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•Identify the social determinants of health care and describe how they affect personal health-related choices, environmental exposures, and access to quality of health care.
•Define health disparity, health inequality, and health inequity.
•Describe the wealth-health gradient.
•Compare and contrast the different definitions of “health disparities”.
•Discuss the problem of health disparities and some of the strategies to eliminate health disparities.
•Discuss the influence of Canada’s universal health system on health status in patients of lower socioeconomic status.
•Contemplate how healthcare reform in the United States may influence the health status of such patients.
The health of individuals and populations is influenced by multiple factors. It seems obvious that an individual’s health status would be influenced by their access to health care (e.g. Does an individual have insurance coverage? Are appropriate health care providers available to them?). However, while researching this topic, I was surprised to discover that one study determined that the contribution of access to health care to a person’s overall health status was only 15%!1 Similarly, this study(Lessons from Canada.pdf) examined the influence of Canada’s universal health system on health status in patients of lower socioeconomic status. The findings are thought-provoking, particularly in the context of the healthcare reform that is taking place in the United States.
If access to healthcare contributes only 15% to a person’s overall health status, what makes up the other 85%? There are numerous environmental and individual characteristics that play a role; some are modifiable, others are not. This PowerPoint (Module 2 health disparities social determinants of health.ppt) discusses in more detail the social determinants of health–the healthcare, individual and environmental characteristics that influence an individual’s health status. Intimately related to the social determinants of health are the health disparities and health iniquities that are present in our country. An online video entitled “Unnatural Causes: In Sickness and In Wealth" (see below for how to access), takes us through the lives of four individuals living in Louisville, Kentucky and shows how the social determinants can affect health. (This video is ~56 minutes long.)
For the wiki, you must make 2 posts: one in response to one of your peers’ posts and one in response to the wiki or one of the questions below. Remember that at least 2 of your posts throughout the semester must include primary literature references that are correctly cited. (See the syllabus for more details.) Consider these questions:
•Given the interplay between access to health care, environmental characteristics and individual characteristics, how do you think health care reform will influence the health status of socially disadvantaged people in the United States?
•Do you think people are willing/able to change the modifiable individual social determinants of health (eg diet, physical activity, etc)? Before you answer, think about (but don’t feel compelled to share) your own health vices (never exercising or eating junk food, for example)…are you willing/able to modify these behaviors?
•The film notes that social reforms made during the Progressive Era, the New Deal, and the Civil Rights Movement improved population health. Do you think that knowing the health effects of social policies would change the value that Americans place on these kinds of policies? Why or why not?
•How do you think public health policies might help reduce health disparities?
•How do you think an interprofessional approach could help eliminate health disparities?
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