Social Determinants of Health is Life Circumstances

The documentary Unnatural Causes has stimulated me as an individual to learn more about what we as a society should and can do to address our health inequities. New social policies are needed to address health education and promotion. I understand more now than ever that minorities and the poor are not getting sick because they have unlucky genes or that they are just too lazy and are not disciplined to eat right, exercise, and abstain from drugs and alcohol. I hate to admit it but I had a huge lack of insight into these problems we face and I almost feel like I have been living in a bubble.

It is alarming that socioeconomic status and racism is so intertwined in our health inequities. The disparities in housing, wealth, jobs, and education combined with a feeling of lack of power and control over one’s life translates into bad health. Health behaviors play a part but they are only part of the big picture.

The Stress diathesis model explains how social circumstances and individual responses to stressful events affect health. This exemplifies how external environmental situations can influence health at the cellular and physiological level. In viewing the documentary this was proven over and over.

It is evident that much needs to be done to reduce the health disparities many populations face. We need to begin at the community level and improve community health. Such as what was done in Louisville. In Louisville, there was a focus on more equitable social policies.

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The collaboration between community members, local government, private business, and healthcare organizations focused on the social conditions that underlie our opportunities for health and wellbeing.

Becoming American was eye-opening. I found it quite troubling that the recent Mexican immigrants although poorer, tend to be healthier than the average American. But as they are in the United States longer, their health declines. Adopting the American way of life increases their stress which contributes to poor health. In only one generation, their health is as poor as other Americans of similar income status. Removal from their culture of a tight family network and community has lead to negative impacts on their health. Again, beginning at the community level can help begin to solve this problem. Kennett Square, Pennsylvania is an example where the community has stepped in. This town has invested in resources that bring together all citizens. Not only immigrants but all socioeconomic classes and this has helped all citizens feel included and connected. This connection, especially for immigrants that have always lived closely connected to family and community can help not only with health-related complications but it also helps the children stay safe, having a place to go after school. The center also provides after-school tutoring, computer access and a path to a better future. It gives these children hope for the future.

Each story in this series revealed to me that there is so much more to our well-being than our genes, behaviors and medical care. It is so vividly apparent that social, economic, and physical environments do indeed have a great effect on our health as does our behaviors and bad habits. As a society, we need to do better. Health linked to personal wealth is so unfortunate especially in a country that can do so much better for its people. Social determinants of health the circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness. These are shaped by economics, social policies, and politics. Social determinants of health include socioeconomic status, income, employment, education, social cohesion, social support, community safety, affordable housing, and food security. These social determinants affect physiology via their influence on stress hormones and result in epigenetic changes that can affect multiple generations.

These social determinants are amendable unlike genetic determinants of health. Understanding of social determinants can help us identify specific health promotion strategies that will result in realistic and meaningful interventions for targeted populations. I believe a change at the community level is a place to start. If communities can organize and gain more control this can lead to better outcomes in health and in peoples lives. Investing in schools, improving housing, integrating neighborhoods, providing better jobs and wages will all promote more control over one’s environment. We need to as a society empower the people and not keep them down. All humans have the right to live a full and healthy life.