Reducing Health Inequalities through Urban Planning

The assignment focuses on addressing health inequalities by promoting cycling and walking through effective urban design, improving public transportation, and tackling social determinants of health. It emphasizes the need for policy makers to formulate interventions that address these inequalities, ensuring equitable access to healthy living environments.

Social Determinants of Health1
SOCIAL DETERMINANTS OF HEALTH
by Student’s Name
Code + Course Name
Professor’s Name
University Name
City, State
Date

Social Determinants of Health2
Table of contents.
Social determinants of health……………………………………………………………………...3
Social gradient as a social determinant of health………….............................................................3
Interventions on the social gradient inequalities at national or local level..............................3
Stress………………………………………………………………………………………...……4
Interventions for addressing stress at a national or local level.................................................4
Unemployment…………………………………………………………………………………….4
Interventions addressing unemployment at a national or local level.......................................4
Work.............................................................................................................................................5
Interventions for work as a social determinant in health..........................................................5
Transport......................................................................................................................................5
Interventions to address transport inequalities at the national or local level............................6

Social Determinants of Health3
Social determinants of health.
The human body needs to be part of a society, fitting in the society leads tohealthier,
more content people who are healthy both mentally and physically. Nevertheless, people who are
less privileged have a shorter life span than rich people do. These differences in health are health
injustices (Marmot 2006). The following paper discusses the social determinants and factors that
lead to differences in health within the social sphere. Furthermore, the paper critically discusses
interventions developed to address inequalities at either the national or local level. In addition to
that, it considers why they were introduced and evaluates their effectiveness.
1. Social gradient as a social determinant of health.
The social circumstances strongly affect health of people globally. Poor social factors
affect the health of people.Furthermore, the extremely poor are at a higher risk of a serious
disease or premature death as opposed to the rich. Most causes of death and diseases are more
prominent at the lowest level of the social hierarchy.Poor health among those people who live
below the poverty level is a show of material disadvantage, effects of insecurity and lack social
integration and anxiety(Marmot 2006).
People who live in the lower social gradient are more disadvantaged in various ways such
as; having few assets, poor levels of education, insecure employment, poor housing anddifficulty
in raising families.The more such people live in such dilapidated conditions, the more they suffer
a greater psychological wear, and their chances of enjoying a healthy old age are very limited
(Kelly, Sacker & Del 2011).

Social Determinants of Health4
Interventions on the social gradient inequalities at national or local level.
Life consists of critical transitions from childhood to old age.This can affect the health of
an individual because the transitions move a person either to a more disadvantaged or less
advantaged path.Welfare policies offer springboards especially to the poor to offset an earlier
disadvantage (Wilkinson & Marmot 2003).
Good health is achieved by reduced levels of failure in education, job security,
andincome. Policy makers need interventions to ensure thatfew people are
disadvantaged.Policies for employment,education, and housing affect thestandards of
health.Citizens need to be fully engaged in the socio economic and cultural aspects of the society
since it encourages people to be healthyinstead of leaving them exclude, insecure and deprived
(Institute of Health 2011).
2. Stress
Socialand psychological circumstances are major causes of long-term stress. Low self-
esteem, insecurity,lack of controlat work or home, and continued anxietyhas massive effects on
the health of an individual. Psychological problems facilitate poor mental health. Furthermore,
they also increase chances of premature death (World Health Organization 2008)
Stress damages any area of life; the stress that followsan emergency activates hormones,
which affects the immune system and the cardiovascular system.The hormones prepare us for
anything by elevating the heart rate, increasing alertness and anxiety, or diverting blood to
muscles.When this biological response to stress is activated too often and for longer periods, it
has multiple effects on the health of a person such as increased chances of getting infections,
depression, cholesterol in blood, high blood pressure, stroke and risks of heart attack. Moreover,

Social Determinants of Health5
the lower people become in social hierarchy, the more they become susceptible to stress and
resultant health problems (World Health Organization 2008).
Interventions for addressing stress at a national or local level.
Stress is controlled medically by the use of drugs in response to the biological changes
within the body. However, attention needs to be focused on the cause of the disease. In schools,
workplaces or businesses the social environment is important to the health of a person same as
the physical environment (Christopher 2012).
Institutions should prevent stressful situations by giving people a sense of belonging and
valuing people, this would inturn positively affect their health by reducing stress.Welfare
programs from the government need to address causes of anxiety and insecurity such as
psychosocial needs. Furthermore, the government needs to encourage social activities, and
support people with young families andstop social isolation. This intervention would be effective
on the health of the person as a stress management strategy (Institute of Health 2018).
2. Unemployment.
Job security increases job satisfaction, well-being, and heath.However, unemployment
negatively affects health. Health risks are higher in regions with higher rates of unemployment,
which leads to higher incidences of premature deaths.The health effects caused by
unemployment are linked to the financial problems and the psychological consequences of
unemployment such as debt. Job insecurity is detrimental to health. Job insecurity increases
effects of self-reported ill health, heart disease, and mental health (Marmot 2010).

Social Determinants of Health6
In the recent years,there have been problems in many economies thus leading to more
people feeling insecure in their jobs and increasing rates of unemployment, which acts asa
chronic stressor (Marmot, Friel& Bell 2008).
Interventions addressing unemployment at a national or local level.
The interventions on unemployment have three goals. The first goal is to prevent job
insecurity and unemployment, reduce hardships in employment, and find secure jobs.
Governments should manage the economies effectively to prevent highs and lows in the business
environment thus improve on job security, and reduce unemployment.Working hours should be
reviewed since long working hours leads to poor health.The quality of education shouldbe
improvedto enable people get quality and secure jobs, this would go in a long way to curb
unemployment (Marmot 2010).
3. Work.
The risk of diseases increases when the workplace is stressful. Stress has a negative
impact on health. Health at the workplace is compromised when people lack the opportunity to
use their skills, and they have low authority especially in decision-making (Michael & Jessica
2018)The low authority over decisions and low control over work leads toill health due to stress
and cardiovascular diseases (Marmot & Bell 2012).
The next factor that affects health at the workplace is rewards. Inadequate rewards leads
to low motivation hence rise of cardiovascular diseases.Rewards can take different forms such as
money,self-esteem, or status. The current change in labour laws is a major hindrance togetting
appropriate rewards. Therefore, the workplace psychosocial environment is a major contributor
to health and it needs major interventions (Morris, Deeming & Wilkinson 2010).

Social Determinants of Health7
Interventions for work as a social determinant in health.
A virtuous cycle needs to be established at the workplace; improving the conditions at the
workplace. This will lead to improvement in productivity. Moreover, employees need to be
involved in decision making at work, this is beneficial to them, and it contributes to better health.
Next, practices at the workplace and offices should be redesigned to allow more control, more
opportunities, and greater varieties for development at the workplace. Workers deserve rewards,
as this will lead to appropriate results in term of self-esteem, money, and status. Musculosketal
disorders need to be reduced at the workplace, this can be done by ensuring that the workplace is
appropriate ergonomically, and work is organized properly (World Health Organisation 2008).
4. Transport.
Healthy transport is achieved through walking, cycling,and a better public transport
system.These reduce fatal accidents, they provide exercises, reduce air pollution, and increase
social contact.People need to find ways of building exercises in their lives because
mechanization has reduced exercise. This can be done via cycling, walking, improving and
expanding the public transport and reducing over reliance on cars.Regular exercises reduce the
risks of heart diseases, limit obesity, and reduce the onset of diabetes. Furthermore, regular
exercises protect the old from depression and promote a sense of well being (Wash & Jones
2010).
Planning the urban environment will help in reducing traffic byseparatingcyclists and
other road user from vehicles, since accidents caused by vehicles are fatal than those caused by
cyclists (Walsh & Jones 2010).

Social Determinants of Health8
Moreover, social interaction is promoted through walking and cycling as opposed to cars
that insulate people from each other.Furthermore, isolated streetscease to be social places. When
people are isolated such as in suburbs, they face loneliness thus leading to ill health (Michael &
Jessica 2014).
Reducing traffic on the roads reduces pollution from vehicle exhausts. Walking and
cycling reduces the use of renewable energy that leads to global warming and effect of
greenhouse gases on health (Walsh & Jones 2010).
Interventions to address transport inequalities at the national or local level.
The use of cars is rapidly on the rise across Europe despite its effects to the environment.
In contrast to this,walking or cycling is reducing across the continent.The main intervention is to
reverse the trend and allow more cycling and walking (Walsh & Jones 2010).
Roads in urban areas should be designed to accommodate more cyclists and walking
pedestrians. The public transport needs improvement through increased government financial
support.The use of cars should be reduced by removing spaces for car parking, dedicating roads
to more pedestrians and cyclists, increasing lanes for buses, reducing the growth of suburbs with
fewer people, and creating supermarkets on the outskirts oftowns (Walsh & Jones 2010).
The following social determinants of health affect people’s health either negatively or
positively. They include; the social gradient, stress, work, unemployment, and transport. Policy
makers have formulated interventions and outlined their effectiveness in handling the
inequalities that are posed by the social determinants of health.

Social Determinants of Health9
Reference List
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Institute of Health 2011, Health inequalities, a challenge for local authorities, International
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Social Determinants of Health10
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