Social determinants of health are social factors that influence people to live long, healthy lives. Examples of factors include education, race, access to health care, sanitation, etc.
ICE Model: Ideas (facts), Connections (what you know + what you learned), Extensions (using your new knowledge to answer a question).
"Health" in Greek is "holos," which means "whole" in English.
Negative health is the absence of disease (disease being objectively diagnosed and medically assessed).
Positive health is also the absence of disease, but the presence of other things: biological wellness, optimism, confidence, etc.
4 Understandings of Health:
1. WHO (World Health Organization): physical, mental, and social well-being
2. "Lay" (ordinary people): being healthy, absence of disease or illness, being able to complete day to day tasks
3. Richard Crawford: Control (discipline, eat, drink, exercise, sleep) and Release (expression, reflection, escapism)
4. Aboriginal: spiritual, mental, emotional and intellectual wellness
Public Health (1848 origin):
What: What society tries to do to improve the public's health by preventing diseases and promoting good health.
Goal: To improve the health of society.
Robert Virchow: was the founder of the theory of the social determinants of health. He discovered that disease often resulted in poverty. He recommended increasing wages to decrease poverty to improve the health of the public.
Edwin Chadwick: demonstrated the first public health act in 1848; it focused on ensuring there was sanitary water to drink, because unsanitary water often lead to disease.
3 Public Health Ideologies:
1. Socialist/Collectivist: positive liberty; freedom to do things because of government interaction, such as if the government provides you with health care, you are healthy and free to do as you please.
2. Neo-Liberalist/Individualist: negative liberty; freedom from government interference. Individualists feel they can make decisions on their own.
3. Environmentalist/Green: local and community based; focus on the interconnectedness of humans and also sustainability (interplay between man and nature)
Broad Model of Public Health: Swimming "upstream" to discover the initial cause of diseases in order to prevent them from effecting anyone else. This notion is represented by Goldberg.
Narrow Model of Public Health: Swimming "downstream" to assist those who are already ill, offering accute/immediate care without focusing on prevention.
Geoffrey Rose discovered this river analogy/prevention paradox.
Social Justice: ensuring everyone in a society is able to benefit from society's benefits, such as health care, education, sanitation, etc.
Lalonde Report: Canada's contribution to public health. The report suggested that there is more to health than just health care; it was also about healthy lifestyles and environments. The motto of this report was about adding life to your years, rather than just years to your life.
EPP Report: This report realized that the socially disadvantaged groups are sicker. This is based on socioeconomic position. They need collectivist assistance (upstream).
Population Health: Improving the health of the population by decreasing/preventing diseases.
Life Under Mike (film):
- social assistance cut and taxes increased
- workers laid off; some are left in poverty
- "scavs" replaced workers
- workers go on strike
- poverty numbers increase
- it becomes illegal to be poor
- the rich don't like seeing the poor; the rich get richer and the poor get poorer
- workers left with jobs under capitalism are underpaid
- workers create their own jobs privately (some got fired for doing so when they initially thought their previous jobs were in jeopardy)
Whitehall Studies: A longitudinal (over time), epidemiological (natural/safe/no drugs) study of civil servants in the UK.
Whitehall I: Focused on observation of executives/administrators/workers in general
Results: It was found that workers on the bottom of the hierarchy had a higher mortality (rate of death) rate than those at the top of the hierarchy; based on socioeconomic position. This is because, presumably, the stress of not being able to find a job or the stress of ensuring your job pays enough so you can provide for you and your family, outweighs the stress of the day-to-day stresses in the working force, such as interviews and deadlines and whatnot.
Whitehall II: 1/3 women, 2/3 men
Results: Found a gradient between mortality (rate of death) and morbidity (rate of how quickly you get sick). The study also showed that if someone were to go from higher to lower class or lower to higher class, their death rate increased. This could be because of early childhood circumstances, social circumstances or behaviours (such as smoking), etc.
John Snow: discovered epidemiology; used maps and statistics to study the causes/effects/effected of diseases.
Status Syndrome: A term that indicates that the higher up on the hierarchy you are, the healthier you are, due to social determinants of health (including a higher level education; being informed, easy access to health care, a high paid job to provide; food/water/sanitation, etc.)
Income Inequality: The differentiating of incomes among groups in societies.
Disease: objectively diagnosed (medically assessed)
Illness: subjective feelings (self assessed)
Some of Public Health's Achievements in the 20th Century:
Healthier moms and babies, recognition of tobacco as a health hazard, motor vehicle safety, safe food and water, etc.
Poverty in Ontario:
- as unemployment increases, poverty increases
- poverty: not being able to afford dental/health care, education, a decent home, and especially not entertainment
Social Exclusion: not being able to do the things others in your society do for entertainment.
Economics: The work we do to produce the goods and services we need to survive and want for leisure.
Work: what we do and how we do it
Production: what we produce
Distribution: who gets what
End-use: how we use what we produce
Environment: the reflection of our work on the environment
Goods: material things (cars, clothing, houses, etc.)
Services: functions performed for others (health care, education, hair cuts, daycare, etc.)
* the successful ingredient of both goods and services is effective work
Micro-economics: individual consumers and firms
Macro-economics: how individuals act in a group
Economists: examine how the economy should be (normative), not just how the economy is at that current time
Measuring the Economy:
GDP: Gross Domestic Product; the total sum value of all goods and services done for money; the goods and services not done for money are not included; ie) a daycare and a stay at home mom provide the same service, but only the daycare gets paid
Real GDP; Real Gross Domestic Product: the output value is increased for inflation
GDP Per Capita; Gross Domestic Product Per Capita: the GDP is divided among populations
Evaluating the Economy:
Based on a subjective criteria;
Democracy & Accountability
* an economy works well if it is successfully producing the goods and services the society needs for survival and wants for leisure
- most production is controlled by private companies looking to make a profit off of its workers
- most work is done by workers looking to earn a salary ("wage labour" or "employment")
Types of Capitalism:
Anglo-Saxon: least regulated/equal
Continental: government plays small role, therefore more regulation
Asian: more regulated and equal
Scandinavian: most regulated and equal
Midterm's Friday, 2.5 more units to study, I feel confident at last.
ps. i like 2 study