Social Determinants of Health 3



SocialDeterminants of Health

Socialdeterminants of health are defined as the condition in which peopleare usually born, raised, live, employed and wider set of forces andconditions that shape the daily life (Marmot, 2007). Socialdeterminants of health are shaped by the uneven distribution ofresources at the local and national level. The surroundings in whichpeople live and work determine their health status (Wilkinson andMarmot, 2003). Socioeconomic status has a significant impact indetermining the access, use, and quality of healthcare in apopulation. There is a great difference in the way individuals withlow level of education and income utilize health services as comparedto people with high educational level and income (Acheson, 1998). TheBlack Report of 1980 elaborated on the SDH.

Thesocial gradient is also a determining factor of health. Socialstratification is useful in explaining the patterns of disease anddifferences in health among the population. This was demonstrated inthe Whitehall study which was conducted in Britain through theparticipation of civil servants (Marmot and Wilkinson, 2005 Marmotet al., 1991). Some of the aspects incorporated in socialstratification include cultural, political and ethnic aspects. Ourunderstanding of these determinants has been enhanced through theknowledge of health inequalities occurring within the society(Wilkinson and Marmot, 2003). The unfair and unacceptable differenceswhich are considered to be avoidable are referred to as healthinequalities (Marmot, 2010). The unequal distribution of resourcescontributes to the health inequalities observed in differentcountries.

Socioeconomicstatus has been shown to have an influence on health. According toMcKewon and Lowe (1974), the 19th century witnessed a decrease in therate of infant mortality due to the improvement of sanitation,nutrition, water provision and a reduction in the family size. SEShas also been found to have an influence on the oral health regardingthe social position and social ties of a person. Social determinantshave the possibility to predict the variance in health status inaddition to having a behavioral influence on health. The mechanismsresponsible for the association between socioeconomic status,morbidity and mortality are yet to be clearly understood. Policyremedies rely on the proper identification of such solutions (Blacket al., 1980).

Inconclusion, it’s prudent to note that the social and economicstructures are crucial in defining the efficiency of healthcare in apopulation and not merely about individual exposure or behavior.


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