Upstream causes, downstream effects

Biological Determinism

Human behaviors and characteristics are innate and unaffected by environmental factors

Social Darwinism

The theory that the principles of evolution, including natural selection, also apply to human social groups ( e.g, races/ethnicities/nationalities) and social classes

Eugenics

The study of improving the human population by controlling hereditary qualities through reproduction and migration

Scientific Racism, Health & Policy

• health gaps as natural byproducts of revolution

• social class differences in life outcomes are ‘natural.’

• poor health and health behaviors attributed to intellectual inferiority and innate ignorance

• Laissez-Faire: Approach to policy - government intervention would interfere with natural selection

Biological Determinism

Scientists like Frederick Hoffman used statistical analyses to demonstrate differences in key outcomes between black and white populations in the U.S.

• higher incarceration rates among black men » higher immorality

• higher death rates among black populations » physical inferiority

Explained the poor life outcomes of non-European people as consequences of cultural practices/ behaviors ( i.e racial tendencies’ that are determined by their genetics

Social Determinants of Health

Social determinants of health are non-medical factors that influence health outcomes. They are conditions in which people are born, grow, work, live, and age, the wider set of forces and systems shaping conditions of daily life

What is part of scope of social determinants of health? HENES

• Healthcare and quality care

• Education access and quality

• Neighborhood and built environment

• Economic stability

• Social and community context

What is the black population's death rate based on in DuBois?

Largely matters of condition not due to racial traits and tendencies—> with improved education, better economic opportunities

Upstream factors

Social structure are the primary forces of driving downstream health patterns

Social Structure

Enduring patters of social life that shape attitudes, beliefs, behaviors, material, and psychological resources

• Structural racism, sexism, and socioeconomic ladder

What are policies that fall under upstream intervention?

1. Promote the well-being of children —> reduce child poverty, high quality education, income security

2. Address Residential Segregation:

• Housing availability and affordability, devaluation of poverty

3. Reduce interpersonal and structural racism

• over policing, gun violence, insurance gaps