University Essay: Social Determinants of Health and Health Strategy

This essay delves into the concept of Social Determinants of Health (SDOH), exploring how factors like income, regional deprivation, and employment status influence health outcomes and contribute to inequalities in New Zealand. The assignment references a research article by Gunasekara et al. (2013) to illustrate the impact of SDOH on health, particularly focusing on income-related disparities. The essay further examines the NZ Health Strategy (2016), outlining its five pillars and how they aim to support health and wellness in Aotearoa New Zealand by addressing health inequities and improving access to healthcare. The conclusion emphasizes the importance of addressing SDOH to reduce health inequalities and highlights the strategy's role in creating culturally sensitive health services.

Running head: SOCIAL DETERMINANTS OF HEALTH (SDOH) 1
Social Determinants of Health (SDOH)
Student’s Name
University Affiliation

SOCIAL DETERMINANTS OF HEALTH (SDOH) 2
Contents
Introduction......................................................................................................................................2
The concept of SDOH.....................................................................................................................2
How SDOH may influence health...................................................................................................3
How the NZ Health Strategy (2016) plans to support health and wellness in Aotearoa New
Zealand............................................................................................................................................4
Conclusion.......................................................................................................................................6
References........................................................................................................................................7

SOCIAL DETERMINANTS OF HEALTH (SDOH) 3
Social Determinants of Health (SDOH)
Introduction
Social determinants of health (SDOH) are the situations in which people live, learn, work
and age. These conditions are the major causes of health inequalities in New Zealand. This
assignment will discuss the concept of SDOH in relation to a selected research article and
pertinent literature. Firstly, the assignment will explore the concept of SDOH. Secondly, it will
discuss how SDOH influence health with reference to the selected research article. Finally, it will
explain how the NZ Health Strategy (2016) intents to improve health and wellness in Aotearoa
New Zealand.
The concept of SDOH
SDOH consist of different overlapping that influence health and wellbeing. Most of the
factors begin at birth including biology and genetic traits, gender, culture and family effects on
healthy child growth. Some of the elements have a greater effect on health and wellbeing than
others. The family factors include the socio-economic resources for the parents to provide basic
needs for children, education level of parents and sufficient social support (McMurray &
Clendon, 2015, p. 10). For better social support, the parents should have access to employment
opportunities or adequate income source. It is evident that some of these SDOH are rooted in the
political and economic environment since policy decisions affect community life. Consequently,
there are various structural conditions within the SDOH. For instance, the social development of
a community requires structures to create employment as well as an environment that supports
healthy lifestyles (McMurray, & Clendon, 2011, p. 11). People within the community require
access to clean water, air and nutritional foods at affordable prices. Besides, hospitals and health

SOCIAL DETERMINANTS OF HEALTH (SDOH) 4
professionals who are accessible on demand create the larger structure of a social environment
(McMurray & Clendon, 2015, p. 10). Evidently, the concept of SDOH is broad and encompasses
factors within the control and beyond the control of the people, and that is why some of the
SDOH are addressed through government policies.
How SDOH may influence health
Gunasekara, F. I., Carter, K., & Mckenzie, S. (2013). Income‐related health inequalities in
working age men and women in Australia and New Zealand. Australian & New Zealand Journal
of Public Health, 37(3), 211‐217. doi:10.1111/1753‐6405.12061
This section investigates how SDOH might influence health with reference to the
research by Gunasekara and colleagues. The authors aimed to evaluate income-linked
inequalities in health in working-age males and females in Australia and New Zealand. They
utilised data from two longitudinal studies to compare concentration indices that evaluate the
distribution of general and mental health-linked quality of life (QOL) scores across income in
working-age males and females. Additionally, decomposition evaluations of the concentration
indices were performed to determine the influence of different factors on the income-related
health inequality. This study unraveled that income, regional deprivation and inactiveness in the
workforce were primary causes of income-associated health inequality. In conclusion, the
authors note that income and employment are the leading causes of health inequality in New
Zealand (Gunasekara, Carter, & Mckenzie, 2013, p. 211). This research is relevant to essay
topic since it is founded on the disparities in health status and inequalities in health with a focus
on socioeconomic position. The findings of this research are similar to several other studies that
have found that SDOH influence health directly. One recent study found that the Maori, Pacific
and other people with low socioeconomic status (SES) are at a higher risk of developing chronic

SOCIAL DETERMINANTS OF HEALTH (SDOH) 5
illnesses compared to those with high SES. This difference results in high mortality and
morbidity among the Maori and Pacific people (Sheridan et al., 2011, p. 45). Apart from these
impacts, the difference in incomes also causes other health inequalities.
Shamshirgaran et al. (2013, p. 1223), conducted a study to determine the influence of
SES on the occurrence of type II diabetes. They found that the incidence of diabetes was higher
in retirees’ and unemployed people compared to those who were employed. Further, the
incidence of diabetes was generally high in individuals with low incomes. This study concluded
that SES is an independent predictor of diabetes. Low SES can result in the occurrence of
diabetes due to various factors. Individuals with low incomes might lack health literacy on the
prevention of chronic illnesses (Benjamin, 2010, p. 784). They may also lack access to proper
diets and exercises that help to prevent the occurrence of diabetes. This argument is supported by
research performed by Grant and colleagues. In their study, they investigated the burden of
communicable diseases in Maori children and non-communicable conditions among the adults in
relation to poverty. Poverty was found to be an important contributor to communicable and non-
communicable diseases in this population. Due to poverty, pregnant women lack access to
nutritious foods resulting in poor health of their children. A Recent study also asserts that area
deprivation in New Zealand leads to poor health. It has been found that a significant number of
the Maori people live in regions considered to be deprived in the country and this factor results
in health inequalities (Bécares, Cormack, & Harris, 2013, p. 76). Area deprivation is directly
associated with poor health because of unequal access to health services and employment
opportunities.

SOCIAL DETERMINANTS OF HEALTH (SDOH) 6
How the NZ Health Strategy (2016) plans to support health and wellness in Aotearoa New
Zealand
The NZ Health Strategy (2016) consists of five pillars meant to enhance the health of the
New Zealanders. The five pillars also outline a plan to support health and wellness in Aotearoa
New Zealand.
People-powered: This pillar is consistent with the Maori Health Strategy. The strategy
proposes that individuals using health care services require ways to meet their immediate and
future needs. As such, the people-powered strategy champions the contribution of Maori in
decision-making on health care services.
Closer to home: This strategy advocates for bring care closer to the people. It argues that
different approaches can be used to offer care to the people who live in remote areas. For
instance, the use of telehealth, outreach clinics and mobile vans can be used to reach the deprived
areas (Minister of Health, 2016, p. 19). This strategy plans to use non-governmental
organisations to bring care closer to the people. It cites the example of Maori and Pacific
approaches and models, which can be embraced to make care affordable and accessible. Another
plan is to use the Maori health network. The Maori health network would entail the use of
population-based strategies to prevent long-term illnesses and promote healthier choices.
Value and high performance: For Aotearoa New Zealand, this strategy aims to focus on
Pacific community group. It plans to enhance the quality of health care for the population groups
that face inequalities specifically the Maori people. This strategic plan would be achieved by
eliminating infrastructural, physical and financial barriers to offer high-quality health services.

SOCIAL DETERMINANTS OF HEALTH (SDOH) 7
One team: This strategic plan realises the need to minimise barriers that inhibit people
from utilising their skills fully. It targets to empower Maori health providers. The support for
Maori health providers might include the provision of health literacy education. Also, it could
entail offering individuals’ opportunities to contribute in the designing of the health system
(Minister of Health, 2016, p. 29).
Smart system: The health system envisions the use of smart systems to offer care to the
disadvantaged communities. The smart system would entail the use of technology such as
telehealth, which can be used to reach people in rural areas (Dinesen et al., 2016, p. e53).
Conclusion
As evident in this assignment, SDOH result in health inequalities in New Zealand. Based
on the selected article, income, regional deprivation and inactiveness in the labour force are
significant causes of health inequalities. People from low SES are likely to experience poor
health compared those from high SES. The NZ Health Strategy of (2016) intends to reduce these
inequalities by improving access and designing culturally sensitive health services.

SOCIAL DETERMINANTS OF HEALTH (SDOH) 8
References
Bécares, L., Cormack, D., & Harris, R. (2013). Ethnic density and area deprivation:
Neighbourhood effects on Māori health and racial discrimination in Aotearoa/New
Zealand. Social Science & Medicine, 88, 76-82. doi: 10.1016/j.socscimed.2013.04.007
Benjamin, R. M. (2010). Improving health by improving health literacy. Public Health Reports,
125(6), 784- 785. doi: 10.1177/003335491012500602
Dinesen, B., Nonnecke, B., Lindeman, D., Toft, E., Kidholm, K., Jethwani, K., ... & Gutierrez,
M. (2016). Personalized telehealth in the future: a global research agenda. Journal of
medical Internet research, 18(3), e53. doi: 10.2196/jmir.5257
Grant, C. C., Wall, C. R., Yates, R., & Crengle, S. (2010). Nutrition and indigenous health in
New Zealand. Journal of paediatrics and child health, 46(9), 479-482. doi:
10.1111/j.1440-1754.2010.01842.x.
Gunasekara, F. I., Carter, K., & Mckenzie, S. (2013). Income‐related health inequalities in
working age men and women in Australia and New Zealand. Australian & New Zealand
Journal of Public Health, 37(3), 211‐217. doi:10.1111/1753‐6405.12061
McMurray, A., & Clendon, J. (2015). Community health and wellness: Primary health care in
practice (5th ed.). Chatswood, Australia: Elsevier Australia.
McMurray, A., & Clendon, J. (2011). Community health and wellness: Primary health care in
practice. Chatswood, Australia: Elsevier Australia.
Minister of Health. (2016). New Zealand Health Strategy: Future Direction. Wellington:
Ministry of Health.

SOCIAL DETERMINANTS OF HEALTH (SDOH) 9
Shamshirgaran, S. M., Jorm, L., Bambrick, H., & Hennessy, A. (2013). Independent roles of
country of birth and socioeconomic status in the occurrence of type 2 diabetes. BMC
public health, 13(1), 1223. doi: 10.1186/1471-2458-13-1223
Sheridan, N. F., Kenealy, T. W., Connolly, M. J., Mahony, F., Barber, P. A., Boyd, M. A., ... &
Dyall, L. (2011). Health equity in the New Zealand health care system: a national survey.
International Journal for Equity in Health, 10(1), 45. doi: 10.1186/1475-9276-10-45