Socio-Economic Status and Social Determinants of Health

Socio-Economic Status and Social Determinants of Health

Introduction

  • Instructor: Dr. Sachil Singh

  • Course: HH/KINE 1000

  • Institution: YORK UNIVERSITY

  • Focus: Socio-Cultural Perspectives in Kinesiology

Intended Learning Outcomes

  • Understand that determinants of health are social, beyond just medical perspectives.

  • Examine how socio-economic status (SES) functions as a social determinant of health (SDoH).

  • Compare qualitative and quantitative approaches to measuring SES.

  • Utilize Pierre Bourdieu's theories to gain insights into SES.

Required Readings

  • Arney, K. (2017). "How your blood may predict your future health."
    (Available at: https://www.theguardian.com/inequality/2017/oct/10/how-your-blood-may-predict-your-future-health-biomarkers)

  • Rudowitz, R. & Drake, P. (2022). "Tracking Social Determinants of Health During the COVID-19 Pandemic."
    (Available at: https://www.kff.org/coronavirus-covid-19/issue-brief/tracking-social-determinants-of-health-during-the-covid-19-pandemic/)

Definition of Social Determinants of Health

  • Social determinants of health: These are the conditions under which individuals are born, grow, live, work, and age, as defined by Drake and Rudowitz (2022).

Categories of Social Determinants of Health

Economic Stability

  • Employment

  • Income

  • Housing

  • Debts

  • Expenses

Neighborhood and Physical Environment

  • Access to Parks

  • Walkability

  • Transportation

  • Safety and Crime

  • Housing Structure

  • Environmental Quality

Education

  • Educational Attainment

  • Literacy

  • Early Childhood Education

  • Vocational Training

Food

  • Food Security

  • Access to Healthy Options

Community, Safety, and Social Context

  • Social Integration

  • Support Systems

  • Community Engagement

  • Exposure to Violence/Trauma

Health Care System

  • Health Coverage

  • Provider Availability

  • Quality of Care

  • Linguistically and Culturally Appropriate Care

Health and Well-Being Indicators

  • Mortality rates

  • Morbidity rates

  • Life Expectancy

  • Health Care Expenditures

  • Health Status

  • Functional Limitations

Sociological View vs Medical View of Health

  • Medical View: Focuses on immediate biological factors causing disease.

  • Sociological 'Life-Course' View: Investigates social causes that influence health outcomes over a person's life span.

Life-Course Perspective on Health Models

Sensitive-Period Model

  • Acknowledges that certain times in a person's life can significantly affect health.

Cumulative Exposure Model

  • Health implications accumulate over time due to social, economic, and environmental exposures.

Social-Trajectory Model

  • Describes how a person’s social path influences their overall health outcomes across their life.

Social Conditions Affecting Health

  • Request to identify and analyze social conditions affecting health (presented by Bartley, cited in Arney, 2017).

Case Examples of Health Determinants

  1. Smoking

    • Historical context regarding smoking's significance in military culture, citing General George Washington and General John J. Pershing during wartime.

  2. COVID-19

    • Examination of how the pandemic impacted various SDoH, particularly in employment sectors and health care context.

Socio-Economic Status (SES) and Health Outcomes

  • SES: Encompasses education, income, and occupation.

  • Higher SES levels correlate with better health outcomes.

  • Discussion on the legacy of colonialism and the impact of discrimination and racism leading to economic stress.

Poverty/Social Inequality

  • Explores the implication of poverty as a significant determining factor in health frameworks.

Numerical Data on Poverty in Canada

  • Canada’s official poverty rate as of 2022: 14.5%, with historical trends showing a decline over the years:

    • 2015: 12.9%

    • 2016: 11.9%

    • 2017: 11.2%

    • 2018: 10.3%

    • 2019: 9.9%

    • 2020: 6.4%

    • 2021: 7.4%
      (Source: Statistics Canada)

The Social Gradient of Health

  • Highlights how social class differences correlate with health outcomes, indicating that higher socio-economic inequalities relate to poorer health outcomes (Pickett and Wilkinson, 2015).

Measuring SES

Methods of Measurement

  • Qualitative: Describing and understanding individual contextual factors.

  • Quantitative: Sharply defined parameters like income level or academic attainment.

Poverty Line Measurement

  • Defines the “poverty line” against which SES is measured, varies by community type and family size; considers a family’s expenditure on basic necessities.

Gini Coefficient

  • A statistical representation of income inequality, with values ranging from:

    • 0 = perfect equality

    • 1 = maximum inequality.

Social Inequality Understanding

  • Differentiates between social groups, social classes, and status groups to elucidate the complexity of inequality.

Insights from Pierre Bourdieu

Forms of Capital

  • Economic Capital: Financial resources.

  • Social Capital: Networks and relationships that can be leveraged.

  • Cultural Capital: Education, skills, and cultural knowledge.

  • Symbolic Capital: Recognition or prestige that confers status.

Summary and Recap

  • Synthesis of how SES informs SDoH, revealing intersectionality within health determinants.

  • Contrasts between sociological and medical views on health and the importance of Bourdieu's capital types in analyzing social dynamics in health contexts.