KINE 1000 - SES AND SOCIAL DETERMINANTS OF HEALTH LECTURE / READINGS

What are SOCIAL DETERMINANTS OF HEALTH?

The conditions in which people are born, grow, live, work and age

What are the Main 6 Social Determinants of Health?

1. Economic Stability

2. Neighbourhood and Physical Environment

3. Education

4. Food

5. Community, Safety, and Social Context

6. Health Care System

What does the MEDICAL VIEW focus on?

The immediate causes of illness (short-term solutions)

What does the SOCIOLOGICAL “LIFE COURSE” VIEW focus on?

The social causes of illness

• Looking at the social factors in their lives that influence the symptoms they present (long-term solutions)

What is the Life-course Perspective on Health?

Looking at the social symptoms affecting the health and wellbeing of society

There are 3 models…

1. Sensitive-period Model

2. Cumulative Exposure Model

3. Social-trajectory Model

What is the SENSITIVE-PERIOD MODEL?

Looking at early life exposure and how this impacts outcomes in adulthood

EX. A baby born to famine might evelop heart disease as an adult

What is the CUMLATIVE EXPOSURE MODEL?

Medical conditions that develop overtime due to social conditions 

EX. Continiously smoking cigarettes will lead to lung disease

What is SOCIAL-TRAJECTORY MODEL?

Early life experiences and how this shapes your future social order

(social circumstances throughout your life impacts the direction you take)

EX. missing school can lead to dropping out and unemployment

How was Smoking / Tobacco Connected to Politics during WWII?

• Linked to patriotism and military

• Seen as part of supporting soliders and the war effort

• Tobacco sales were used to generate profit that helped fund military

How did the Tobacco Industry Address Causes of Lung Disease?

• That infection, nutrition and hormones contributes to lung disease

• Promoted these alternative causes of lung disease to reduce publics concern on smokings health risks

• This then encouraged people to continue smoking, increasing lung disease and other health issues

During the COVID-19, what did Physicians Primarily Focus on?

Treating individual health concerns and symptoms of those infected

What Factors Contributed to the Cargill Outbreak?

• Cargill is a meat processing plant in Alberta

• Poor working conditions

  • Employees worked while waiting for COVID results

• Many workers were foreign and vulnerable making them more exposed to unsafe workign conditions

Medical View v. Sociological View on the COVID-19 Outbreak?

Medical View: treats symptoms

Sociological View: examines how social or working conditions caused illness

What are the Main Components of SES?

Education, income, occupation

Representing ones position in the social hierarchy

What does SES stand for?

Socio-Economic Status

How does SES Relate to Health Outcomes?

The higher a persons socio-economic status (education, income, occupation) then the longer and healthier their lives tend to be

• The Basement Metaphor

  • The health decline of those in the basement (lower SES) is faster than those on the upper levels (higher SES)

What is a KEY characteristic of low SES that affects SDoH?

Poverty

What is the SOCIAL GRADIENT OF HEALTH?

Each step down the latter is linked to poorer SES and poorer health

Revealing that SES influences disaprties in both acute and chronic diseases

What is a SOCIAL CLASS?

A group based on economic position / characteristics, something individuals are born into (ascribed)

What is a STATUS GROUP?

A group defined by social behaviour and lifestyle choices (i.e., clothing, food, habits)… this is not necessarily tied to income

Who introduced the idea of different forms of CAPITAL in society?

Pierre Bourdieu

What are the 3 Types of Capital?

1. Economic

2. Social

3. Cultural

What is ECONOMIC CAPITAL?

The money / financial resources a person has 

What is SOCIAL CAPITAL?

The network of people you know / rely on

What is CULTURAL CAPITAL?

The knowledge of cultural codes in society (i.e., how to act, speak, behave)

What is SYMBOLIC CAPITAL?

The ability to use economic, social, and cultural capital effectively in social situations (considered an automatic process)

What are BIOMARKERS?

Measurable biological markers in the bloodstream that reflect underlying health and predict life expectancy

For Example,

Cholesterol and blood pressure are important biomarkers for heart disease

What two Molecules were Studied to Assess the Impact of SES on Health?

Fibrinogen and C-reactive protein (CRP)

• They indicate the levels of inflammation in the body

• Linked to stress and poor health outcomes

What did Researchers find whem comparinf CRP / Fibrinogen to SES?

The lower the SES is associated with higher levels of inflammation and short life expectancy 

What is the Impact of Stress on the Body?

• Cortisol and adrenaline hormones released intp bodu

• Short term stress reduces inflammation

• Chronic stress increases inflammation

What are CRP and Fibrinogen markers of?

Chronic inflammation caused by long-term stress

When do the Differences in CRP and Fibrinogen Between Socioeconomic Groups Begin to Show?

• Noticeable differences at age 30

• Low income, financial instability, and social hardship can cause chronic stress leading to increase in CRP and Fibrinogen  

At what age Should Public Health Efforts Target to Reduce Inequalities in Health?

• At around age 30, when chronic inflammation amrkers peak

• More research should be spend on midlife individuals as this is. when many stressors begin to appear in individuals lives

How did the COVID-19 pandemic affect individuals lives?

Many lost jobs and income and stressed to pay for basic needs impacting their overall health and wellbeing

What survey foes the article use for their data?

The Census Bureus “Hosuehold Pulse Survey”

Which groups were msot affected by the pandemic?

People of colour and oteher high-need / vulnerable groups 

What racial / ethnic groups faced greatwr hardships?

Black and Hispanic adults faced more difficulities than white adults

What age griup was more affected?

Younger adults afced worse measures compared to older adults

How did adults with children compare to those without?

Adults with children faced worse condition than general adult populations

What is the Build Back Better Act?

To expand health coverage and reduced health disparities across different demographic groups