hlsc 2p21 midterm lesson 1 and 2

SDOH according to the world health organization

circumstances in which people are born, grow up, live, work, age & the systems put in place to deal with illness

what are two models of health

medical model and social model

assumptions behind the medical model

1. health and illness are objective biological states (they exist independent of other factors)

2. individuals are responsible for their own health

3. health is the “absence of disease”

the biomedical model of health

• the human body is similar to a machine or robot

• it is made up of parts that are interrelated and can be replaced

• parts can be treated in isolation by specialists

some criticisms of biomedical perspective

1. the fallacy of a specific etiology (a single cause of disease)

2. focus on disease can lead to a lack of focus on preventative efforts

3. it’s “reductionist”

4. it doesn’t account for the social origins of health and illness

5. it can reinforce “victim blaming”

the biomedical perspective of health

• biomedical approaches to health save lives

• they help doctors and researchers to uncover the underlying pathology of the disease

• enormous value

the social model of health

• focuses attention on the societal level of health determinants and health intervention

• examines the social, structural, environmental, cultural and political factors (or determinants) that contribute to health of individuals and populations

• often referred to as “the social determinants of health”

assumptions behind the social model

• health and illness are social constructions (more than just biological)

• society is responsible for the health of its people

some criticisms of the social perspective

1. its “utopian” and unrealistic

2. solutions can appear to be complex and difficult to implement

3. individual responsibility for health isn’t taken seriously enough

the medicine wheel

a tool for supporting First Nations’ life and health, interpreted by Kacey Dool

oxford dictionary definition of health

the state of being free from illness or injury

the WHO(1948) definition of health

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

biomedical model - focus

• individual focus: acute treatment of ill individuals

• clinical services, health education, immunization

the Ottawa charter

An international agreement signed at the first WHO International Conference on Health Promotion conference in 1986

• launched a series of actions among governments, organizations and communities to achieve “health for all” through better health promotion.

what does the Ottawa charter say about health

“Health is therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities

• focus on health as a resource

Kiles et al.(2002) article

“Ultimately, adequately addressing the SDOH to meet population health goals set by Healthy People 2030 will require an “all-hands on deck” approach.

• This includes leveraging not only local, state, and federal governments and institutions, but also all members of the healthcare team”

Kiles et al.(2002) article - community

• community engagement

• community needs assessment and planning

• political advocacy

Kiles et al.(2002) article - practice

• primary prevention strategies

• social needs screening and referral

• interdisciplinary collaboration

Kiles et al.(2002) article - patient

• culturally sensitive patient education

• medication affordability

• medication adherence interventions

who created the rainbow model of health

Dahlgren and Whitehead

what is the rainbow model of health

a widely used framework in public health to explain how different layers of influence affect people’s health and health inequalities

• illustrates the layers of influence

• helps policymakers, researchers and practitioners understand how health is shaped by multiple interconnected levels of influence

layers of the rainbow model

inner layer - individual factors (age, sex, etc.)

second layer - individual lifestyle factors

third layer - social and community networks

fourth layer - living and working conditions

outermost layer - general socioeconomic, cultural and environmental conditions

strengths of the rainbow model

• highlights complexity

• encourages holistic approaches, pushes for upstream interventions

• supports equity

• illustrates health is not only about personal choices or biology but is deeply shaped by the social determinants at multiple levels

• often used in health equity research, health promotion, and policy

what is the social gradient

refers to the consistent and systematic relationship between socioeconomic position and health outcomes

• means that health inequalities are graded across the whole population, not only concentrated among the very poorest

Equity Stratifiers

a characteristic (such as gender, race, age, income, etc.) that identifies population subgroups for measuring differences in health and health acre that may be inequitable (systemic, avoidable, and unfair or unjust)

8 CIHI Equity Stratifiers

• age

• education

• gender

• geographical location

• income

• indigenous identity

• racialized group

• sex at birth

health Canada has identified 12 main determinants of health

determinants of health are the broad range of personal, social, economic, and environmental factors that determine individual and population heath, the main determinants of health include:

1. income and social status

2. employment and working conditions

3. education and literacy

4. childhood experiences

5. physical environments

6. social supports and coping skills

7. healthy behaviours

8. access to health services

9. biology and genetic endowment

10. gender

11. culture

12. race/racism