The social determinants of health care are the circumstances in which ordinary people are born, live and work. These social determinants of health are often shaped by the distribution of money, resources, and power from a local, national and global level (Kristjansson et al., 2006). Therefore, these social conditions are often blamed for health inequalities that are experienced as a result of mean and also avoidable differences encountered in the health sector today between different countries. Achievement of sustainable development in a country heavily depends on health equity and social determinants. Every person deserves an equal opportunity to make choices that lead to good health. However, to ensure there is an equal opportunity but to ensure so, it is fundamental advances are not only made in healthcare but in other fields like media, education, housing child care, business, transport, and agriculture (Lorenc, Petticrew, Welch & Tugwell, 2013). Why are social determinants of health important? First, poor clinical outcomes are fuelled as a result of interaction between the individuals and their physical and social environments. Second, developed policies in the social and physical environment have the potential to cause in the health status of a population as some policies affect an entire community. Third, improving the living conditions of the people results in better and healthier community (Lee & Marmot, 2005). Sociological theories have attempted to explain the social determinants of health despite their differences. These approaches help answer questions such as to how the availability of resources determine the health condition of a community and how important decisions that often made without their knowledge and input potentially impact their health status as a whole. Therefore, understanding the intricate relationship between different communities experiences of their place of residence and the impact of the place is fundamental to the overall health of the community.
Social selection theoryThe theory suggests that the health of individuals determine the socioeconomic position rather than the social, economic activities determining the health of people. Therefore, the core lesson from the theory is that healthier people have a higher likelihood of enjoying better socioeconomic positions as opposed to less healthy which translates to inequalities. Inequalities in health have been measured using many different outcomes including mortality outcomes, infant deaths, disability, morbidity and life expectancy. Research has proven that health issues are noted to worsen with greater socioeconomic disadvantage continually (Currie et al., 2012).
Healthy people have a higher probability of being willing to try new methods of innovation to check on their health status. Moreover, people from larger social, economic situation are likely to be early adopters of new (healthy) behaviors first then followed by those from the social position. With the current technology, there is a higher likelihood of identifying different diseases at very early stages. However, research has proved only the healthy people are quick to gather as much information about the conditions and they take precautionary measures like seek for immunization so that they can continually function at the level best (Curie et al., 2012). Moreover, healthy people have an attitude prevention better than cure. Therefore, there is a higher likelihood of the ensuring they practice all recommendations by the doctor. Thus, third dynamic results to large and ever widening inequalities in the health behavior which in turn leads to disparities in the health in the healthcare.
There are differences in consumption behavior with differences noted in attitude knowledge and competence among different groups. The cultural differences are observed from the social distinction as people from higher socioeconomic groups often behave in a particular manner. Given that many of who in the higher social class are keen on their health conditions often shows of their social position by being successful in their healthy lifestyle. Therefore, individuals who are often not cautious of their health maybe because they cannot afford due to the poverty levels also have a particular form of demonstration in their trends and have distinctive tastes (Viner et al., 2012). Consequently, it means different persons have varied options in their consumption patterns and their choices is based on their beliefs. Moreover, with the healthy people noted of their willingness to gather more information on the different healthy lifestyle they are often at a better and safer position to be able to engage at their places of work maximally.
Personal characteristic of individuals has a high significance on the health state of the individual. There are persons who by nature choose on some of the unhealthiest options consciously not because they cannot afford the healthy options but they purposely settle on the less healthy options either because they are cheap or are just ignorant of the implications of their choices (Marmot, 2005). Therefore in these instances, the health state of the individual is dependent on the choices made by the individual and not the social, economic state of the person.
Social causation theoryIllustrates that a range of unequally in a variety of materialism, psycho-social and behavior factors gives rise to the increase in equalities in the health outcomes of different individuals (Solar & Irwin, 2007). There are noted four models that are used to explain social class inequalities in health.
Behavioural modelThe model explores the difference that is experienced in the social class about their health choices. Often individuals who have resources often have a habit to make healthier and conscious decisions (Colley et al., 2013). Therefore, this allows them to enjoy life with little exposure to diseases. People with resources have a higher likelihood to stick to their doctors routine check and ensure they adhere to their physicians advice by watching on what they consume and ensure they do the necessary practice. With the bodies checked they are best able to work and ensure they give the best. However, persons who are not able to make conscious decisions concerning their health as they do have the money to ensure they do occasional visits to the doctor and ensure they eat healthily are likely to be exposed to diseases. Therefore, healthy people with the ability to make healthy decisions are in a better position to ensure they deliver their best.
Materialistic modelPoverty has a way of exposing people to health hazards (WHO Commission on Social Determinants of Health & World Health Organization 2008). Example, poor people are likely to live in the slum where access to health facilities is a nightmare, access to clean water is a challenge and access to enough food is a struggle. Therefore such individuals are not in a position to work and deliver their best. An individual health determines the socioeconomic activities surrounding the individual. This is because if a person is not able to eat well and seek the necessary medical attention is likely not to be able to function adequately. Therefore, this result to the poverty cycle going on (Katzmarzyk et al., 2013). Thus, in this case, an individuals capability to avoid poverty gives them a better chance of medical care. Inequalities in health tend to follow a steady gradient, with there being poor outcomes for most of the disadvantaged groups in the society and equally good results for the rest of the community who have the ability to escape poverty. In the long run effects of poverty like lack of the best medical care, poor infrastructure, and polluted air and water as poverty puts them in unhealthy zones.
Social inequality has a way of affecting how people feel about themselves when presented with different scenarios. Example stressful social relations have a habit of producing negative emotions that affect the individuals response to different situations. Therefore, healthy people who have resources and less stressful situations have a higher capability of avoiding stress related diseases. Moreover, studies have proved that imbalance between social life often affects works of an individual (Currie et al., 2009). Furthermore, an imbalance in social activities and work causes pressures to the person, and some of the stress related diseases are high blood pressure, adverse blood fat profile, and fibrinogen. Therefore, when an individual feels there are not able to provide for their families and their relationships are affected, there is a higher probability of the work of the person being significantly affected (Tugwell, et at., 2010). When an individual is unable to perform maximally in their job due to their social stress is not able to deliver their expectations which translate to more depression on the individual.
Life-course modelThe model advocates there is need to take action even before the birth of a child and continue throughout the life of a child to ensure there is avoidance of inequality. Moreover, this model makes a reflection on the patterns highlighted in the social, psycho-social and biological advantages and disadvantages that are experienced by an individual over time (Bambra, et at., 2009). Therefore, a child who is born of a well of family and can access all the necessary medical care and also opportunities has a high probability of influencing the social, economic activities as the child is more in a command center as opposed to dealing with the effects of the socio-economic activities.
Social selection theory and social causation theory differ significantly in their explanation on the social determinants of health of individuals. Social choice theory notes that the health of a person determines the social, economic status. This is evident with the personal choices made affecting their working ability in different fronts. While social causation theory notes that the inequalities that are presented in the social, economic environment determine the health of the person later to the impact of the working ability of the individual.
In conclusion, social determinants of health are well explained by the two theories that they can be viewed from two different perspectives as social selection theory notes that the health status of a person dictates the social, economic status of the individual. While the counter theory social causation theory explains that the living conditions, working condition of the persons are the ones responsible for the output of an individual.
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