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Hello. I am a student minoring in Global Poverty and Practice and will be contributing to Wikipedia's SDH (Social Determinants of Health) and Screening (Medicine) pages.


Screening (Medicine) Page Edits:

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Screening for social determinants of health (new section under Examples Section)

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Social determinants of health are defined as an all encompassing set of factors that are related to an individual’s state of being. As that individual experiences life, it is those set of factors that may have adverse effects on their health and wellbeing. To mitigate those adverse effects, certain health policies like the Affordable Care Act gave increased traction to preventative programs, such as those that routinely screen for social determinants of health.

Policy Background in the United States

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When established in the United States, the Affordable Care Act was able to bridge the gap between community based health and healthcare as a medical treatment, leading to programs that screened for SDH.[1] The Affordable Care Act established several services with an eye for social determinants or an openness to more diverse clientele, such as Community Transformation Grants, which were delegated to the community in order to establish "preventative community health activities" and "address health disparities".[2]

Clinical Programs

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Social determinants of health are defined as a set of factors in an individual's social environment that affect their growth trajectory in terms of health and well-being. They include social status, gender, ethnicity, economic status, education level, access to services, education, immigrant status, upbringing, and much, much more.[3][4] Several clinics across the United States have employed a system in which they screen patients for certain risk factors related to social determinants of health.[5] In such cases, it is done as a preventative tool in order to mitigate any detrimental effects of prolonged exposure to certain risk factors, or to simply begin remedying the adverse effects already faced by certain individuals.[6][7] They can be structured in different ways, for example, online or in person, and yield different outcomes based on the patient's responses.[6] Some programs, like the FIND Desk at UCSF Benioff Children's Hospital, employ screening for social determinants of health in order to connect their patients with community resources that may provide autonomy and mobility in their specific circumstances.[8]


Social Determinants of Health Page Edits:

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I plan on shortening and consolidating the information in the 'Commonly Accepted Determinants' Section. My edits will be bolded.

Historical development of social determinants of health (renamed the section from commonly accepted determinants)

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Social Determinants of Health visualization

Starting in the early 2000s, the World Health Organization facilitated the academic and political work on social determinants in a way that provided a deep understanding of health disparities in a global perspective.

In 2003, the World Health Organization (WHO) Europe suggested that the social determinants of health included: the social gradient, stress, early life, social exclusion, work, unemployment, social support, addiction, food, and transportation.[9]

In 2008, the WHO Commission on Social Determinants of Health published a report entitled "Closing the Gap in a Generation.", which aimed to understand, from a social justice perspective, how health inequity could be remedied, and what actions could combat factors that exacerbated injustices.[10] The work of the Commission was based on development goals, and thus, connected SDH (social determinants of health) discourse to economic growth, and bridging gaps in the healthcare system. [10] This report identified two broad areas of social determinants of health that needed to be addressed.[10] The first area was daily living conditions, which included healthy physical environments, fair employment and decent work, social protection across the lifespan, and access to health care. The second major area was distribution of power, money, and resources, including equity in health programs, public financing of action on the social determinants, economic inequalities, resource depletion, healthy working conditions, gender equity, political empowerment, constitution of reserves[11] and a balance of power and prosperity of nations.[10]

The 2010 Affordable Care Act (ACA) established by the Obama administration in the United States, embodied the ideas put in place by the WHO by bridging the gap between community-based health and healthcare as a medical treatment, meaning that a larger consideration of social determinants of health was emerging in policy.[12] The ACA established community change through initiatives like providing Community Transformation Grants to community organizations, which opened up further debates and talks about increased integration of policies to create change on a larger scale.[13]

The 2011 World Conference on Social Determinants of Health, in which 125 delegations participated, created the Rio Political Declaration on Social Determinants of Health.[14] With a series of affirmations and announcements, the Declaration aimed to communicate that the social conditions in which an individual exists were key to understanding health disparities that individual may face, and it called for new policies across the world to fight health disparities, along with global collaborations.[15]

Commonly accepted social determinants

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The United States Centers for Disease Control defines social determinants of health as "life-enhancing resources, such as food supply, housing, economic and social relationships, transportation, education, and health care, whose distribution across populations effectively determines length and quality of life".[16] These include access to care and resources such as food, insurance coverage, income, housing, and transportation.[16] Social determinants of health influence health-promoting behaviors, and health equity among the population is not possible without equitable distribution of social determinants among groups.[16]

In Canada, these social determinants of health have gained wide usage: Income and income distribution; Education; Unemployment and job security;Employment and working conditions

  1. Early childhood development
  2. Food insecurity[17]
  3. Housing
  4. Social exclusion/inclusion
  5. Social safety network
  6. Health services
  7. Aboriginal status
  8. Gender
  9. Race
  10. Disability[18]
Ongoing debates
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Steven H. Woolf, MD of the Virginia Commonwealth University Center on Human Needs states, "The degree to which social conditions affect health is illustrated by the association between education and mortality rates".[19] Reports in 2005 revealed the mortality rate was 206.3 per 100,000 for adults aged 25 to 64 years with little education beyond high school, but was twice as great (477.6 per 100,000) for those with only a high school education and 3 times as great (650.4 per 100,000) for those less educated. Based on the data collected, the social conditions such as education, income, and race were dependent on one another, but these social conditions also apply to independent health influences.[19]

Marmot and Bell of the University College London found that in wealthy countries, income and mortality are correlated as a marker of relative position within society, and this relative position is related to social conditions that are important for health including good early childhood development, access to high quality education, rewarding work with some degree of autonomy, decent housing, and a clean and safe living environment. The social condition of autonomy, control, and empowerment turns are important influences on health and disease, and individuals who lack social participation and control over their lives are at a greater risk for heart disease and mental illness.[20]

Early childhood development can be promoted or disrupted as a result of the social and environmental factors effecting the mother, while the child is still in the womb. Janet Currie’s research finds that women in New York City receiving assistance from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), in comparison to their previous or future childbirth, are 5.6% less likely to give birth to a child who is underweight, an indication that a child will have better short term, and long term physical, and cognitive development. [21]

Several other social determinants are related to health outcomes and public policy, and are easily understood by the public to impact health.[22] They tend to cluster together – for example, those living in poverty experience a number of negative health determinants.[23]

References

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  1. ^ Heiman, Harry J., and Samantha Artiga. "Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity." Health 20.10 (2015): 1-10.
  2. ^ United States. Department of Health and Human Services, author. HHS action plan to reduce racial and ethnic health disparities : a nation free of disparities in health and health care. OCLC 872276544. {{cite book}}: |last= has generic name (help)
  3. ^ Dasgupta, Rajib (2009). Cook, Harold J.; Bhattacharya, Sanjoy; Hardy, Anne (eds.). "Making Sense of Social Determinants". Economic and Political Weekly. 44 (23): 30–32. ISSN 0012-9976.
  4. ^ Singh, Gopal; Daus, Gem; Allender, Michelle; Ramey, Christine; Martin, Elijah; Perry, Chrisp; Reyes, Andrew; Vedamuthu, Ivy (2017). "Social Determinants of Health in the United States: Addressing Major Health Inequality Trends for the Nation, 1935-2016". International Journal of MCH and AIDS (IJMA). 6 (2). doi:10.21106/ijma.236. ISSN 2161-8674.
  5. ^ Billioux, Alexander; Verlander, Katherine; Anthony, Susan; Alley, Dawn (2017-05-30). "Standardized Screening for Health-Related Social Needs in Clinical Settings: The Accountable Health Communities Screening Tool". NAM Perspectives. 7 (5). doi:10.31478/201705b. ISSN 2578-6865.
  6. ^ a b Gottlieb, Laura; Hessler, Danielle; Long, Dayna; Amaya, Anais; Adler, Nancy (2014-12). "A Randomized Trial on Screening for Social Determinants of Health: the iScreen Study". Pediatrics. 134 (6): e1611–e1618. doi:10.1542/peds.2014-1439. ISSN 0031-4005. {{cite journal}}: Check date values in: |date= (help)
  7. ^ Foy, Jane Meschan (2010-06). "Enhancing Pediatric Mental Health Care: Algorithms for Primary Care". Pediatrics. 125 (Supplement 3): S109–S125. doi:10.1542/peds.2010-0788f. ISSN 0031-4005. {{cite journal}}: Check date values in: |date= (help)
  8. ^ "UCSF Benioff Children's Hospital Oakland". UCSF Benioff Children’s Hospital Oakland. Retrieved 2020-04-29.
  9. ^ Wilkinson, Richard; Marmot, Michael, eds. (2003). The Social Determinants of Health: The Solid Facts (PDF) (2nd ed.). World Health Organization Europe. ISBN 978-92-890-1371-0.
  10. ^ a b c d Commission on Social Determinants of Health (2008). Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health (PDF). World Health Organization. ISBN 978-92-4-156370-3. Retrieved 2013-03-27. Pg 2
  11. ^ Cullati, Stéphane; Kliegel, Matthias; Widmer, Eric (2018-07-30). "Development of reserves over the life course and onset of vulnerability in later life". Nature Human Behaviour. 2 (8): 551–558. doi:10.1038/s41562-018-0395-3. ISSN 2397-3374. PMID 31209322.
  12. ^ Heiman, Harry J., and Samantha Artiga. "Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity." Health 20.10 (2015): 1-10.
  13. ^ Leong, Donna; Roberts, Elizabeth (2013-07-01). "Social determinants of health and the Affordable Care Act". Rhode Island Medical Journal (2013). 96 (7): 20–22. ISSN 2327-2228. PMID 23819136.
  14. ^ "The Social Determinants of Health", Vital Signs, Pluto Press, pp. 39–52, 2019-08-20, ISBN 978-1-78680-424-2, retrieved 2020-05-14
  15. ^ The World Health Organization, World Conference on Social Determinants of Health, Rio Political Declaration on Social Determinants of Health (21 October 2011), available from https://www.who.int/sdhconference/declaration/Rio_political_declaration.pdf?ua=1.
  16. ^ a b c Brennan Ramirez, Laura K.; Baker, Elizabeth A.; Metzler, Marilyn (2008). Promoting Health Equity: A Resource to Help Communities Address Social Determinants of Health (PDF). United States Centers for Disease Control and Prevention. p. 6. Retrieved May 3, 2015.
  17. ^ Arenas, Daniel J., et al. "A Systematic Review and Meta-analysis of Depression, Anxiety, and Sleep Disorders in US Adults with Food Insecurity." Journal of general internal medicine (2019): 1-9. || https://doi.org/10.1007/s11606-019-05202-4
  18. ^ Bryant, Toba; Raphael, Dennis; Schrecker, Ted; Labonte, Ronald (2011). "Canada: A land of missed opportunity for addressing the social determinants of health". Health Policy. 101 (1): 44–58. doi:10.1016/j.healthpol.2010.08.022. PMID 20888059.
  19. ^ a b Woolf, Steven H. (2009). "Social Policy as Health Policy". JAMA. 301 (11): 1166–9. doi:10.1001/jama.2009.320. PMID 19293418.
  20. ^ Marmot, Michael G.; Bell, Ruth (2009). "Action on Health Disparities in the United States". JAMA. 301 (11): 1169–71. doi:10.1001/jama.2009.363. PMID 19293419.
  21. ^ Currie, Janet; Rajani, Ishita. "WITHIN-MOTHER ESTIMATES OF THE EFFECTS OF WIC ON BIRTH OUTCOMES IN NEW YORK CITY" (PDF). NATIONAL BUREAU OF ECONOMIC RESEARCH.
  22. ^ Islam, M M (2019). "Social Determinants of Health and Related Inequalities: Confusion and Implications". Front. Public Health. 7: 11. doi:10.3389/fpubh.2019.00011. PMC 6376855. PMID 30800646.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  23. ^ Bryant, Toba; Raphael, Dennis; Schrecker, Ted; Labonte, Ronald (2011). "Canada: A land of missed opportunity for addressing the social determinants of health". Health Policy. 101 (1): 44–58. doi:10.1016/j.healthpol.2010.08.022. PMID 20888059.
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