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Social Determinants (social + determinant)
Selected AbstractsTHE ETHICAL IMPLICATIONS OF THE SOCIAL DETERMINANTS OF HEALTH: A GLOBAL RENAISSANCE FOR BIOETHICSBIOETHICS, Issue 2 2009PATRICIA ILLINGWORTH First page of article [source] EPIDEMIOLOGY AND SOCIAL JUSTICE IN LIGHT OF SOCIAL DETERMINANTS OF HEALTH RESEARCHBIOETHICS, Issue 2 2009SRIDHAR VENKATAPURAM ABSTRACT The present article identifies how social determinants of health raise two categories of philosophical problems that also fall within the smaller domain of ethics; one set pertains to the philosophy of epidemiology, and the second set pertains to the philosophy of health and social justice. After reviewing these two categories of ethical concerns, the limited conclusion made is that identifying and responding to social determinants of health requires inter-disciplinary reasoning across epidemiology and philosophy. For the reasoning used in epidemiology to be sound, for its scope and (moral) purpose as a science to be clarified as well as for social justice theory to be relevant and coherent, epidemiology and philosophy need to forge a meaningful exchange of ideas that happens in both directions. [source] Guest Editors' Introduction: In Pursuit of the Social Determinants of Health: The Evolution of Health Services ResearchHEALTH SERVICES RESEARCH, Issue 6p2 2003Article first published online: 18 DEC 200 First page of article [source] Message Effects and Social Determinants of Health: Its Application to Cancer DisparitiesJOURNAL OF COMMUNICATION, Issue 2006K. Viswanath Recent work on message effects theories offers a fruitful way to systematically explore how features, formats, structures of messages may attract audience attention and influence the audience and is of great relevance to public health communications. Much of this work, however, has been pursued primarily at the individual level of analysis. It is our contention that message effects on health outcomes could potentially be moderated and mediated by social contextual factors in public health such as social class, social organizations and neighborhoods among others, leading to differential effects among different audience sub-groups. This essay, through a selective review of literatures in communication and social epidemiology, will explore how major message effects may moderate and mediate the role of social determinants of health on cancer control, specifically cancer-related health disparities. [source] Global Health Governance: Commission on Social Determinants of Health and the Imperative for ChangeTHE JOURNAL OF LAW, MEDICINE & ETHICS, Issue 3 2010Ruth Bell In May 2009 the World Health Assembly passed a resolution on reducing health inequities through action on the social determinants of health, based on the work of the global Commission on Social Determinants of Health, 2005,2008. The Commission's genesis and findings raise some important questions for global health governance. We draw out some of the essential elements, themes, and mechanisms that shaped the Commission. We start by examining the evolving nature of global health and the Commission's foundational inspiration , the universal pattern of health inequity and the imperative, driven by a sense of social justice, to make better and more equal health a global goal. We look at how the Commission was established, how it was structured internally, and how it developed external relationships , with the World Health Organization, with global networks of academics and practitioners, with country governments eager to spearhead action on health equity, and with civil society. We outline the Commission's recommendations as they relate to the architecture of global health governance. Finally, we look at how the Commission is catalyzing a movement to bring social determinants of health to the forefront of international and national policy discourse. [source] Social Determinants and Their Unequal Distribution: Clarifying Policy UnderstandingsTHE MILBANK QUARTERLY, Issue 1 2004HILARY GRAHAM Public health policy in older industrialized societies is being reconfigured to improve population health and to address inequalities in the social distribution of health. The concept of social determinants is central to these policies, with tackling the social influences on health seen as a way to reduce health inequalities. But the social factors promoting and undermining the health of individuals and populations should not be confused with the social processes underlying their unequal distribution. This distinction is important because, despite better health and improvement in health determinants, social disparities persist. The article argues that more emphasis on social inequalities is required for a determinants-oriented approach to be able to inform policies to address health inequalities. [source] Social determinants of songbird vocal activity and implications for the persistence of small populationsANIMAL CONSERVATION, Issue 5 2008P. Laiolo Abstract Conspecific attraction is an important aspect of animal behaviour and several avian studies have shown that vocalizations may be used as an inadvertent cue to locate areas of suitable habitat. By studying the metapopulation system of a territorial passerine, the Dupont's lark Chersophilus duponti, we analysed the demographic correlates of population vocal activity, and the relationships between the occurrence of immigration and the availability of social information (e.g. vocal activity, population size, density and productivity) in 22 local populations. We found that the proportion of active singing days in spring and territorial call advertisement after breeding were positively related to the number of males within local populations. In turn, the intensity of vocal activity was associated with the likelihood of receiving immigrants, better explaining immigration than other kinds of social or public information. Because of depressed signalling, small local populations could experience reduced rescuing from others, thus compromising population persistence. In such cases, habitat management alone may not be enough to overcome this behavioural constraint. Because we found that the occurrence of inter-patch movements also depended on the size of nearby local populations, understanding regional processes may be as important as controlling social and environmental factors for the maintenance of small populations. [source] The potential power of social policy programmes: income redistribution, economic resources and healthINTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 2010Olle Lundberg Lundberg O, Fritzell J, Åberg Yngwe M, Kölegård ML. The potential power of social policy programmes: income redistribution, economic resources and health Int J Soc Welfare 2010: ,,: ,,,,,© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. This Supplement includes a number of articles dealing with the role of social policy schemes for public health across the life course. As a key social determinant of health, poverty and its consequences have historically been at the forefront of the public health discussion. But also in rich countries today, economic resources are likely to be important for health and survival, both on an individual and an aggregate level. This introductory article serves as a background for the more specific analyses that follow. The focus is on why income and income inequality could have an effect on individual and population health. We discuss relationships between the individual and population levels and between income and health, and some of the possible mechanisms involved. We also present arguments for why welfare state institutions may matter. [source] Personal and social determinants of health services utilization by Mexican older peopleINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 3 2010Maria Isabel Peñarrieta De Córdova PhD de córdova m.i.p., mier n., curi e.j.m., gómez t.g., quirarte n.h.g. & barrios f.f. (2009) Personal and social determinants of health services utilization by Mexican older people. International Journal of Older People Nursing 5, 193,201 doi: 10.1111/j.1748-3743.2009.00193.x Background., Increased healthcare needs among older individuals around the world demands a better understanding of factors influencing healthcare service utilization patterns. Objective., To examine personal and social correlates to health services utilization among Mexican older persons. Design and methods., This was a cross-sectional study conducted between 2004 and 2006 with 2030 Mexican adults 60 years and older and based on a health services utilization framework. A two-stage cluster sampling with probability proportionate to size was used. Participants were randomly selected and recruited in four metropolitan areas in Northeastern Mexico. Chi-square and Pearson's chi-squared tests and logistic regression were used for data analyses. Results., Significantly more women than men had lost a spouse and were illiterate. Also, females reported significantly poorer health, higher nutritional risk and lower ability to perform activities of daily and instrumental living than males. Predictors of healthcare utilization were: Having a caregiver during an illness; perceiving to have a health problem; being able to afford food, and having children. Conclusions., Predisposing, enabling and need factors are strong predictors of health services utilization among Mexican older persons. In addition, gender differences exist among this population in relation to health status, but not to health services demands. [source] Effects of in-group and out-group support on behavioral consistency: The majority and minority in the context of an intergroup belief crossJAPANESE PSYCHOLOGICAL RESEARCH, Issue 1 2008HIROSHI NONAMI Abstract: The present study investigated the social determinants required to stimulate consistency in minority members' attitudes and behavior. The experiment was designed to examine the consistency of individuals in the context of an intergroup belief cross wherein the majority belief (or minority) in a categorical in-group shifted to the minority (or majority) in the out-group. The results indicated that the members of a majority within an in-group consistently preserved their behavioral intentions and beliefs even though they were positioned as a minority within an out-group. That is, the minority members in the whole intergroup context maintained consistency diachronically as a result of support from the majority of their in-group. The theoretical implications on the consistency of minority members, such as whistle-blowers in companies, are discussed. [source] Message Effects and Social Determinants of Health: Its Application to Cancer DisparitiesJOURNAL OF COMMUNICATION, Issue 2006K. Viswanath Recent work on message effects theories offers a fruitful way to systematically explore how features, formats, structures of messages may attract audience attention and influence the audience and is of great relevance to public health communications. Much of this work, however, has been pursued primarily at the individual level of analysis. It is our contention that message effects on health outcomes could potentially be moderated and mediated by social contextual factors in public health such as social class, social organizations and neighborhoods among others, leading to differential effects among different audience sub-groups. This essay, through a selective review of literatures in communication and social epidemiology, will explore how major message effects may moderate and mediate the role of social determinants of health on cancer control, specifically cancer-related health disparities. [source] Swinging within the iron cage: Modernity, creativity, and embodied practice in American postsecondary jazz educationAMERICAN ETHNOLOGIST, Issue 3 2010EITAN WILF ABSTRACT In this article, I seek to contribute to the anthropology of embodied practice by asking, what would embodied practical mastery that mandates constant differentiation look like, and what would be its cultural and social determinants? In doing so, I draw on ethnographic fieldwork I conducted in a postsecondary jazz school in the United States. Through an exploration of how jazz educators cope with the paradoxical task of training the body and liberating it, I inquire into the challenge of negotiating the tension between the two key modernist ideas of rationalized schooling and Romantic creativity in contemporary institutional contexts. [source] Sociodemographic determinants of growth among Malian adolescent femalesAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2010Timothy F. Leslie In Africa, research concerning the social determinants of poor nutritional status has typically focused on children under 5 years of age and has used defined categorical boundaries based on international reference standards. In this article, stunting and wasting of 1,157 Malian adolescent girls is measured through both categorical and continuous data. The focus on adolescent girls is significant because there is relatively little literature examining this group, and because adolescence marks the time when girls gain greater workload responsibilities, autonomy of food choices, and, as a result of the adolescent growth spurt, require the greatest amount of caloric intake respective to their weight since infancy. To differentiate stunting and wasting causes, a number of socioeconomic, geographic, and demographic factors are explored. The findings suggest that continuous data provides a basis for modeling stunting and wasting superior to utilizing international reference categories. Estimations show that decreasing age, the presence of servants, a greater number of wives in a compound, and residence in a large urban area correlate with improved nutritional status while wealthier families appear to correlate with greater stunting and wasting, and no correlation exists with estimated energy expenditure. Future studies should incorporate continuous data, and the need exists for greater analysis of social determinants of growth indicators among adolescent females. Further, these findings have significant implications in the development of nutrition intervention programs aimed at the vulnerable population in Mali, leading us to conclude that factors beyond socioeconomic indicators such as household structure and location should be more fully examined. Am. J. Hum. Biol., 2010. © 2009 Wiley-Liss, Inc. [source] Global Health Governance: Commission on Social Determinants of Health and the Imperative for ChangeTHE JOURNAL OF LAW, MEDICINE & ETHICS, Issue 3 2010Ruth Bell In May 2009 the World Health Assembly passed a resolution on reducing health inequities through action on the social determinants of health, based on the work of the global Commission on Social Determinants of Health, 2005,2008. The Commission's genesis and findings raise some important questions for global health governance. We draw out some of the essential elements, themes, and mechanisms that shaped the Commission. We start by examining the evolving nature of global health and the Commission's foundational inspiration , the universal pattern of health inequity and the imperative, driven by a sense of social justice, to make better and more equal health a global goal. We look at how the Commission was established, how it was structured internally, and how it developed external relationships , with the World Health Organization, with global networks of academics and practitioners, with country governments eager to spearhead action on health equity, and with civil society. We outline the Commission's recommendations as they relate to the architecture of global health governance. Finally, we look at how the Commission is catalyzing a movement to bring social determinants of health to the forefront of international and national policy discourse. [source] Achieving Health Equity on a Global Scale through a Community-Based, Public Health Framework for ActionTHE JOURNAL OF LAW, MEDICINE & ETHICS, Issue 3 2010Laura Anderko Despite good intentions and decades of discussion addressing the need for transformative changes globally to reduce poverty and improve health equity, little progress has been made. A fundamental shift in framing the current conversation is critical to achieve "health for all," moving away from the traditional approaches that use the more narrowly focused medical model, which is intent on treating and curing disease. A public health framework for action is needed, which recognizes and confronts the complex, and often-times difficult-to-achieve social determinants of health. A restructuring of global health policy development and implementation will be ineffective unless key areas are addressed including primary education and the environment, in addition to economic considerations. A public health framework that embraces a community-based participatory approach would provide a comprehensive platform for identifying critical components that impact health, and for developing effective strategies for change. A participatory approach would encourage dialogue and problem-solving for region-specific issues among those most affected by the broader health and social justice issues, with those who create policy. [source] Social Determinants and Their Unequal Distribution: Clarifying Policy UnderstandingsTHE MILBANK QUARTERLY, Issue 1 2004HILARY GRAHAM Public health policy in older industrialized societies is being reconfigured to improve population health and to address inequalities in the social distribution of health. The concept of social determinants is central to these policies, with tackling the social influences on health seen as a way to reduce health inequalities. But the social factors promoting and undermining the health of individuals and populations should not be confused with the social processes underlying their unequal distribution. This distinction is important because, despite better health and improvement in health determinants, social disparities persist. The article argues that more emphasis on social inequalities is required for a determinants-oriented approach to be able to inform policies to address health inequalities. [source] Can human rights discourse improve the health of Indigenous Australians?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2006Natalie Gray Objective:Recognition of the poor health outcomes of Indigenous Australians has led to an interest in using human rights discourse as a framework for arguing that the Australian Government has an international obligation to improve Indigenous health. Method:This paper explores two potential directions for human rights discourse in this context. The first is the development and elaboration of an asserted ,human right to health'. The second focuses on developing an understanding of the interactions between health and human rights, particularly the underlying social determinants of health, and thereby creating an advocacy framework that could be used to promote the inclusion of human rights considerations into the policy-making agenda. Results:This paper argues that despite the symbolic force of human rights discourse, its capacity to improve the health of Indigenous Australians through international law is limited. This is so irrespective of whether recourse is made to a legal or moral imperative. Conclusion and Implications:The ,human right to health' is limited primarily by several barriers to its implementation, some of which are perpetuated by the current Australian Government itself. Although the potential advocacy capacity of human rights discourse is similarly limited by the hostility of the Government towards the notion of incorporating human rights considerations into its public policy decision making, it does provide a sustainable intellectual framework in which to consider the social and structural determinants of health and maintain these issues on the political agenda. [source] Models for individual oral health promotion and their effectiveness: a systematic reviewAUSTRALIAN DENTAL JOURNAL, Issue 3 2009D Yevlahova Abstract Background:, There is a recognized need to deliver oral health information to people during clinical encounters to enable them to develop personal skills in managing their own oral health. Traditional approaches to individual oral health education have been shown to be largely ineffective and new approaches are required to address personal motivations for preventive behaviour. This systematic review aims to identify and assess the effectiveness of behaviour models as a basis for individual oral health promotion. Methods:, Electronic databases were searched for articles evaluating the effectiveness of health behaviour models in oral and general health between 2000 and 2007. Eighty-nine studies were retrieved and data were extracted from the 32 studies that met the inclusion criteria. Results:, Thirty-two studies were identified in the fields of clinical prevention and health education, motivational interviewing (MI), counselling, and models based interventions. MI interventions were found to be the most effective method for altering health behaviours in a clinical setting. Conclusions:, There is a need to develop an effective model for chairside oral health promotion that incorporates this evidence and allows oral health professionals to focus more on the underlying social determinants of oral disease during the clinical encounter. There is potential to further develop the MI approach within the oral health field. [source] Biomarkers of periodontal inflammation in the Australian adult populationAUSTRALIAN DENTAL JOURNAL, Issue 2 2009TR Fitzsimmons Abstract Background:, Several inflammatory biomarkers are implicated in the pathogenesis of periodontitis including interleukin-1, (IL-1,) and C-reactive protein (CRP). This study investigated the presence of these factors in gingival crevicular fluid (GCF) and their relationship to clinical and social determinants of periodontitis in the Australian population. Methods:, Equal numbers of periodontitis cases and non-cases were sampled during oral epidemiologic examination in the National Survey of Adult Oral Health. GCF was sampled from four sites where probing pocket depth (PPD) and recession were recorded. From these, IL-1, and CRP were quantified by ELISA and the log amount of GCF IL-1, (pg) per person and the proportion of adults with detectable CRP was computed. Results:, Periodontitis cases (n = 511) had significantly higher levels of IL-1, and CRP than non-cases (n = 562). PPD, clinical attachment loss, plaque and gingivitis indices were positively associated with elevated levels of both biomarkers. Levels of both were positively associated with age, low socio-economic position and non-Australian birth. Conclusions:, The presence of IL-1, and CRP in GCF are associated with periodontal disease parameters within the Australian population. The levels of both biomarkers are influenced by age, education and eligibility for public dental care. [source] EPIDEMIOLOGY AND SOCIAL JUSTICE IN LIGHT OF SOCIAL DETERMINANTS OF HEALTH RESEARCHBIOETHICS, Issue 2 2009SRIDHAR VENKATAPURAM ABSTRACT The present article identifies how social determinants of health raise two categories of philosophical problems that also fall within the smaller domain of ethics; one set pertains to the philosophy of epidemiology, and the second set pertains to the philosophy of health and social justice. After reviewing these two categories of ethical concerns, the limited conclusion made is that identifying and responding to social determinants of health requires inter-disciplinary reasoning across epidemiology and philosophy. For the reasoning used in epidemiology to be sound, for its scope and (moral) purpose as a science to be clarified as well as for social justice theory to be relevant and coherent, epidemiology and philosophy need to forge a meaningful exchange of ideas that happens in both directions. [source] Millennium development goals and oral health in cities in southern BrazilCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 3 2010Roberto Eduardo Bueno Bueno RE, Moysés SJ, Moysés ST. Millennium development goals and oral health in cities in southern Brazil. Community Dent Oral Epidemiol 2010; 38: 197,205. © 2010 John Wiley & Sons A/S Abstract,,, Objectives:, To investigate social determinants of oral health, analysing the occurrence of associations between millennium development goals (MDG) indicators and oral health (OH) indicators. Methods:, An ecological study was performed in two distinct phases. In Phase 1, MDG indicators and related covariates were obtained from the demographic census of the Brazilian Institute of Geography and Statistics, the Ministry of Health database and the 2000 Human Development Atlas, making up the whole set of independent variables. Principal component analysis was carried out for the independent variables showing the correlations among the variables comprising the main components, and generating a synthetic index allowing the performance of the cities to be known with regard to the MDG (MDG index). In Phase 2, the DMFT index (mean number of decay, missing or filled permanent teeth) and the CF index (prevalence of caries-free individuals), in 12 years old were obtained from the epidemiological survey undertaken in 2002,2003, in 49 cities in southern Brazil, and were analysed in relation to the MDG index using Spearman's correlation. Results:, A statistically significant correlation was found for the DMFT and CF indices, respectively, with: the MDG index (R2 = 0.49 and 0.48; P = 0.00); the socioeconomic status of the population (R2 = 0.12 and 0.12; P = 0.02); the socioenvironmental characteristics (R2 = 0.41 and 0.46; P = 0.00). Conclusions:, The MDG synthetic index of the cities analysed and the respective components relating to their socioeconomic and socioenvironmental status demonstrated a positive correlation with OH indicators. As such, intersectoral public policies based on population strategies that act on social determinants of general and oral health need to be integrated so as to impact on the MDG and OH outcomes. [source] Oral health inequalities between young Aboriginal and non-Aboriginal children living in Ontario, CanadaCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 6 2009Herenia P. Lawrence Abstract,,, Objectives:, To investigate (i) oral health inequalities between off-reserve Aboriginal and non-Aboriginal children entering junior kindergarten (JK) in the Thunder Bay District, Northwest Ontario, Canada, (ii) oral health inequalities between kindergarten-aged (4 years old) Aboriginal children living on reserves in the Sioux Lookout Zone (SLZ), Northwest Ontario and those living off-reserve in the Thunder Bay District and (iii) early childhood caries (ECC) trends among SLZ children between 2001 and 2005. Methods:, Cross-sectional oral health data (dmft/s Indices) for 416 (2003/2004), 687 (2004/2005) and 544 (2005/2006) 3- to 5-year olds attending JK in the Thunder Bay District were collected by calibrated dental hygienists with the District's Health Unit. Secondary analysis of oral health status data from two studies conducted in the SLZ between 2001 and 2005 provided the dmft of random samples of children younger than 6 years of age living in 16,20 First Nations communities. Results:, When compared with non-Aboriginal children aged 3,5 years attending the same schools in the Thunder Bay District between 2003 and 2006, off-reserve Aboriginal children had 1.9 to 2.3 times the risk of having ECC (dmft > 0), 2.9 to 3.5 times the risk of a dmft > 3 and 1.8 to 2.5 times the risk of untreated decayed teeth after adjusting the prevalence ratios for child's age and sex, school's risk level and clustered-correlated data. The mean dmft of on-reserve Aboriginal 4-year olds in 2005 was 11.2 and 5.9 for their off-reserve Aboriginal counterparts. In 2001, the mean dmft scores (95% confidence interval) of 2-, 3- and 4-year-old Aboriginal children in the SLZ were: 9.1 (8.3,9.9), 12.4 (11.8,13.1), 13.1 (12.1,14.2). In 2005, similarly aged SLZ children had a mean dmft of: 6.2 (5.2,7.1), 8.9 (8.2,9.6), 11.2 (10.5,11.9), representing significant reductions in caries severity (32%, 28% and 14.5%, respectively). Conclusions:, Significant disparities in caries experience exist between off-reserve Aboriginal and non-Aboriginal children living in the same locales and between Aboriginal children living on- and off-reserve in northwestern Ontario. The study showed decreased trends in the severity of ECC for children in the SLZ occurring over the 5-year period. Despite this progress, the oral health of young Aboriginal children in Ontario continues to lag far behind that of non-Aboriginal children, demanding further programs and policies to tackle the social determinants of oral health and resolve these inequalities. [source] Concepts of risk in dental public healthCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 4 2005Brian A. Burt Abstract , The purpose of this paper is to review the concepts of risk as we use them today in dental public health practice, and to suggest that we should broaden our view of risk. Use of terms like risk factor in the literature can be quite vague, and it is recommended that a clear definition of that and related terms be adhered to. A broader view of risk in dental research would take in the concepts of social determinants of health and population health. While some progress has been made in our understanding of these issues, better knowledge would give the public health administrator more readily available information to use in program planning. The skewed distribution of caries in the high-income countries has led to the emergence of targeted prevention programs toward those considered to be at high risk. In public health programs, targeting at the individual level is not practical: the risk assessment methods are not yet sufficiently precise, and even when individuals are identified there are practical problems with schools and with the children themselves. (For private practice, however, high-risk child patients can be identified as those with at least one approximal lesion in permanent teeth.) For public health purposes, an argument is made for geographic targeting, i.e. identification of areas of social deprivation where whole schools or school districts can be targeted. Geographic targeting is something between individual targeting and whole-population approaches. Ideally, geographic targeting would supplement population measures like water fluoridation and dental health education. Examples of geographic targeting from Ohio and New York are presented as illustrations. [source] | ||||||||||||||||||||||||||||