In the past, efforts to improve health have primarily focused on restructuring the health care system to enhance health outcomes. However, in recent years healthcare industry leaders have realized the significant influence of environmental, social and economic factors on health outcomes. Therefore, contemporary efforts to improve health and realize health equity have considerably focused on improving the social, economic and environmental factors that influence health. These factors are known as the determinants of health. They fall under several broad categories, with the most dominant one being the social factors.
The Social Determinants of Health
According to the World Health Organization (WHO), the social determinants of health are conditions in which people are born, grow, live, work and age. The WHO further suggests that these conditions are influenced by the distribution of power, money and resources at global, national and local levels (Marmot, et al., 2012). These social determinants include education, employment, social support networks, physical environment, access to health care and access to housing and utility services, among others. These social factors create a stratified society based on economic classes, gender and ethnicity; thus, they influence the health of individuals as they impact their quality of life outcome. For instance, lack of education may reduce employment opportunities for individuals and consequently constrain their income. This may, in turn, reduce their access to quality healthcare, nutritional diet and quality housing. Inadequate access to these amenities results in poor health of the individuals. Also, low income may increases hardship in people's lives, which may upsurge stress levels and reduce mental health. Individuals may then engage in unhealthy practices such as drug abuse and unhealthy eating to cope with stress. Therefore, the social determinants of health have a significant underlying influence on public health.
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Alterations and Problems Associated with Inadequate/ Lack of Social Determinants of Health
The interaction between individuals and their social and physical environment has a significant influence on their health outcomes. The potential to realize full health potential by individuals is, however, limited by their socioeconomic status and other socially determined conditions (Marmot, et al., 2012). Therefore, health inequity is a significant problem associated with inadequate social determinants of health. Studies have shown that health follows a social gradient where an improved socioeconomic position of an individual is linked with better health outcome. Factors such as the quality of housing, quality of work and access to quality healthcare have been found to shift the social gradient and impact health outcomes. Several scholars have researched the issue of health inequity in the past. In one study, some of the dominant social factors were evaluated, and their impact on health equity was discussed.
First, the evaluation studies revealed that housing and living environment has a significant impact on the health of an individual (Bambra, et al., 2010). For instance, inadequate housing with limited lighting may increase the risk of falls and injury of individuals, thus undermining their physical health. Also, the perception of individuals about their neighborhood’s safety in terms of exposure to crimes was found to impact the mental health of individuals (Bambra, et al., 2010). Therefore, inadequate housing and the insecure living environment of an individual may lead to poor health of an individual. Secondly, the working environment has a significant impact on the health of and individual. Individuals working in a sterile work environment may be vulnerable to occupational diseases and other health-related risks such as injuries (Bambra, et al., 2010). Inadequate or lack of workplace safety regulations may, therefore, pose a threat to the health of the employees.
Another health inequality issue is associated with limited or lack of clean water and proper sanitation (Bambra, et al., 2010). Aspects of water management, such as pollution and contamination, all have a potential impact on public health. Individuals who cannot access clean water and proper sanitation are more vulnerable to infectious diseases such as cholera. Therefore, inadequate availability of these essential utilities to some individuals in society brings about a health disparity that should be addressed. Closely related to this issue is the inability of some individuals to afford adequate nutritious food (Bambra, et al., 2010). The quality and quantity of food are dependent on the social class of an individual, and this disparity threatens public health.
Lastly, the lack of education and unemployment also pose a significant problem to the realization of equitable health in society. Education has traditionally been linked to improved chances of employment for most individuals (Blane, 1995). Better employment means increased income and improved working conditions, all of which impact public health. Individuals with adequate income can afford quality healthcare which positively impacts their health. Such individuals can also afford nutritious food, and safe housing thus improves their health outcomes. Therefore, lack of education and by extension, unemployment poses a significant public health risk for the underprivileged individuals.
Solutions to Health Inequity
Addressing the social determinants of health provides the first approach to address health inequity. The initial approach would be to improve the living conditions of individuals at home and in their work environments. For instance, housing policies that reduce the cost of housing, such as rent subsidies would enhance people's ability to afford safe housing (Bambra, et al., 2010). Also, policies that encourage mixed housing may improve the perception of individuals about the safety of their neighborhoods. Improved work environment and increased employee control would be vital in reducing health risks at the workplace.
Secondly, it would be crucial to address the inequality in the distribution of economic resources (Bambra, et al., 2010). For instance, the government should ensure that all people, irrespective of their socioeconomic status, have access to clean water and proper sanitation. Also, all children should be accorded quality education to improve their employability in the future. This will ensure they have adequate income to afford essential utilities such as medical care, nutritious food and quality housing.
Conclusion
The social determinants of health have a considerable impact on public health. Inadequate education and unemployment appear to have the most influence on the overall outcome of public health. This is because they considerably impact the income of individuals, thus affecting their ability to afford others social determinants of health such as healthcare and quality housing. Policy changes and employer initiatives to improve the working and living conditions of people may significantly improve the public health outcomes.
References
Bambra, C., Gibson, M., Sowden, A., Wright, K., Whitehead, M., & Petticrew, M. (2010). Tackling the wider social determinants of health and health inequalities: evidence from systematic reviews. Journal of Epidemiology & Community Health , 64 (4), 284-291.
Blane, D. (1995). Social determinants of health--socioeconomic status, social class, and ethnicity. American journal of public health , 85 (7), 903-905.
Marmot, M., Allen, J., Bell, R., Bloomer, E., & Goldblatt, P. (2012). WHO European review of social determinants of health and the health divide. The lancet , 380 (9846), 1011-1029.
