Social Determinants of Health

Summary

This video script addresses the impact of social determinants of health, emphasizing that health is influenced by more than individual choices but also by systemic factors such as discrimination and access to resources. It outlines the upstream and downstream factors affecting health, using race as an example to illustrate how systemic racism can lead to health disparities. The script calls for community advocacy and provides a starting point with the US Healthy People website, which lists goals to improve access to jobs, education, healthcare, and safe neighborhoods, aiming to enhance overall health.

Takeaways

• 🏥 The script emphasizes the importance of considering not just personal choices but also environmental factors in maintaining health.
• 🌐 Social determinants of health are conditions like where people are born, grow, work, and live, which can significantly impact their well-being.
• 🔍 Health determinants are categorized into upstream (systemic) and downstream (individual) factors, with the former influencing the latter.
• 🏛️ Upstream factors include systemic issues like institutional discrimination and access to essential services and resources.
• 👤 Downstream factors pertain to individual circumstances such as employment status, education, and personal identity aspects.
• 🔄 The impact of upstream determinants on downstream ones is likened to a dam's effect on a river's flow, highlighting the direct influence of systemic issues on individuals.
• 📊 Disturbing statistics are presented, such as higher suicide rates in certain regions and racial disparities in life expectancy and infant mortality.
• 💰 Economic status plays a role in health, with lower-income individuals facing increased psychological distress and barriers to healthcare.
• 🌱 Addressing social determinants of health is a collective task that requires advocacy and community involvement.
• 📘 The US Healthy People website offers goals aimed at improving various social determinants, including access to jobs, education, and healthcare.
• 💡 Change in social structures is a gradual process that requires empathy, understanding, and sustained effort from everyone.

Q & A

What are social determinants of health?

Social determinants of health are the conditions in which people are born, grow, work, play, learn, and worship. They include factors like education, employment, housing, healthy foods, and quality healthcare that impact health.

How are social determinants of health categorized?

Social determinants of health are categorized into upstream factors and downstream factors. Upstream factors occur at the systemic level, while downstream factors are specific to individuals.

What are some examples of upstream factors?

Upstream factors include institutional discrimination, accessibility of education, employment, housing, healthy foods, and quality healthcare.

What are some examples of downstream factors?

Downstream factors include employment status, level of education, and aspects of identity such as gender, race, and disability status.

How do upstream social determinants affect downstream ones?

Upstream social determinants directly affect downstream ones by influencing systemic conditions that in turn impact individual health outcomes.

How does systemic racism impact health according to the script?

Systemic racism leads to consequences like less access to employment and education, which negatively impact health.

What are some statistics mentioned in the script that highlight the impact of social determinants on health?

Some statistics include the highest suicide rates in western American states and Appalachian regions, the shortest life expectancy among Non-Hispanic Black individuals, and the mortality rate of Black infants being more than double that of white infants.

How does income affect the likelihood of experiencing serious psychological distress and going without needed care due to cost?

People with a family income of $35,000 or lower are 5.4 times more likely to experience serious psychological distress and 10.6 times more likely to go without needed care due to cost compared to those with an annual family income of $100,000 or higher.

What is the role of the US Healthy People website in addressing social determinants of health?

The US Healthy People website provides stated goals related to social determinants aimed at improving access to jobs, food, housing, education, community connectedness, healthcare, health literacy, neighborhood safety, and housing quality.

What is the importance of advocating for change in one's own community to tackle social determinants of health?

Advocating for change in one's own community can help address upstream factors and make a difference in improving health outcomes for everyone.

Why is empathy and sustained effort important in addressing social determinants of health?

Empathy and sustained effort are important because systemic issues impact individuals differently, and people are the experts of their own lives. Change in social structures won't happen overnight, so a compassionate and consistent approach is necessary.

Outlines

00:00

🌟 Social Determinants of Health

The script begins with a narrative of personal struggles, including unemployment, stress, and a lack of community, which segues into a discussion on the broader concept of social determinants of health. These determinants encompass the conditions in which people live, work, and play, and are categorized into upstream and downstream factors. Upstream factors are systemic, such as institutional discrimination and access to resources like education and healthcare, while downstream factors are individual-specific, including employment status and education level. The script emphasizes that addressing these social determinants, particularly the upstream ones, can significantly impact health outcomes. It also provides statistics illustrating disparities in health outcomes across different demographics and suggests that community advocacy and resources like the US Healthy People website can be instrumental in initiating change.

Keywords

💡Social Determinants of Health

Social Determinants of Health (SDOH) refer to the conditions in which people are born, grow, live, work, and age. These conditions shape a wide range of health, functioning, and quality-of-life outcomes and risks. In the video, SDOH are discussed as factors that can be visualized as a river with upstream and downstream determinants, emphasizing that systemic factors like institutional discrimination and accessibility to resources directly impact individual health outcomes.

💡Upstream Factors

Upstream factors are systemic issues that occur at a societal or community level and can influence health outcomes. They include institutional discrimination, accessibility of education, employment, housing, and healthcare. The video uses the metaphor of a river to illustrate how upstream factors can affect the flow (health outcomes) downstream, indicating that changes at the systemic level can have profound effects on individual health.

💡Downstream Factors

Downstream factors are individual-level conditions that are influenced by upstream determinants. They include employment status, level of education, and aspects of identity such as gender, race, and disability status. The video explains that these factors are specific to individuals and are shaped by the broader social and environmental conditions, which are considered upstream.

💡Systemic Racism

Systemic racism refers to the ways in which racial discrimination is embedded within societal institutions and structures. It does not directly impact health but leads to consequences such as less access to employment and education, which in turn negatively affect health. The video uses systemic racism as an example of how social structures can create disparities in health outcomes among different racial groups.

💡Healthcare Accessibility

Healthcare accessibility is the ease with which individuals can obtain the healthcare services they need. The video discusses how the accessibility of quality healthcare is an upstream factor that can significantly impact health outcomes. It is highlighted as a critical component of social determinants of health that needs to be addressed to improve overall health in communities.

💡Employment Status

Employment status is an individual's current relationship with the labor market, whether they are employed, unemployed, or not in the labor force. The video mentions employment status as a downstream factor that can be influenced by upstream factors like systemic discrimination, and it directly affects an individual's health and well-being.

💡Education Level

Education level refers to the highest degree or level of education an individual has achieved. In the video, it is presented as a downstream factor that can impact health outcomes. Higher levels of education are often associated with better health literacy and access to resources, which can lead to improved health.

💡Community Connectedness

Community connectedness refers to the relationships and sense of belonging that individuals have within their communities. The video emphasizes the importance of community connectedness as a social determinant of health, suggesting that a strong sense of community can contribute to better mental and physical health.

💡Neighborhood Safety

Neighborhood safety pertains to the perception and reality of security within one's living environment. The video includes neighborhood safety as one of the areas that need improvement according to the US Healthy People website's goals, indicating that a safe environment is crucial for the well-being and health of community members.

💡Psychological Distress

Psychological distress refers to a state of emotional suffering that can result from a variety of stressors, including financial difficulties and social isolation. The video cites statistics showing that people with lower family incomes are more likely to experience serious psychological distress, highlighting the link between economic factors and mental health.

💡Health Literacy

Health literacy is the ability to obtain, process, and understand basic health information and services needed to make appropriate health decisions. The video mentions health literacy as one of the goals of the US Healthy People website, emphasizing its importance in enabling individuals to navigate the healthcare system and make informed choices about their health.

Highlights

The importance of considering environmental factors in maintaining mental and physical health.

Social determinants of health are conditions in which people live, work, and play.

Social determinants can be categorized into upstream and downstream factors.

Upstream factors are systemic and include institutional discrimination and accessibility to resources.

Downstream factors are individual-specific, such as employment status and education level.

Upstream social determinants directly affect downstream ones, as illustrated by the river analogy.

Systemic racism is a significant upstream factor that impacts health through limited access to opportunities.

Statistics show disparities in suicide rates, life expectancy, and infant mortality across different demographics.

Economic status significantly influences the likelihood of psychological distress and access to healthcare.

Advocating for change in communities can tackle social determinants of health.

The US Healthy People website provides goals to improve social determinants in areas like jobs, education, and healthcare.

Community connectedness and inclusion are key goals to improve social determinants of health.

Healthcare access and health literacy are essential aspects of the social determinants of health.

Neighborhood safety and housing quality are critical social determinants that impact health.

Systemic issues affect individuals differently, and recognizing this diversity is crucial for change.

People are the experts of their own lives, and their insights are invaluable for addressing social determinants.

Social structures won't change overnight, but sustained effort can lead to improvements in public health.

Transcripts

(bright music)

(gentle music)

I should really go to the doctor,

but the closest office is an hour away.

I can't take that much time off work.

(air whooshes)

Since I got laid off last month, I felt so stressed.

I need to provide for my kids, but no one is hiring.

I don't know what to do.

(air whooshes)

I used to know every single person that lived on my block.

Now I don't even recognize the place.

There's just no sense of community anymore.

When we talk about how to maintain our mental

and physical health, we often focus on things

like eating healthy and going to the doctor.

But our health isn't just affected by the choices we make.

It's impacted by our environment.

The conditions in which people are born, grow, work, play,

learn, and worship are called social determinants of health.

Social determinants of health can be visualized

as a river with two categories of determinants,

upstream factors and downstream factors.

Upstream factors occur at the systemic level.

Examples include institutional discrimination

and accessibility of education, employment, housing,

healthy foods, and quality healthcare.

Downstream factors are specific to individuals.

Examples include employment status, level of education,

and aspects of identity such as gender,

race, and disability status.

Just as building a dam upstream impacts the flow

of a river downstream, upstream social determinants

directly affect downstream ones.

Consider race.

In and of itself, race does not impact health.

Rather, systemic racism leads to consequences

like less access to employment and education,

which in turn negatively impact health.

(air whooshes)

To begin to recognize the relationship

between social factors and health,

consider these statistics.

Suicide rates are highest in the western American states

and in Appalachian regions.

Non-Hispanic Black individuals have the

shortest life expectancy of any racial group.

And the mortality rate of Black infants is more than double

that of white infants.

And as compared to people with an annual family income

of $100,000 or higher, people with a family income

of $35,000 or lower

are 5.4 times more likely

to experience serious psychological distress,

but 10.6 times more likely to go

without needed care due to cost.

(air whooshes)

Tackling the social determinants of health,

especially the upstream factors can seem like a huge task,

but we can all make a difference

by advocating for change in our own communities.

(air whooshes)

A good place to start is with the US Healthy People website.

This site has stated goals related to social determinants,

which are aimed at improving the following.

One, access to jobs, food, and housing.

Two, access to education.

Three, community connectedness and inclusion.

Four, access to healthcare and health literacy.

And five, neighborhood safety and housing quality.

Throughout this process, remember

that systemic issues impact individuals differently,

that people are the experts of their own lives,

and that social structures won't change overnight.

But with empathy and sustained effort,

we can better the health of everyone.

(bright music)