS, IQR: 2, 4) with mild disability (median mRS: 1, 4). Those living with children (LWC) had more moderate strokes, while those living with a spouse/partner (LWP) had more severe strokes (p=0.004). Less than high school (HS)-, HS-, and college-educated patients had more moderate, mild, and severe strokes, respectively (p=0.02). ZIP-level unemployment rate was positively associated with NIHSS (p=0.031). Higher mRS was seen among Spanish and Haitian Creole speakers (p=0.005); HS- and less than HS-educated patients (p=0.005); and those with lower levels of social support (p=0.019). LWC had higher mRS scores, while the opposite was true for LWP (p=0.001). Conclusions: Despite the intersectional nature of SDH, these findings highlight possible mechanisms by which education, economic conditions and psychosocial factors may influence stroke severity and disability after stroke. More data are necessary to determine whether these SDH influence long term stroke outcomes post-discharge.

scholarly journals California Healthy Places Index: Frames Matter

2019 ◽  
Vol 134 (4) ◽  
pp. 354-362
Author(s):  
Neil Maizlish ◽  
Tracy Delaney ◽  
Helen Dowling ◽  
Derek A. Chapman ◽  
Roy Sabo ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Census Tract ◽  
Well Being ◽  
Determinants Of Health ◽  
Policy Action ◽  
Census Tracts ◽  
Life Expectancy At Birth ◽  
The Social

Introduction: We describe the California Healthy Places Index (HPI) and its performance relative to other indexes for measuring community well-being at the census-tract level. The HPI arose from a need identified by health departments and community organizations for an index rooted in the social determinants of health for place-based policy making and program targeting. The index was geographically granular, validated against life expectancy at birth, and linked to policy actions. Materials and Methods: Guided by literature, public health experts, and a positive asset frame, we developed a composite index of community well-being for California from publicly available census-tract data on place-based factors linked to health. The 25 HPI indicators spanned 8 domains; weights were derived from their empirical association with tract-level life expectancy using weighted quantile sums methods. Results: The HPI’s domains were aligned with the social determinants of health and policy action areas of economic resources, education, housing, transportation, clean environment, neighborhood conditions, social resources, and health care access. The overall HPI score was the sum of weighted domain scores, of which economy and education were highly influential (50% of total weights). The HPI was strongly associated with life expectancy at birth ( r = 0.58). Compared with the HPI, a pollution-oriented index did not capture one-third of the most disadvantaged quartile of census tracts (representing 3 million Californians). Overlap of the HPI’s most disadvantaged quartile of census tracts was greater for indexes of economic deprivation. We visualized the HPI percentile ranking as a web-based mapping tool that presented the HPI at multiple geographies and that linked indicators to an action-oriented policy guide. Practice Implications: The framing of indexes and specifications such as domain weighting have substantial consequences for prioritizing disadvantaged populations. The HPI provides a model for tools and new methods that help prioritize investments and identify multisectoral opportunities for policy action.

The Social Determinants of Health in a Community Context: Lessons for Sociological Practice

2018 ◽  
Vol 12 (2) ◽  
pp. 67-81
Author(s):  
Tim Knapp ◽  
Lisa Hall
Keyword(s):  
Public Health ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Access To Health Care ◽  
Well Being ◽  
Community Context ◽  
Determinants Of Health ◽  
Physical And Mental Health ◽  
Sociological Practice ◽  
The Social

Much of the research on the social determinants of health has been done at national or international comparative levels. Findings from these studies highlight the importance of macro social factors that affect health outcomes, such as limited and unequal access to health care and the effects of racial discrimination, economic inequality, and patriarchy. However, such macro-level research provides limited information about how applied and clinical sociologists can address local social determinants of health and improve the well-being of individuals and community residents. Results from a county-level public health survey shed more specific light on how interpersonal networks, social activities, and neighborhood characteristics affect people’s physical and mental health. The results can be utilized by clinical and applied sociologists who counsel individuals and work to invigorate neighborhoods, and by public health officials who develop and reform community-level health policies and programs.

scholarly journals Understanding the Influence of Ghanaian Women’s Migration Patterns on Access to Health Care 

2021 ◽  
Author(s):  
Michelle Malagón ◽  
Laiba Rizwan ◽  
Solina Richter
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Care Professionals ◽  
Secondary Analysis ◽  
Well Being ◽  
Determinants Of Health ◽  
Primary Study ◽  
Female Migrants

Abstract Background: In recent years, there has been a noted increase in migration rates with trends marking a rise in women seeking relocation as means to access employment or academic opportunities; this growth is referred to as the feminization of migration. Migration stimulates female empowerment, increases access to financial opportunities, and promotes cultural diversity; all while simultaneously exposing women to detrimental conditions that impose risks to their physical and psychological well-being. Health is a fundamental human right that female migrants often get deprived of due to various social, cultural, political and economic factors in the destination region. These factors catalyze inhabitable environments in which migrant women are further exposed to harm, stimulating their status as vulnerable populations. Methods: We performed a secondary analysis to explore how the social determinants of health, specifically socioeconomic status, culture, and education impact health outcomes and health care access of Ghanaian women who migrated internally within Ghana or externally to Canada. Fourteen interview transcripts, seven from each primary study dataset, were analyzed using thematic analysis and an intersectionality approach. Ethical approval was received for the primary studies and our secondary analysis via the Ethics Review Board at the University of Alberta, Canada. Results: Ghanaian female migrants experienced varying obstacles in terms of accessing health care services. The barriers were identified as cultural, financial, social, and lack of health insurance. Ghanaian women’s health outcomes were influenced by the conditions surrounding their migration including working conditions, separation from family, altered social support systems, and financial constraints. Conclusion: Areas requiring further research and development were identified by assessing migrants’ social determinants of health in the destination country and the associated-barriers in accessing health services. We hope our findings will serve as a foundation for improving health outcomes for female migrant populations and support health care professionals' practice of cultural competence.

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