Addressing Social Determinants of Health in Primary Healthcare

This article discusses the importance of addressing social determinants of health in primary healthcare and the strategies to tackle them. It emphasizes the need for equity and social justice in healthcare initiatives to improve health outcomes for all individuals. The article also highlights the role of health promotion programs in modifying lifestyle choices and reducing the burden of chronic diseases.

Running head: PRIMARY HEALTHCARE
PRIMARY HEALTHCARE
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Issue: Chronic disorder burden in the nation
One of the most important strategic outcomes of the National Primary Health Care
Strategic Framework is strategy number three that talks about effective ways for tackling
social determinants of health and well being with the help of health promotion as well as
prevention and even screening and early interventions. One of the chosen actions under this
strategy that the assignment would be based on is the identification of proper ways that would
help in addressing the social determinants of health like “social status, geographic location,
health literacy, housing, education, employment and access to health services” that remain
associated with poor health conditions (National primary health care strategic framework,
2013). This can be referred to as the best intervention that had been proposed by the Standing
Council in Health in Australia as it aligns with the main foundations of the bio-psycho-social
model of health that primary health professionals are following now. Studies have criticised
the biomedical model of health that was in practise in the nation for long. This model mainly
governs that professionals need to care for all the biological determinants of health that
causes different disorders. However, this model had been criticised as it does not provide a
comprehensive care approach to patients that includes considering social factors,
psychological factors, economic issues and similar other factors that also indirectly affect
health. This chosen strategy had been seen to reject the notion of biomedical model and had
been based on the bio-psycho-social model of care. Many chronic ailments like obesity,
diabetes, osteoarthritis and cardiovascular disorders are seen to be linked with social
determinants of health. The latter have the capacity of affect lifestyle choices, poor healthcare
decision-making, inappropriate diets and many others that can make individuals vulnerable to
develop chronic ailments (Mossialos et al., 2015). Hence, the strategy correctly addresses the
factors that need to be considered while developing health promotion programs, prevention
and screening systems and early interventions. This would help in preventing the individuals

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of the nation in developing such chronic disorders rather than making them spend huge
amount of funds for treating them and suffering from poor quality life.
Equity has been defined by WHO as the absence of avoidable as well as remediable
differences among different groups of people based in society, economy, demography and
geography. It mainly means fairness where everyone in the nation would have the fair
opportunity in living healthy long lives. It mainly wants to state that health should never be
compromised as health should never be disadvantaged because of an individuals’ or a groups’
race, gender, ethnicity, sexual orientation, income, and many others. Social justice, similarly,
ensures justice that needs to be maintained in terms of distribution of wealth, opportunities as
well as different privileges within the society (Gibson et al., 2015). These two aspects are
intricately associated with health of individuals in the nation.
Studies have shown that people belonging to low socio-economic cohorts are more
vulnerable in developing chronic disorders and suffer from poor quality life. In such instance,
financial security plays great role in determining the quality of life a person leads. This can
be explained with the help of an example. A person from such background would always opt
for cheaper calorie dense fast foods pr take-away foods for their diets. Such foods make them
highly prone to obesity that in turn in the risk factor for diabetes, osteoarthritis and others.
People who have low income or unemployed also tend to settle for such cheaper calorie
dense foods. Hence, it can be understood that maintenance of equity and social justice in
ensuring equal distribution of wealth, finance, jobs, education scopes and similar others can
help such cohorts of people to adopt better lifestyles and diet choices. Individuals who have
low level of education might never understand the importance of being physically active and
importance of exercises in regular lives (Baum et al., 2016). People who are unemployed and
with low income may be forced to remain in small or shared houses, which are overcrowded,
unhygienic and prone to infection. Therefore, primary healthcare initiatives need to address

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such social determinists of health and develop interventions that can ensure equity and social
justice ensuring proper quality life of all people irrespective of their backgrounds.
About 20% of the Australians are seen to live in the lowest socioeconomic areas in
the year 2014-2015. They were found to be 1.6 times as likely as that of the highest 20% in
suffering from at least two chronic disorders like diabetes and heart disorders. People who
had reported about the worst physical as well as the mental health conditions for the year
2006 were two times more likely to have lived in a overcrowded dwelling or poor quality
houses (Wutzke et al., 2017). Unemployed people were 1.6 times as likely to have used
cannabis, 1.8 times as likely to have used ecstasy and 2.4 times to have used amphetamines in
comparison to that of the employed people as found in the data of 2013. People who were in
the cohort of low economic resource households were found to be spending proportionally
less on medical as well as healthcare than other households (“3.0% and 5.1% of weekly
equivalised expenditure, respectively, in 2009–10”). Hence, this shows that social
determinants of health, equity as well as social justice are not effectively managed and
maintained by the healthcare departments and hence, immediate interventions, promotional
programs and screening programs are necessary. Primary healthcare professionals need to
devise out ways to tackle such determinists and enhance equity and social justice successfully
for better health outcomes for all people in the nation.
World Health Organisation had proposed five important principles that need to be
incorporated in the primary healthcare initiatives in order to ensure comprehensive services to
all individuals in the nation. The strategy need to ensure universal access to care as well as
coverage based on needs. It should ensure commitment to health equity as part of the
development oriented social justice (Davey et al., 2015). Community participation needs to
be ensured for defining as well as implementing of the health agendas. There should also be
inter-sectoral approaches to health in the strategies that need to be developed. All the above

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mentioned principles had been included in the chosen strategy. Not only the strategy had
correctly identified the important social determinants like education, employment, transport,
road structure, suitable housing, fresh food, literacy levels and socio-economic positions that
need to be addressed in their initiatives but they also have identified the importance of health
promotion programs. Different plans and programs like Aboriginal and Torres Strait Islander
Education Action Plan 2010-14, Community Engagement Officers, Refugee Health Nurse
Program, Bi-Cultural Community Health Program and many others had separately ensured
inter-sectoral collaboration, addressing disadvantaged communities, assessing needs,
providing financial aides, educating cohorts and many others (Burstein et al., 2015). They
have also stressed on the importance of a whole of government approach at all levels
ensuring engagement and involvement of all organisations and service providers beyond
health sectors. This had helped in development of care pathways ensuring universal access to
care that address social and welfare needs of the client.
Increase of the burden of chronic disorders in the nation can never be managed
successfully unless social determinants of health are addressed sufficiently. Therefore, there
is need for all nursing professionals to advocate on the behalf of the disadvantaged patients
and their population cohorts who die snot get the scope of education, employment, proper
housing, better quality foods and others (Wakerman et al., 2017). I also believe that health
promotion programs that develop health literacy level of all people can help in modifying
their lifestyle choices and of habits. This could result in reduction in the rate of chronic
ailments and hence reduce the disease burden of chronic ailments from the nation.
References:

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