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The Social Determinants of Health
We do not have the opportunity to pick out our parents, their race, demographics, or
educational backgrounds. The characteristics and the determinants we are born into are things
we do not have control over. Yet a child born from two loving parents with limited education and
a lack of available resources will not have the same access to health care and educational
opportunities as a child born into a family with the means, education, and opportunities from
inception. Ultimately, neighborhoods differ from one another, and those where there are
neighboring hospitals, pharmacies, and sports facilities will have fewer health disparities than
those that lack all of those same resources. The type of resources available in individual
neighborhoods and even places of worship affect the quality of life. This is a global problem
involving socioeconomic factors, all discussed in an article by Braveman (2011) titled The Social
Determinants of Health: Coming of Age.
The term social determinants of health are often used to refer broadly to any nonmedical
factors influencing health, including health-related knowledge, attitudes, beliefs, or behaviors
(Braveman et al., 2011). According to Braveman (2011), some direct concerns impacting health
outcomes involve one’s race, income, educational status, and environment (i.e., neighborhood
conditions). The World Health Organization and the Centers for Disease Control are
instrumental in tracking data related to determinants of health.
Braveman’s (2011) research determined that a steady source of income can help families
maintain economic stability by putting food on the table and providing the necessities for daily
living. Secondly would be to provide access to quality education that is the same across
communities. Braveman (2011) believes that when there is access to appropriate tools for
learning, children can do better academically, increasing their quality of life. Lack of resources
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is a direct downstream determinant of health. Downstream determinants are factors that are
temporarily close to health effects but are influenced by upstream factors (Braveman et al.,
2011). The downstream determinants are the health conditions/ illness influenced by the
upstream factors being the environment or even the source of contamination found in a water
source that communities used to drink from, the example in Braveman’s (2011) article.
Braveman (2011) reports that some issues of significant magnitude are downstream
social determinants and upstream social determinants of health, which influence health
pathways. The conditions in which people are born, live, work, grow, and age directly determine
health disparities. It makes little to no sense to disproportionately allocate resources downstream
only to allow health services to returning upstream to environments responsible for life and
death. Focusing on communities in need as a pathway to better health would be nice. The
pandemic is a prime example of social determinants of health because of social isolation, where
increased depression and sickness were seen.
Improvements in life expectancy in the past century have generally had more to do with
improvements to the social determinants than with medical therapies, though both are important
(Nutbeam & Lloyd, 2020). According to Nutbeam and Lloyd (2020), we can determine that a
strong and consistent relationship exists between health literacy and health outcomes. Education
about health and learning about communities’ needs is key.
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References
Braveman, P., Egerter, S., & Williams, D. R. (2011). The Social Determinants of Health:
Coming of Age.<Annual Review of Public Health,<32(1), 381–
398.<https://doi.org/10.1146/annurev-publhealth-031210-101218
Nutbeam, D., & Lloyd, J. E. (2020). Understanding and Responding to Health Literacy as a
Social Determinant of Health. Annual Review of Public Health, 42(1).
https://doi.org/10.1146/annurev-publhealth-090419-102529
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