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Book part
Publication date: 4 September 2013

Anne M. Hewitt

Recent national policy adoptions of the social determinants of health approach present enormous challenges to practitioners designing health promotion programs aimed at…

Abstract

Purpose

Recent national policy adoptions of the social determinants of health approach present enormous challenges to practitioners designing health promotion programs aimed at eliminating health disparities. This chapter provides a framework for understanding the social determinant rationale embedded in Healthy People 2020 and introduces the concept of place as an important consideration.

Methodology/Approach

This chapter presents a conceptual explanation of social determinant thinking and describes the potential impact for traditional health promotion activities that target the at-risk populations.

Findings

Two major resources, the Health Impact Assessment Toolkit and the HHS Disparities Action Plan, have emerged as frameworks for developing a health in all policies approach that will enable health practitioners to enhance their social determinant interventions.

Research limitations/implications

Current social determinant approaches and models need to be strategically tailored to interventions aiming to reduce health disparities. Additional research focusing on how these approaches are integrated within the existing health promotion program frameworks is required.

Practical implications

Very few health practitioners have had the opportunity to integrate a social determinant approach that emphasizes the concept of place and explores the consequences of using a health in all policies approach. This chapter serves as a practical introduction and outlines the major challenges.

Originality/value of paper

The tipping point for the inclusion of social determinants of health in addressing health disparities occurred with the publication of Healthy People 2020. As this innovation begins to diffuse throughout the country, health practitioners will benefit by reviews and applications of the new rationale and model.

Details

Social Determinants, Health Disparities and Linkages to Health and Health Care
Type: Book
ISBN: 978-1-78190-588-3

Keywords

Article
Publication date: 12 March 2018

Lynn A. Stewart, Amanda Nolan, Jennie Thompson and Jenelle Power

International studies indicate that offenders have higher rates of infectious diseases, chronic diseases, and physical disorders relative to the general population…

Abstract

Purpose

International studies indicate that offenders have higher rates of infectious diseases, chronic diseases, and physical disorders relative to the general population. Although social determinants of health have been found to affect the mental health of a population, less information is available regarding the impact of social determinants on physical health, especially among offenders. The purpose of this paper is to examine the relationship between social determinants and the physical health status of federal Canadian offenders.

Design/methodology/approach

The study included all men admitted to federal institutions between 1 April 2012 and 30 September 2012 (n=2,273) who consented to the intake health assessment. Logistic regression analyses were used to explore whether age group, Aboriginal ancestry, and each of the individual social determinants significantly predicted a variety of health conditions.

Findings

The majority of men reported having a physical health condition and had experienced social determinants associated with adverse health outcomes, especially men of Aboriginal ancestry. Two social determinants factors in particular were consistently related to the health of offenders, a history of childhood abuse, and the use of social assistance.

Research limitations/implications

The study is limited to the use of self-report data. Additionally, the measures of social determinants of health were indicators taken from assessments that provided only rough estimates of the constructs rather than from established measures.

Originality/value

A better understanding of how these factors affect offenders can inform strategies to address correctional health issues and reduce the impact of chronic conditions through targeted correctional education and intervention programmes.

Details

International Journal of Prisoner Health, vol. 14 no. 1
Type: Research Article
ISSN: 1744-9200

Keywords

Abstract

Purpose

This chapter analyses and discusses local government health promotion in Norway.

Approach/methodology

Institutional theory indicates that political and administrative jurisdictions are path dependent in their policy formation and implementation. By using data from different sources this assumption is analysed and discussed according to health promotion in Norwegian municipalities. The main methodology is cross tabulations, bivariate correlations and regression is carried out to supplement analyses.

Findings

Municipalities are path dependent in their health promotion policies. They acknowledge and prioritize health behaviour independent of experienced socio-economic challenges, municipal capacity as size and income, and local government political profile. Competence devoted to health promotion can create changes in policies.

Limitation/policy implications

The rhetoric on determinants and social determinants in particular is new in Norway. Rhetoric on, and interventions, that highlight the social determinants of health need to be coordinated.

Originality

The chapter presents new knowledge on Norwegian local government health promotion and how this is implemented in relation to the challenges experienced.

Details

Technology, Communication, Disparities and Government Options in Health and Health Care Services
Type: Book
ISBN: 978-1-78350-645-3

Keywords

Article
Publication date: 16 December 2019

Juan Smart and Alejandra Letelier

The purpose of this paper is to do a systematic assessment and testing of identified human rights norms alongside social determinant approaches in relation to identified…

Abstract

Purpose

The purpose of this paper is to do a systematic assessment and testing of identified human rights norms alongside social determinant approaches in relation to identified health issues of concern in four Latin American countries (Argentina, Chile, Paraguay and Uruguay) to show how social determinants and human rights frameworks improve population health.

Design/methodology/approach

To do so, in the first part the authors analyze the inequalities both between and within each of the selected countries in terms of health status and health determinants of the population. Then, in the second section, the authors analyze the level of recognition, institutionalisation and accountability of the right to health in each country.

Findings

From the data used in this paper it is possible to conclude that the four analysed countries have improved their results in terms of health status, health care and health behaviours. This improvement coincides with the recognition, institutionalisation and creation of accountability mechanisms of human rights principles and standards in terms of health and that a human rights approach to health and its relation with other social determinants have extended universal health coverage and health systems in the four analysed countries.

Originality/value

Despite of the importance of the relation between human rights and social determinants of health, there are few human right scholars working on the issues of social determinants of health and human rights. Most of the literature of health and human rights has been focussed specific relations between specific rights and the right to health, but less human right scholar working on social determinants of health. On the other hand, just a few epidemiologists and people working on social medicine have actually started to use a universal human rights frame and discourse. In fact, according to Vnkatapuram, Bell and Marmot: “while health and human rights advocates have from the start taken a global perspective, social medicine and social epidemiology have been slower to catch up”.

Details

International Journal of Human Rights in Healthcare, vol. 13 no. 1
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 1 June 2007

Bridget Candy, Vicky Cattell, Charlotte Clark and Stephen Stansfeld

Those most socially disadvantaged are at a greater risk of common mental disorder (CMD). The need to evaluate the health impact of social policy interventions that aim to…

Abstract

Those most socially disadvantaged are at a greater risk of common mental disorder (CMD). The need to evaluate the health impact of social policy interventions that aim to reduce social inequalities between the disadvantaged and the better off is well recognised. This paper reports findings from a review to explore evidence on the health impact of UK policy interventions that aim to tackle the key social determinants of CMD. These were previously identified from the literature as cumulative socioeconomic deprivation, unemployment, psychosocial work characteristics, and poor social relationships. We identified some evidence of a positive impact on CMD of urban regeneration schemes, but evidence was sparse on interventions relating to the other determinants. The ability of research to inform policy designed to improve the lives of the disadvantaged could be assisted by a broader definition of what counts as evidence. This may include wider use of qualitative methodologies and a more deliberate focus on social processes known to be implicated in mental health.

Details

Journal of Public Mental Health, vol. 6 no. 2
Type: Research Article
ISSN: 1746-5729

Keywords

Article
Publication date: 15 June 2021

Lilcelia A. Williams

Intersectionality theory is a social justice theory customarily employed to address inequities which arise in the academic or legal arenas as it relates to race and…

Abstract

Purpose

Intersectionality theory is a social justice theory customarily employed to address inequities which arise in the academic or legal arenas as it relates to race and gender. The application of intersectionality theory extends beyond the convergence of multiple social identities. It provides an invaluable framework to examine the convergence of social identities, the social determinants of health and a global pandemic in communities of historically marginalized and underrepresented persons. The purpose of this paper is to examine how the coronavirus pandemic has exacerbated the disparities experienced by African American and Latinx persons using the principles of intersectionality theory as the schema.

Design/methodology/approach

A literature review was performed on the scholarly articles examining the disproportionate incidence and mortality rates of African Americans and Latinx persons in America.

Findings

The current literature confirms that the disparities which existed prior to the onset of the coronavirus pandemic have been magnified by systemic oppression and racism of historically marginalized and underrepresented persons in America. The coronavirus pandemic has spotlighted the disparities in sustainable employment and access to health care for African American and Latinx persons.

Originality/value

Employing a social justice theoretical framework of intersectionality provides an opportunity to examine the lived experiences of African American and Latinx persons without race/ethnicity being the primary focal point. Future research will illustrate the urgent need for public health policy reform to eradicate the disparities experienced by African American and Latinx populations.

Details

Equality, Diversity and Inclusion: An International Journal, vol. 41 no. 1
Type: Research Article
ISSN: 2040-7149

Keywords

Article
Publication date: 12 July 2017

Katy Gordon, Juliette Wilson, Andrea Tonner and Eleanor Shaw

The purpose of this paper is to examine the impacts of social enterprise on individual and community health and well-being. It focusses on community food initiatives…

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Abstract

Purpose

The purpose of this paper is to examine the impacts of social enterprise on individual and community health and well-being. It focusses on community food initiatives, their impact on the social determinants of health and the influence of structure on their outcomes.

Design/methodology/approach

Using an interpretive qualitative approach through case studies focussed on two community food social enterprises, the research team conducted observations, interviews and ad hoc conversations.

Findings

Researchers found that social enterprises impacted all layers of the social determinants of health model but that there was greater impact on individual lifestyle factors and social and community networks. Impact at the higher socio-economic, cultural and environmental layer was more constrained. There was also evidence of the structural factors both enabling and constraining impact at all levels.

Practical implications

This study helps to facilitate understanding on the role of social enterprises as a key way for individuals and communities to work together to build their capabilities and resilience when facing health inequalities. Building upon previous work, it provides insight into the practices, limitations and challenges of those engaged in encouraging and supporting behavioural changes.

Originality/value

The paper contributes to a deeper insight of the use, motivation and understanding of social enterprise as an operating model by community food initiatives. It provides evidence of the impact of such social enterprises on the social determinants of health and uses structuration theory (Giddens, 1984) to explore how structure both influences and constrains the impact of these enterprises.

Details

International Journal of Entrepreneurial Behavior & Research, vol. 24 no. 3
Type: Research Article
ISSN: 1355-2554

Keywords

Article
Publication date: 30 August 2010

Bayard Roberts, Pamela Abbott and Martin McKee

Although it is well recognised that the collapse of the Soviet Union and the subsequent widespread social and economic changes impacted on the levels and distribution of

Abstract

Although it is well recognised that the collapse of the Soviet Union and the subsequent widespread social and economic changes impacted on the levels and distribution of physical health, there is very limited evidence on the social patterning of mental health in the countries that emerged. The aim of this paper is to assess levels of psychological distress and describe its demographic, social and economic correlates in eight former Soviet countries.Cross‐sectional surveys using multi‐stage random sampling were conducted in Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. A standardised questionnaire was used for all countries, including the main outcome for this study of psychological distress, which consisted of 12 items on symptoms of psychological distress. Respondents who repor ted 10‐12 of the symptoms were considered to have a high psychological distress score. Multivariate logistic regression analysis was then used to investigate how demographic, social and economic factors were associated with a high psychological distress score.High psychological distress in seven of the eight countries ranges from 3.8% in Kazakhstan to 10% in Ukraine but was substantially higher (21.7%) in Armenia. Factors associated with psychological distress in the multivariate analysis included: being female; increasing age; incomplete secondary education; being disabled; experiencing two or more stressful events in the past year; lack of trust in people; lack of personal suppor t in crisis; being unemployed; and poor household economic situation.The study contributes evidence on the association of impoverishment and social isolation on psychological distress in countries of the former Soviet Union and highlights the impor tance of exploring ways of improving mental health by addressing its social determinants.

Details

Journal of Public Mental Health, vol. 9 no. 3
Type: Research Article
ISSN: 1746-5729

Keywords

Article
Publication date: 29 November 2013

Patrick Larsson

The purpose of this paper is to establish that social determinants are vital contributing factors to mental health difficulties and that, similar to physical health

Abstract

Purpose

The purpose of this paper is to establish that social determinants are vital contributing factors to mental health difficulties and that, similar to physical health, mental health follows a social gradient. Despite this acknowledgement, there is a rhetoric/reality gap found in social determinants of mental health (SDMH). It will be argued in this paper that this rhetoric/reality gap is located on a number of levels, including theoretical, methodological, practical, political and policy based, which are proposed here to be interrelated.

Design/methodology/approach

The approach is a conceptual analysis of the rhetoric/reality gap found in SDMH using a critical perspective. It draws on a wide variety of theories in order to provide an analysis of the issues outlined.

Findings

The paper's central finding is that there is a dissonance between the dominant ontological, epistemological and methodological, or axiomatic, focus in contemporary mental health theory and practice and SDMH. This dissonance has led to a form of “analysis paralysis” on all levels, and the initiatives required to tackle SDMH have been marginalised in favour of a narrow interpretation of evidence-based research and its accompanying ideology centring on the individual, which has established itself as a primary position on what constitutes valid knowledge to the detriment of other views.

Originality/value

The paper offers a critical perspective on an area of SDMH which is often alluded to but never explicitly explored, and questions the underlying assumptions inherent to mental health theory and practice. The paper's value is that it draws attention to this particular dilemma on a wider scale, including on a political and policy-based level, which is often neglected in mental health theory, and it makes some recommendations on how to move forward.

Details

Mental Health Review Journal, vol. 18 no. 4
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 10 August 2021

Fateh Tavangar, Hassan Rafiey, Farhad Nosrati Nejad, Ahmad Ali Noorbala and Gholamreza Ghaedamini Harouni

Social determinants of stressful events (SE) play an important role in justifying the cause of inequality in the experience of SE. The purpose of this study is to…

Abstract

Purpose

Social determinants of stressful events (SE) play an important role in justifying the cause of inequality in the experience of SE. The purpose of this study is to investigate the determinants that impact on inequality in the experience of SE.

Design/methodology/approach

The statistical population of this study includes all residents of Tehran. The statistical sample was 5,895 people who were selected by multistage cluster method and were proportional to the population size. The research tool is a researcher-made questionnaire designed to measure SE in Tehran, which includes 11 psychological stressors. The Oaxaca–Blinder decomposing method was used to analyze data.

Findings

In a total of 11 psychological SE, in 6 of those events, there was significant inequality in the experience of SE. Concentration Index (CI) of political SE is (CI = −0.27, 95% CI: −0.47, −0.07) and in favor of the rich (pro-rich). Education (OR = 1.60) in poor group and region development in poor and rich (respectively in all of the following) (OR = 0.42–0.73) are the main determinants of inequality in this stressor. CI of neighborhood underdevelopment SE is (CI = −0.47, 95% CI: 0.66, −0.28) and pro-rich. Education (OR = 1.26–1.27) and region development (OR = 1.18–2.24) are the main determinants of inequality in this stressor. CI of livelihood problems SE is (CI = −0.58, 95% CI: 0.68, −0.32) and pro-rich. Education (OR = 1.40) and health status (OR = 1.63) in poor group are the main determinants of inequality in this stressor. CI of future uncertainty SE is (CI = −0.12, 95% CI: 0.34, −0.08) and pro-rich. Gender (OR = 1.22) in poor group and region development (OR = 0.24–0.58) are the main determinants of inequality in this stressor. CI of education problems (CI = 0.19, 95% CI: 0.05, 0.32) and pro-poor. Age (OR = 0.32–0.34) and education (OR = 3.65–3.30) are the main determinants of inequality in this stressor. CI of housing problems is (CI = −0.29, 95% CI: −0.49, −0.08) and pro-rich. Education (OR = 1.31) and region development (OR = 1.64) in poor group are the main determinants of inequality in this stressor.

Research limitations/implications

The first limitation is related to the level of data analysis, and the second limitation is the lack of comprehensive data on social determinants.

Practical implications

Social determinants affecting the formation of inequality in the experience of SE. Some social determinants, such as the level of education and development of the region, play a more prominent role in justifying inequality in the experience of stress between rich and poor groups.

Social implications

Inequality in the experience of SE is a serious threat to mental and social health. One of the ways to reduce the experience of psychological and social stress is to pay attention to social determinants that play a role in the formation of stress.

Originality/value

This original paper was conducted by examining the effect of social determinants on the formation of inequality in the experience of stress, which draws the serious attention of policymakers.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

Keywords

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