The SDoH
A systematic framework showing the main determinants of the health of populations
The Dahlgren & Whitehead model (1991)
Two ways to measure education at population level
2.Participation
What can socio-economic status include?
Education or Income or Employment
A multi-dimensional view of an 'environment' considers?
Natural
Built
Social
Any factor that is directly associated with a change in health status.
Proximal or downstream determinant
The number of social determinants of health
No set list/number
The relationship between level of qualification and mortality at a population level
higher educational achievement eg. qualification, associated with lower mortality.
A step-wise, education health gradient
A definition of socio-economic status
A measure of one’s combined economic and social circumstances
traffic calming measures are a feature of what aspect of our environment
built environment
The impact of the Preceed/Proceed Model on SDOH
Comprehensive assessment of social, environmental and behavioral factors of a community or population
A factor distant in either time or place from a change in health status
Distal or upstream determinant
A concept describing the two-way causal relationship between health and education
Reverse causality
Age, religion, nursing knowledge, literacy, cultural preferences
A pathway through which the social environment can impact health
Greater social cohesion = more trust = communities work together to improve environments = positive influences on health
Social Support, Economic Rewards, and Changing Social Norms
Reinforcing factors of the Preceed/Proceed Model
The relationship between structure and agency in health
Structure refers to the larger social determinants or circumstances that shape our everyday lives. The factors that determine or limit peoples’ ability to act/make decisions.
Agency is the capacity for individuals to act independently and to make their own free choices.
Structures influence or determine agency
The relationship between education, neighbourhoods and health
Greater education attainment increase purchasing power/access to material resources, which allows for access to healthier neighboorhood conditions - positive influences on health
The error of applying an area level measure to an individual
Ecological Fallacy
A pathway through which climate change could impact respiratory health outcomes in Aotearoa/NZ
increased rain, impacts on damp/cold housing, increases in asthma and other respiratory conditions
A reason why social inequalities are bad for societies
Countries with greater income inequality have lower life expectancy, higher infant mortality, poorer mental health outcomes etc.
The relationship between upstream and downstream determinants of health
Upstream determinants are those that occur at the macro level and include global forces, government policies and societal structures that influence health through impact on the downstream determinants, such as health behaviours or lifestyle factors
The relationship between education, health knowledge and disease management
Greater educational attainment creates opportunities for better health as people have stronger health knowledge, which supports more effective disease management/understanding of medical conditions.
The term used to describe the phenomenon whereby people who are less advantaged in terms of socioeconomic position have worse health (and shorter lives) than those who are more advantaged.
A social gradient in health
A pathway through which climate change can increase social inequity
Extreme weather, influences on food supply, impacts on prices and availability/cost of food
lower SES, greater exposure to risk factors such as stress, poorer nutrition and road traffic accidents, contributes to poorer health outcomes across the life-course