Social determinants of health
Health starts in our homes, workplaces, schools and communities. Most of us may think that the state of health is determined by our own behaviors and we are taking the initiatives in taking care of ourselves. By having a balanced diet, getting enough rest, exercising, not taking alcohols and smoking, receiving recommendation of preventive vaccine injection and screening tests, and seeing a doctor when we are sick, these behaviors all have great impact on our health. However, social determinants which are mostly responsible for health inequalities are also involved in influencing our state of health partly.
Social determinants of health are the general socio-economic, cultural and environmental conditions in which people are born, grow, live, learn, work and age that influence the current state of health of people and communities. These conditions are shaped by the distribution of money, power and resources that people have. According to the Healthy people 2020 Approach, a “place-based” organizing framework stated that there are five areas of social determinants of health, including economic stability, education, social and community context, health and health care and neighborhood and built environment.
There are lots of social determinants affecting our health. For instance, social gradients, stress, early life, social exclusion, work and unemployment, social support, addiction, healthy food and transport are social determinants examples provided by the World Health Organization. (World Health Organization, 2003) Firstly, the social gradients affect the life expectancy and health status of a person. According to the data from the Office for National Statistics, professionals such as lawyers and accountants usually have longer life expectancy than the unskilled workers such as road workers and cleaners.
As poor economic and social circumstances affect health throughout life, people down the social ladder usually die sooner and tend to have worse health. Those in the lower classes always have a shorter life expectancy and more common to contract diseases. It is possibly because lower classes are always at low educational level which leads to insecure employment. They are unskilled and unlikely to hold on well-paid jobs, thus they can only be struck in dead-end job or physical labor. The intense work deprive them of rest hours.
There is also a greater chance for them to develop backpain or joint arthritis. According to the BBC, the process of aging is much faster in physical workers than professionals. Their health deteriorated twenty years faster than professionals. The low paid, unskilled physical workers have shorter life expectancy because it is easier for them to get injuries due to tireness. They are at greater risk to suffer from heart disease and respiratory disease as well in the unpleasant working environment. (BBC, 2003) http://news. bbc.co. uk/chinese/trad/hi/newsid_3290000/newsid_3294200/3294283. stm.
For example, inhaling air with dusts and pollutants when working, much road workers suffered from respiratory disease like Pneumoconiosis or even lung cancer. Also, they may live in poor housing, trying to improve the living condition which may put a lot of pressure on them. The consistence and accumulation of the disadvantages will greatly influence the health. In contrast to the lower class, upper class and middle class tend to live longer and free from disease.
The upper class and middle class seems to prefer health-enhancing activities. The professionals, like doctors and accountants, gain awareness in their own health. Their working hour is shorter and the working environment is comfortable compared to that of unskilled workers. As a result, people die sooner and have poor health down the social ladder in the society. Furthermore, another social determinant of health, stress, will damage our health and lead to premature death. Stressful circumstances contribute to the feeling of anxiety, worry and phobia.
The lack of control over work, study and home life, work intensification, unemployment, social isolation, widening income inequality had contributed to an increase in the stress level, leading to detrimental effect on health. The accumulation of stress and anxiety during life not only affect mental well-being, but also influence the body through the cardiovascular, endocrine and immune system. If people feel tense, they become more vulnerable for conditions including high blood pressure, depression, aggression and other health problems.
Also, people especially those in working class may ttake illness-related behavior like smoking and drinking in an attempt to release stress. Since it is unaffordable for people in working class to seek help from psychotherapy, living under stress, they would turn to illness-related behaviors as a coping mechanism within a generally adverse conditions . According to a survey conducted by the Hong Kong federation of youth group, 30% of interviewees adopt a negative approach such as smoking, taking alcohols and drugs to deal with