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Social Determinants of Health

Presented the topic of social determinants of health for public health team.

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Social Determinants of Health

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  1. Social Determinants of Health Ahmad Zhafir bin Zulkfli@Zulkifli TGP 1/2023 Hospital Shah Alam

  2. What is health? • WHO constitution: health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. • Well-being: a positive state experienced by individuals and societies • Factors are known to influence the health status of individuals are referred to as the determinants of health.

  3. Health determinants • Factors that contribute to a person's current state of health.

  4. Social determinants of health • Social determinants of health are the nonmedical factors that influence health outcomes. • Social determinants of health are shaped by the distribution of money, power, and resources throughout local communities, nations, and the world. • WHO definition: the conditions in which people are born, grow, live, work and age and the fundamental drivers of these conditions.

  5. Social determinants of health • Safe housing, transportation, and neighborhoods • Racism, discrimination, isolation and violence • Education, job opportunities, and income • Access to nutritious foods and physical activity opportunities • Polluted air and water • Language and literacy skills • Early life, social gradient and support Source: U.S. Department of Health and Human Services

  6. Source: U.S. Department of Health and Human Services Healthy People 2030

  7. Source: American Hospital Association - Societal Factors That Influence Health

  8. EXAMPLE: SDOH IN DEVELOPMENT OF CARDIOVASCULAR DISEASE Source: Social Determinants of Health and Cardiovascular Disease, Jilani et. al 2021

  9. Source: Department of Statistics, Malaysia

  10. Social determinants of health • Health inequality: generically refers to differences in the health of individuals or groups • Health inequity or health disparity: a specific type of health inequality that denotes an unjust difference in health Race? Financial status? Education level? Urban vs. rural? Social background? Source: Inequalities in health: definitions, concepts, and theories, Arcaya et.al. 2015

  11. Congested traffic in KL. Credit: WHO Flickr Vagrant people in KL. Credit: Kosmo Credit: The Star Urban poor. Credit: The Edge Markets

  12. Diseases of poverty • Diseases that are more prevalent in low-income populations - infectious diseases • Vs. diseases of affluence - disease of the rich people - non communicable diseases (NCD) • The big three: HIV, TB and malaria • Cycle of poverty: families already in poverty are likely to remain in those circumstances unless there is an intervention Source: Diseases of Poverty and Lifestyle, Well-Being and Human Development,Singh, 2008

  13. References Arcaya, M.C., Arcaya, A.L. and Subramanian, S.V. (2015). Inequalities in health: definitions, concepts, and theories. Global Health Action, 8(1), pp.1–12. ‌Braveman, P. and Gottlieb, L. (2014). The Social Determinants of Health: It’s Time to Consider the Causes of the Causes. Public Health Reports, [online] 129(2), pp.19–31. doi:https://doi.org/10.1177/00333549141291s206. Jabatan Perangkaan Malaysia (2022). Penemuan Utama Banci Penduduk dan Perumahan Malaysia 2020 Bandar dan Luar Bandar. Jabatan Perangkaan Malaysia. Jilani, M.H., Javed, Z., Yahya, T., Valero-Elizondo, J., Khan, S.U., Kash, B., Blankstein, R., Virani, S.S., Blaha, M.J., Dubey, P., Hyder, A.A., Vahidy, F.S., Cainzos-Achirica, M. and Nasir, K. (2021). Social Determinants of Health and Cardiovascular Disease: Current State and Future Directions Towards Healthcare Equity. Current Atherosclerosis Reports, 23(9). doi:https://doi.org/10.1007/s11883-021-00949-w. Office of Disease Prevention and Health Promotion (2022). Social determinants of health. [online] Healthy People 2030. Available at: https://health.gov/healthypeople/priority-areas/social-determinants-health. World Health Organisation (2021). Social Determinants of Health. [online] www.who.int. Available at: https://www.who.int/health-topics/social-determinants-of-health.

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