Social Determinants of Health – Review Flashcards

Flashcards cover definitions, theories, case studies, empirical findings, ideological perspectives, and key statistics related to the social determinants of health, as presented in the lecture materials.

According to the Commission on the Social Determinants of Health, how can a society’s development be judged?

By the quality of its population’s health, how fairly health is distributed, and the degree of protection from disadvantage due to ill-health.

What phrase does Dr. Stu Skinner use to describe Maxine’s situation?

The “End Stage of Poverty.”

Why was Maxine considered a “rapid progresser” with HIV?

Her infection advanced to AIDS within a few years instead of many, due to factors such as genetics, virus strain, or poor underlying health.

What major barrier kept Maxine from accessing methadone treatment?

Most drug-rehab programs would not accept people starting methadone, and the waiting list for initiation was months long.

What was the aim of Saskatoon’s cancelled Station 20 West project?

To provide integrated services (health, dental, grocery co-op, housing support, etc.) that address social determinants in core neighbourhoods.

What political action derailed Station 20 West after funding had been pledged?

The newly elected Saskatchewan Party rescinded the NDP government’s $8 million commitment.

List the top three determinants in the Canadian Institute for Health Information ranking.

1) Income status 2) Education 3) Social support networks.

Give three determinants that appear near the bottom of the CIHI list.

Biological & genetic factors, health services, gender, culture, mass-media technology.

What does the WHO (1947) define health as?

A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.

How does Health Canada define population health?

It focuses on the full range of individual and collective factors and their interactions that determine Canadians’ health and well-being.

Institute of Medicine’s definition: Public health is what?

“What we do collectively as a society to assure the conditions in which people can be healthy.”

Which two broad categories are most often confused in public debate?

Health care versus health (or determinants of health).

Picard’s tongue-in-cheek ‘Top-10’ List #2 begins with what instruction?

“Don’t be poor.”

What startling CD4 and viral-load numbers did Maxine have?

CD4 count of 4 (vs ≥400 normal) and viral load of 3 million (vs ≤100,000 desirable).

In Saskatoon, residents of core neighbourhoods are how many times more likely to have type 2 diabetes than those in suburbs?

Thirteen times more likely.

What is infant mortality like in the poorest six Saskatoon neighbourhoods compared to affluent ones?

Three times higher.

What simple nutritional deficiency was linked to over half of childhood strokes in a Canadian study?

Iron-deficiency anemia.

Why are “milk babies” at risk for iron-deficiency anemia?

Excessive reliance on cow’s milk after 12 months displaces iron-rich foods.

State Rudolf Virchow’s famous linkage of medicine and politics.

“Medicine is a social science, and politics is nothing else but medicine on a large scale.”

Materialist theory: name the three pathways from living conditions to poor health.

1) Direct health-threatening conditions 2) Psychosocial stress 3) Stress-driven coping behaviours.

Neo-materialist theory adds what extra layer to the materialist model?

How unequal distribution of economic and political resources creates the unequal living conditions in the first place.

Psychosocial comparison theory centres on which psychological feelings?

Shame, worthlessness, and envy arising from perceived lower social status.

What is meant by the ‘social gradient’ in health?

Health improves step-wise with each increase in socio-economic position; it’s not just a rich-poor gap.

How much of 20th-century longevity gains are attributed to medical care?

Roughly 10–15 percent.

Ontario study: Which was the stronger predictor of poor health—low income or smoking?

Low income (≈4× risk) vs smoking (≈1.6× risk).

What is decommodification in the context of health?

Providing resources (e.g., education, child-care) as rights rather than goods that must be bought in the marketplace.

Define neoliberalism in one sentence.

An ideology favouring minimal government intervention, prioritizing market freedom, competition, and individual responsibility.

Contrast social-democratic and neoliberal views on taxes.

Social democracy: taxes fund equity and public goods; Neoliberalism: taxes impede growth and personal liberty.

Which welfare-state model (liberal, conservative, social-democratic) delivers the best overall health outcomes?

Social-democratic welfare states (e.g., Scandinavia).

‘The Spirit Level’ researchers concluded what about wealth distribution and health?

More equal wealth distribution correlates with better health for everyone, including the rich.

UN Universal Declaration of Human Rights Article 25 guarantees what relevant right?

An adequate standard of living for health and well-being (food, housing, medical care, social security).

Health inequality vs health inequity—what’s the key difference?

Inequality is a descriptive difference; inequity implies the difference is unfair and avoidable.

What did Saskatoon’s health disparity study call the political implication of poverty?

Poverty and inequality kill; governments that allow it are complicit.

Name three social determinants emphasised in Queen’s HLTH 101 slide on SDOH examples.

Income distribution, early childhood development, housing (others include food insecurity, racism, social safety net, etc.).

What are latent, pathway, and cumulative effects in life-course health?

Latent: early exposures with later impact; Pathway: early experiences set trajectories; Cumulative: disadvantages/advantages add up over time.

Define ‘sense of coherence’.

A mix of comprehensibility, manageability, and meaningfulness—feeling life is understandable and controllable; linked to better health.

Physiological stress response over-activation can lead to which chronic diseases?

Heart disease, adult-onset diabetes, immune suppression, kidney failure, etc.

Why can lifestyle messaging ‘add insult to injury’ for low-income Canadians?

It blames individuals for illness while ignoring the adverse living conditions causing both stress and unhealthy coping.

What is meant by ‘market-driven politics’ (Leys) or ‘disorganized capitalism’ (Scambler)?

An economy where market interests dominate political decisions, undermining social supports vital to health.

Corporate lobbying often seeks which two policy changes that harm health equity?

Deregulation of labour/markets and tax cuts that shrink public programs.

Why does addressing the poorest first yield the greatest health gains?

The social gradient is steepest at lower levels; small improvements among the poor produce large overall health benefits.

Give one reason epidemics like HIV, diabetes, and obesity are called ‘fundamentally political’.

Their prevalence is driven by policy choices affecting poverty, education, housing, and social services.

Fill in the blank: “People care about health. It is that transcends class, colour, and ideology.”

common ground / a shared value (either wording earns credit).

What does the Public Health Agency of Canada say its primary focus is?

Preventing disease and injuries, promoting good physical and mental health, and providing information for informed decisions.

What everyday expression reflects Canadians’ deep preoccupation with health?

“We don’t care if it’s a boy or a girl, as long as it’s healthy.”

How can equality improve the health of even the wealthy?

Reduced social stress, stronger public services, and lower burden of social problems benefit all classes.

Which three broad categories does Fergus’s slide list as determinants besides SDOH?

Biology & genetics, health care services, individual behaviours.

What percent of childhood strokes in the Toronto SickKids study involved iron deficiency?

53 percent.

Why is focusing solely on health care budgets considered ‘reactive’ rather than preventive?

It treats illness after it occurs instead of improving upstream conditions that keep people healthy.

'Joe the Plumber' incident illustrates what challenge in U.S. politics about health equity?

Public resistance to redistributing wealth despite evidence it would improve overall health.

In the Saskatoon study, how much more likely were core residents to attempt suicide than affluent residents?

Fifteen times more likely.

What is a ‘risk condition’ give one example?

A social or material circumstance influencing health; e.g., low income, unsafe housing, precarious employment.

How do neo-materialists link welfare-state generosity to population health?

Generous, universal benefits reduce inequality, improve SDOH quality, and thus enhance health outcomes.

List two policy shifts recommended to move from treatment to prevention.

Invest in affordable housing and living wages; expand early-childhood education and care (many other acceptable examples).

Explain ‘blaming the victim’ in public-health messaging.

Attributing illness to personal choices while ignoring structural conditions that limit choices and cause disease.

What does ‘decommodification of child-care’ mean in practice?

Providing publicly funded, universally accessible child-care instead of relying on market pricing.

Which ideology views poor people as victims of a system favouring the wealthy?

Social democracy.

Which ideology believes competition in free markets leads to innovation and that regulations stifle growth?

Neoliberalism.

Complete Virchow’s assertion: ‘Diseases of the populace are traceable to .’

defects in society.

Why is equality considered both the “right” and the “smart” thing in Meili’s argument?

It advances social justice and simultaneously improves economic performance and population health for everyone.

What are the three primary ‘public-health’ domains listed by the Institute of Medicine?

Health protection, disease/injury prevention, and population health assessment/surveillance.

Define ‘health inequity’ in one sentence.

A health difference that is systematic, avoidable, unfair, and unjust.

What overarching objective does Ryan Meili propose to unite political discourse?

Building a healthy society by focusing all policy areas on improving health.