SOCIAL DETERMINANTS OF HEALTH2 Social Determinants of Health Socio-determinants of health are the living conditions that impact or indicate the health or the health outcome of a population. They include both the social and economic factors and their distribution among a community that results in the differences in the health status. They also include the neighboring and working conditions, income level, and race and education attainments. They are the factors that impact on the access, demand and utilization of health care. This essay seeks to explain the effect of the low socio-economic status of the families living in Sydney, Australia (Vilela Brito & Vilela, 2018). It also describes how low income influences the access to quality healthcare, good nutrition and good housing. Highlighted also are the recommendations that may help in solving the health disparities in health and health care. There is evidence that low socioeconomic status and its correlates are often related to the increase in the occurrence of diseases and poor health. People from poor backgrounds are more susceptible to many chronic diseases; they also have a lower life expectancy compared to individuals with high socio-economic status. They also have reduced access to healthcare and nutritious foods. This is because poor individuals do not have resources to spend on eating healthy foods and seeing doctors (Frimpong, 2014). Poverty in Australia has been growing in recent years with approximately 13.3% of the people living under the internationally set standards. An estimated 731,000 children live in poverty with 17.5% below the age of 15. There are high levels of poverty in Sydney, the capital of Northern South Wales Australia. Research indicates that there is a wide gap between the rich
SOCIAL DETERMINANTS OF HEALTH3 and the poor in the area. Around 18,000 families are living under the poverty line in the place. This has adversely affected the health and access to health care by the families. The main cause of poverty in the area is the rise in the cost of living. Lack of employment and education has also led to the increase in the poverty levels (Key domestic economic forecasts for Australia, 2016). Low socioeconomic status and access to Health Care Low socio-economic status has negatively influenced the access to healthcare among the people living in Sydney. Most families live far from the health care facilities making it hard for them to acquire the services. They are always faced with the problem of paying for transport to reach the facilities. Due to lack of enough income, they do not visit the hospitals which result in poor health, worsening of health problems, deaths and disabilities. Expectant women also find it hard to reach the hospitals making them deliver at home. This may lead to the development of birth complications and even the death of the infant. The mothers who are lucky enough to safely deliver their children often miss out on essential vaccinations, predisposing the infant to communicable diseases (Frimpong, 2014). Some of the facilities in the area have a small number of healthcare professionals. As a result, they do wait for long to get medical attention. This discourages the patients from visiting the hospitals and hence lacking treatment. They also miss out on the type of services they need most because most facilities are not adequately equipped with medical equipment (Middleton et al., 2018). Research indicates that there is a high prevalence rate of diseases such as diabetes and cancer in the area. Patients suffering from the conditions need constant access to health care for survival. Lack of access to the healthcare they need leads to the increase in mortality rates. It also
SOCIAL DETERMINANTS OF HEALTH4 has an impacts on the emotional and psychological well-being of both the patients and family members due to the pain they undergo through as a result of lack of treatment. The costs and prices of health care services are high in the area. The families face barriers such as lack of medical insurances and lack of enough funds which leads to delay or lack of medical treatments (Health insurance for the poor, 2012). They also lack funds to purchase quality drugs and end up getting low quality drugs that worsens their health. Some also resort to seeing traditional doctors with the hope that they will get better. Low socio-economic status and Nutrition Socio-economic status greatly influences nutrition. The cost of poor nutrition is high and continues to rise over the years. Due to lack of enough income, the families living in Sydney are unable to afford nutritious foods. Inadequate consumption of major macronutrients and high intake of calories do predispose them to conditions such as undernutrition and obesity. It may also contribute to the development of chronic conditions such as diabetes, high blood pressure and cardiovascular disease which have high economic costs. (Factors Contributing to Health and Disease, 2016), suggests that better nutrition can improve intellectual capacity and hence increasing their labour productivity. Improved nutrition is also vital to the high-income creation and rapid development. Studies indicate that poor people do make cheaper food choices which are less healthy and less energy dense. On the other hand, people with high socioeconomic status purchase foods such as fish, fresh vegetables and whole grains which reduce their risk of contracting heart diseases and weight gain. Poverty has also resulted to poor nutrition in pregnant women. Proper
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SOCIAL DETERMINANTS OF HEALTH5 nutrition is essential during the peri-conceptual and antenatal periods as it is a significant determinant of the health of both the mother and the infant. Under nutrition during pregnancy is related to low birth weight. The infants also have a probability of developing childhood obesity during their childhood (Williams, 2011). There is a high prevalence of obesity and emotional and health problems among the children living in Sydney. Proper nutrition is necessary for a child's growth. Children with no access to healthy nutritious foods or essential nutrients are susceptible to acute and chronic diseases. According to Williams, children with poor nutrition have a high likelihood of developing mental and emotional health effects and obesity. Data retrieved from the World Health Organization suggests that children with lack of access to healthy foods have a chance of not attending schools and repeating grades. This results in the inability to succeed academically which has a huge impact on their future lives (Williams, 2011). Low Socioeconomic Status and Housing The residents of Sydney are unable to afford proper housing due to their socio-economic status. Poor housing adversely affects the health of both the children, elderly, youths and expectant mothers. Housing is one of the prime concerns for public health. This is because it influences health and well-being since it is where people spend most of their time. Decent housing is essential for psychological reasons and protection against physical, biological and chemical hazards (Carpenter, 2016).
SOCIAL DETERMINANTS OF HEALTH6 According to the World Health Organization, four concepts define the housing of a person. They include both the dwelling, the neighborhood, the home and the community. The home is the economic, social, cultural and economic structure developed by the family. The dwelling refers to the structures with adequate capacity and facilities that accommodate the family members. The community refers to the structures built by those living in the locality. The neighborhood includes social amenities such as shops, playgrounds and churches. Good housing is that which is free from preventable hazards. Secondly, it should be quiet and provide adequate privacy. Thirdly it should provide room for enough relaxation. Lastly, it should provide suitable means for sleeping and personal hygiene. Any undesirable condition in the dwelling may lead to adverse effects such as physical and mental illnesses. There are high rates of respiratory diseases such as asthma in Sydney. This is due to constant exposure to radon and asbestos. Depression and anxiety rates are also high in the area due to lack of proper housing. Many people suffer from accidents and fires, high body temperature and common physical symptoms (Lauster, 2010). There are also high rates of allergic reactions, headaches, asthma, diarrhea and nausea among the children and the elderly in Sydney. This is because they live in damp houses. The presence of house dust mites and airborne mould spores intensifies the respiratory conditions. Overcrowding in the area has also increased the spread of communicable diseases such as tuberculosis in the area. This has resulted in higher deaths rates among the children and the elderly since most of the conditions are left untreated.
SOCIAL DETERMINANTS OF HEALTH7 Low socioeconomic status and education Recent studies indicate that low socio-economic status hinders individuals from acquiring quality education. There is a healthy relationship between high educational attainment and good health and healthy practices. In today’s life, graduates or people with high level of education are likely to get a job that gives benefits such as health insurance, paid retirements and leaves. However, people from poor background are more likely to land jobs that are high risk with few benefits. The fact that educated people have a high chance of getting health insurance helps them get quality affordable health care that is timely and hence reducing mortality. They also have access to quality healthcare. It also ensures that people have the income to buy nutritious foods (Greß & Wasem, 2017). Education also ensures that people engage in healthy practices such as going for screening services which enables them to know early enough if they are infected or at risk of having a particular disease. Research indicates that the families living in Sydney do not go for screening services. This has resulted in the late diagnosis of diseases such as cancers and cardiovascular diseases and hence leading to early deaths and economic costs in treating the conditions. . Research shows that there are more health inequalities among the less educated people. Education also helps eliminate health disparities as people will be educationally empowered, and this will make them independent. It also helps them understand more about their rights which will help them fight the health inequalities (Marmot, Allen, Bell & Goldblatt, 2011).
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SOCIAL DETERMINANTS OF HEALTH8 Recommendations The families living in Sydney should be economically empowered to ensure that they receive the health benefits and healthy foods just like the rest. This can be achieved through the creation of employment opportunities through increased productivity. The jobs should be sustainable to help the families have enough money to afford healthcare and good nutritious foods. The government should also offer micro-loans to the people for them to start small businesses that can depend on as a source of income (Polack & Warwick, 2016). The government can also source for donor funding to acquire money to fund startups businesses or already established ones to ensure that they are sustainable enough. They can also identify market opportunities and to ensure that they maximise their profits (Women's economic empowerment, 2012). The government should also train the people on income generating activities such as tailoring and food production. The people should be encouraged to save part of the income to use during tough economic times (Northridge & Freeman, 2011). Population nutrition can be enhanced through society empowerment through the use of community nutrition programs. It is vital for the community to eat well and live a healthy life to prevent them from being obese or suffering from malnutrition. Nutrition education is a critical aspect especially for the low-income families because they will get to understand a proper dietary habit and the choice of food that they are required to consume. (Yoo & Kim, 2017). Policies that promote good eating habits, books and other sources with information on nutrition should be given to the community. Nutrition has an essential duty to improve childhood health
SOCIAL DETERMINANTS OF HEALTH9 and maternal care. Proper nutrition among children leads to a healthy lifestyle and prevention of many diseases. Nutrition education also provides suggestions on how to develop good eating behaviors in the community. Nutrition guidelines can be of great help in informing people about nutritious family nourishment. It should also be included in the curriculum so that even the weak learners can also acquire knowledge regarding healthy meals. This should be supported by the school management and the participation of the community. This will improve healthy food accessibility for the poor people in Sydney. For the intervention to be effective, the community members should also have interest in promoting healthy living. Nutrition education can encourage people to do physical activities which is a significant role in preventing chronic diseases by burning excess calories in the body. It also helps people to keep fit. (World Health Organization) Access to quality and affordable health care for the poor has been a significant challenge in Sydney. To increase the access to quality of health is to develop health centers in the community. There is need to give preventive healthcare services and serve people who are not able to afford quality treatment. The government should make the medical covers affordable to the poor. This will ensure that they receive treatments even when they lack enough funds. It will also reduce the financial costs and stress they face when they are unable to pay hospital bills. After lowering the prices for the insurance covers, the government should ensure that the people embrace the usage of the insurances (Stolldorf, 2017). Health care services should consider the homeless and those who survive in public housing. There should be increased access to services such as gynecologic, paedriatic, and family practice services. (Middleton et al., 2018).
SOCIAL DETERMINANTS OF HEALTH10 The government should also ensure that there are enough well-trained health service providers. As a result, majority of the people will have access quality healthcare. This will help in ensuring that their service reaches the people in the rural and marginalized area. This is will also assist in the provision of quality and appropriate treatment for all patients, regardless of the complexity of the health issue. This will also ensure that there are reduced delays in acquiring treatment. The community centers should be expanded so that the population can be covered accordingly. The centers should also be put in a location that is easily accessible by the poor to reduce time coverage and the costs involved in transport. Emergency rooms should also be adequately equipped so that those patients who are in critical condition get quality treatment and avoid further loss of life. Transport and ambulance services should be offered for the victims who live in the rural areas and those who require urgent treatment. The state should also reduce taxes on food industries to enhance the provision of quality food to the community. (Mukherjee, 2017). Proper habitation is essential in promoting health in Sydney. An unworthy housing may cause respiratory diseases and other preventable ailments. Through appropriate housing, respiratory diseases can be greatly avoided. This may contribute to proper physical health development. Respiratory conditions may be reduced through proper modification of the houses. Therefore the people from Sydney should be encouraged to have adequate ventilation in their houses to prevent tuberculosis which results from overcrowding (Saunders, Watanabe & Wong, 2015). This will assist in the protection of the respiratory health system and the prevention of asthma. Ventilation will also help in minimizing condensation by temperature regulation and the controlling of the level of moisture status. Ventilation is also more likely to reduce radon gas concentration (Baskaran, 2016).
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SOCIAL DETERMINANTS OF HEALTH11 The government should ensure that overcrowding should is avoided to prevent the spread of infectious diseases. It should also train the community health nurses on how to conduct an environmental evaluation in the houses present in the community and also educate them about the importance of good air quality of air indoors. The government should also ensure that the health care personnel’s conduct community assessment so that they can create policies that take care of risks involved in poor housing. It should also collaborate with the department that deals with housing issues and constructions and create awareness on the effect of housing condition on the health of the population. It should also focus on providing better houses for the less unfortunate. Medical experts should educate people in the community concerning proper sanitation and hygiene. They should be taught the essence of practising good hygiene behaviors such as washing hands after visiting the washrooms and before preparing and having meals. The ladies should also be taught on good menstrual hygiene (Yoo & Kim, 2017). This will reduce the number of illnesses and deaths from communicable diseases. The personnel’s should determine the hygiene practices that require changes in the area and provide information to the public about it. The government should also create programs that will help in maintaining good health and increasing the lifespans of the population (Sassen, 2017). Education on the benefits of hospital deliveries should be explained to the people. People from low economic status do not attend the hospital because of low income. The government should create programs that change people’s perception on visiting hospitals. The people should be informed about the advantages of visiting the hospital early enough (Tausch, 2012). The importance of proper health-seeking behaviours should be emphasized. They should be
SOCIAL DETERMINANTS OF HEALTH12 discouraged from waiting for severity of the illness for them to get treatment to prevent further damage to the patient or disease progression that may result in unnecessary disability. Early treatment also minimizes mortality rate and hence increasing economic productivity (Primary Care, 2017). More education is needed to create awareness about the ailments that can be prevented and controlled, effects on the body and the methods of prevention. The people living in Sydney should be educated about general signs and symptoms of diseases and how they should handle them if they are far from the health facility. They should also be discouraged from purchasing over the counter drugs without proper. This will help in avoiding many illnesses and deaths due to the wrong subscription of medications through the counter method. (Vilela, Brito & Vilela, 2018). Reducing the poverty level to the minimum has the chance of ensuring that the community leads a normal healthy and productive life. However, this is a difficult task to achieve and requires good political goodwill and the participation of both the community and relevant stakeholders.
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