Social Determinants Of Health

Front 1

Life expectancy at birth vs average annual income graph

Back 1

• There is a plotted correlation between wealth and life expectancy in general
• Not always the case, e.g. Many with low GDP are in the 70-80 age range

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People Live longer in More equal Societies

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• Countries where distribution of wealth is less equal have lower life expectancy
• Higher income, higher taxes leads to better health, e.g. Sweden

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Factors Impacting Health

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• Social and Economic Development (50%)

• Health Care System (25%)

• Biology and genetics (15%)

• Physical environment (10%)

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Social Determinants of Health

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The economic and social circumstances within which people live:

• processes/mechanisms by which members of different socio-economic groups come to experience varying degrees of health and illness

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Core Determinants of Health

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According to Public Health Agency of Canada there are 12 Core determinants:

1. Income and social status
2. Social support networks
3. education
4. employment and working conditions
5. social environments
6. physical environments
7. personal health practices
8. health and child development
9. biology and genetic make-up
10. health services
11. gender
12. culture

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Socio-ecological Model

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• Individual (knowledge, attitude, skills)
  
• Interpersonal (social network)
• Organizational (environment, ethos)
• Community (cultural values, norms)
• Public Policy

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Socio-ecological Model: Individual

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aka Intrapersonal: personal level factors

• age, food preferences, emotional, ability to cope with stress, education

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Socio-ecological Model: Interpersonal

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Factors relating to the influence of families, peers and partners, culture, media, societal norms

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Socio-ecological Model: Organizational/Institutional

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Practices and physical environment of an organization, e.g. a school/child care, workplace

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Socio-ecological Model: Community

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Cultural values or norms unique to urban, rural and remote settings, e.g. reserve

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Socio-ecological Model: Public Policy

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Broader guidelines at various levels of government, e.g. Canada's Food Guide

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What social factors impact nutrition?

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• socioeconomic status might impact where you shop, what you buy

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What environmental factors impact nutrition?

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Natural disaster, desertification, war impacting farmland usage

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What economic factors impact nutrition?

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How much you have will determine what you can afford

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What physical factors impact nutrition?

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• what you like to eat
• ability to go and buy food (seniors, disabilities)
• e.g. celiac disease

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Food security

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All people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life

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Food insecurity

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the inability to acquire nutritionally adequate foods in culturally acceptable ways

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Food availability

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• Daily energy, macronutrient and micronutrient needs must be met
  
• quantity as well as quality of foods available are both important (food bank vs fresh foods)

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Food Access

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gardens, canning, etc

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Food Supply and Systems

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The environmental impacts of climate change can also lead to droughts, floods, sharp price increases, especially in Northern Canada

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Cultural acceptibility

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Example shows oven bread, smoked salmon

• Canada's food guide written for First nations, Inuit, Metis

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Food Insecurity in Canada

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• 1.7 million Canadians are food insecure
• Ontario, Quebec, Alberta and BC accounted for largest share of food insecure households in Canada (85% of food insecure population)

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Nutritional Transition

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Going from traditional to more processed, readily available food

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Traditional Foods

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• plants and animals harvested from the local environment
• these foods along with their collection and harvesting practices contribute towards nutritional health and well being
• e.g. haha fruit, dandelion

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Traditional Food Systems

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• Include food preferences at the individual level
• Physical, social cultural environments making up each unique food system
• e.g. only 25g of Rosehips contain 370 mg of Vit C

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Food is a Social Determinant of Health

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To achieve sustainable food systems, community members of all ages must identify a shared vision of food security and translate it into a locally controlled food system in order to ensure a vibrant healthy community.

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What are the four main factors that need to be fulfilled in order to achieve Food Security?

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1. Food Availability
2. Food Supply
3. Food Access
4. Cultural Acceptability