KIN 278: Topic 2 Introduction to Health Promotion - Study Notes

Define & Identify SDHs: Understand and articulate the concept of Social Determinants of Health (SDHs) affecting Canadians.
Discuss Importance: Comprehend the significance of SDHs as major underlying factors influencing the health of the population.
Role in Population Health Promotion: Acknowledge the crucial role of SDHs in the promotion of population health.

Definition: SDHs are the socio-economic conditions that shape the health of individuals, communities, and populations.
Key Characteristics:
- Conditions: The environments in which people are born, grow, live, work, and age.
- Shaping Forces: These circumstances are influenced by the distribution of money, power, and resources at varied levels (global, national, and local).
Importance: Understanding SDHs is critical to analyzing patterns of health and illness in Canada, as they significantly contribute to health inequities—unfair and avoidable differences in health status both within and between countries.

Components: A model illustrating the determinants of health, categorized into:
- Socio-economic Factors: Income, education, employment, housing, food security.
- Cultural Factors: Societal norms, community participation.
- Environmental Factors: Living conditions, healthcare services, and access.
- Individual Factors: Age, sex, genetic predisposition.
- Examples of Social Determinants:
- Work environment
- Education
- Lifestyle
- Unemployment
- Water and sanitation

Definitions:
- Equality: Involves treating every individual the same, without consideration for differences or specific needs.
- Equity: Focuses on fairness, treating individuals according to their specific needs to ensure equal opportunities.

Health follows a social gradient where the poorest individuals typically experience the worst health outcomes.
Gradient Observations:
- The lower an individual's socioeconomic position, the worse their health.
- This effect is observable within countries across the socioeconomic spectrum, affecting low, middle, and high-income nations.
Implication: It suggests that health inequities are pervasive and affect all social strata.

The health landscape is influenced by broader forces such as:
- Economic dynamics
- Policy frameworks
- Political environments
Crucial Insight by WHO: The unequal distribution of health-threatening experiences stems from poor social policies, inequitable economics, and inadequate politics, creating disparities.

The significance of SDHs has been recognized in Canadian government policy since the mid-1970s.
Despite being a wealthy nation, Canada struggles with poverty, social exclusion, and underemployment issues, which remain often obscured.
While healthcare spending is high, a robust social safety net is lacking, leading to a cycle where illnesses are treated without addressing underlying conditions.

Key Determinants Include:
- Income and poverty levels
- Education and literacy
- Housing and neighborhoods
- Food security
- Access to healthcare
- Social support and safety networks
- Unemployment and job security
- Employment and working conditions
- Early childhood development
- Social cohesion, community participation, social inclusion
- Exposure to crime and violence
- Social norms: discrimination, racism
- Environmental conditions
- Gender, race, and Indigenous status
- Disability and transportation challenges
- Public safety issues

Effects of Adverse Conditions:
- Individuals in poor social and material conditions experience elevated levels of both physiological and psychological stress.
- Chronic Stress: Results in physiological strain which disrupts bodily systems and weakens immunity to diseases.
Psychological Stress: Can manifest as feelings of shame, insecurity, worthlessness, anxiety, hopelessness, and exhaustion, often leading to unhealthy coping mechanisms.

Classified as the most influential SDH due to its extensive impact on living conditions, mental health, lifestyle behavior, and overall wellbeing.
Implications of Income Inequality:
- Disparities in income distribution contribute to numerous deleterious effects like social exclusion and deteriorated health conditions.

Figure 3.1: Life Expectancy of Females and Males by Income Quintile in Canada (2009-2011)
- Gender differences in life expectancy correlated with income strata—individuals in wealthier neighborhoods tend to live longer.

Figure 3.2: Depicts the Gini Coefficient of Income Inequality across various nations, indicating the disparity of income among inhabitants.
- The Gini coefficient reflects how income is distributed, with lower values indicating more equal distributions.

Location-Based Health Disparities: Poor neighborhoods align with high diabetes rates, showcasing a clear linkage between socioeconomic status and health outcomes.

Oxfam Report Findings:
- The richest 1% possess as much wealth as the poorest 50% of the global population combined.
- In Canada, wealth concentration is exemplified by individuals whose fortunes rival millions of others.

Differences Explained:
- Wealth: Assets minus debts; offers long-term security.
- Income: Money received over a certain period, which may be less stable than wealth.

Calls for Wealth Redistribution: Suggested policies include progressive taxation and increased public spending on social services to ameliorate inequalities.

Women often face more adverse social determinants than men due to caretaking roles, lower wages, and less full-time employment opportunities.

Standard Health Tips:
- Budget for a balanced diet, exercise regularly, manage stress, and avoid smoking.
Innovative Health Considerations:
- Living situation impacts health dramatically, highlighting the importance of conducive living conditions and financial stability.

Social Exclusion: Underrepresented groups (e.g., indigenous peoples, recent immigrants, women, people with disabilities) face barriers to resources and opportunities, leading to feelings of hopelessness and marginalization.
Access to Care: The Canada Health Act mandates equitable access to healthcare, yet implementation gaps remain, particularly for underserved populations.

Addressing the social determinants of health is vital for ensuring comprehensive health equity and improving public health outcomes in Canada. Policy reform has been suggested to tackle underlying disparities for the benefit of all.