Analysis of Social Determinants of Health in Healthcare Report

This report examines the social determinants of health and their impact on healthcare inequalities, focusing on the Canadian context. It explores factors such as income, education, job security, stress, and social justice, and how these elements influence health outcomes. The report emphasizes the disparities faced by marginalized communities and discusses the role of nurses and healthcare professionals in addressing these inequalities through policy, advocacy, and cultural competence. It highlights the ethical considerations of health equity and social justice, advocating for interventions that promote equal access to resources and healthcare services. The report also includes reflection on cultural competence and the importance of understanding the patient's background in providing quality healthcare. This report is valuable for students seeking to understand the complexities of healthcare and the impact of social determinants on population health.

Running head: HEALTHCARE 1
Healthcare
Student’s Name
Institution

HEALTHCARE 2
Healthcare
Introduction
The social determinants of the health distribution are the situations in which people are
born, live, grow, work and age. Such conditions are shaped by the placement of aspects like
power, money, and resources at the local, national and global level, also known as a structural
determinant of health inequalities. The social determinants of health include education, income,
and housing that impacts the health of a population. The social determinants of health
inequalities are apparent in the unequal distribution of the broad societal aspects in an unfair
manner (Batterham et al., 2016).
Determinants of health
The main factor that defines the health of the Canadians is not the lifestyle choices or the
medical treatments but rather the conditions of living that they experience. The Canadian
contributions to the social determinants of health aspects have been pervasive and categorize
Canada as the ‘'health promotion powerhouse'' in the global perspective. The well-being of the
Canadians is determined by the distribution of wealth and income, employment status, working
conditions, as well as the ability to acquire quality education, food, and housing (Raphael, 2016).
There is enough evidence that the quality of the social determinants of health with the Canadian
experience assist in explaining the vast inequalities of health that exist among the citizens. The
life expectancy and the susceptibility to cardiovascular disease or adult-onset diabetes are more
determined by the conditions of living. The same explanations apply to their offspring: the
survival difference among the children living in Canada is beyond the first year of life.

HEALTHCARE 3
Childhood challenges like injuries and asthma, but their performance in school is part of the
social determinants of health these kids go through (Sharma et al. 2018).
Stress body and illness
Persons suffering from adverse material and social lifestyle also experience a high level
of psychological and physiological stress. The situation arises due to difficulty in coping with
poor quality housing, inadequate working conditions, food insecurity and low income as well as
various forms of discrimination. Stressful situations provoke the ‘'fight or flight'' reaction, which
introduces chronic stress in the body if an individual does not have enough recovery opportunity
in a conducive environment (Sharma et al. 2018). Continuous feeling of insecurity, shame and
lack of self-esteem can result from the poor living and stressful conditions.
Therefore, the best way to eliminate stress and improve health situations is enhancing the
standards of living of people. The elected representatives are committed to implementing a
policy that ensures good quality social health determinants for each Canadian.
Income and income distribution
It might be the most crucial social health determinant that affects physical functioning.
The increasing income inequality also enhanced the growth of the middle class in the country
since 1980-2005 in the proportion of the families that are currently very poor or rich (Blair,
Siddiqi & Frank, 2018). The increased wealth inequality in Canada is more than troubling.
Wealth is the best long-term outcome of health since it is a better metric of calculating financial

HEALTHCARE 4
security as compared to income. There is the possibility of experiencing reduced income and
wealth inequality in Canada through the unionized markets (Sharma et al. 2018).
Education
The pursuit of higher education in Canada is attributed to greater employability. In the
end, educated people can make better health decisions (Shankar et al., 2013). For a young adult,
securing a job is a step up since it provides one with the social, economic and personal resources
required to facilitate good health. Educated people stand in better positions to make informed
health decisions for themselves and their families and loved ones. The individuals with higher
education usually tend to be healthier compared to the ones with lower levels of education,
because they have more opportunities to exploit (Iwelunmor & Airhihenbuwa, 2017). Also,
education increases the overall understanding and literacy of how to improve the health of a
person. In Canada, the children whose parents do not have post-secondary education perform
worse as compared to the educated ones (Adler et al. 2016). People pursuing higher education
are more likely to receive higher education and experience a lower socio-economic status. This
means they can afford better health care for themselves and their loved ones.
Inequality in terms of education contributes to some people in Canada lacking better
health care because of the ignorance but also the socio-economic status. In Canada, Aboriginal
people are not offered equal employment opportunities. As a result, the youth will drop out of
school, thereby contributing to poverty and diminished literacy in the preceding generations.
Job security and unemployment

HEALTHCARE 5
The employment status of an individual is a sure indicator of the economic stability of the
country. According to Kansas DOHE (2015), there is a direct link between having employment
and good health. An increase in unemployment increases the number of illnesses and premature
deaths due to infectious diseases. It is more likely that the unemployed will forego medication
compared to the working individuals. Unemployment usually leads to poverty and discrimination
due to reduced income and eliminating benefits that were previously offered by the employers
(Andermann, 2016; Marleen Thornton PhD, 2018). It also disrupts daily routines. In addition,
most chronic diseases and mental health problems are common among the unemployed. This is
because they commonly engage in unhealthy practices such as drug and substance abuse which
deteriorates their health.
Poverty is the most significant cause of health inequality. Poverty leads to a lack of
access to the most important resources such as nutritious food leading to the emergence of
diseases like diabetes and obesity. Also, it leads to poor renal and cardiovascular health among
the citizens (Daniel, Bornstein & Kane, 2018). Further, poverty is connected with increased
crime, social exclusion and reduced social cohesion. For instance, social exclusion makes the
Aboriginal people get excluded from pursuing education which can land those jobs. Poverty
creates insecurity, hopelessness, anxiety and low self-esteem (Greenwood et al., 2015). Together
with other psychological stressors, poverty contributes immensely to increased addictions, lack
of social support, poor parenting, and violence. Because of the influx of these psychological
stressors, the victims often have poor mental health and are vulnerable to infections and high
blood pressure, depression and diabetes (Greenwood et al., 2015). Additionally, because of
poverty and exclusion, the high rates of psychological stress are linked with suicide cases and
substance abuse.

HEALTHCARE 6
Employment is the greatest in equalizer since it allows people with employment and
money great opportunities to easily access healthcare. On the other hand, the economically
disadvantaged citizens due to unemployment lack anything to pay their bills with. Therefore,
there is a need to champion for equal access to healthcare among citizens in Canada. This
ensures that regardless of an individual's economic status, they have full access to quality
healthcare.
Social justice
Minimizing health inequalities is a very ethical exercise. The enormous burden inflicted
by illness, poverty, lack of proper sanitation and overcrowding in terms of housing is a severe
health inequality in Canada. Besides, marginalization differences in the social class of different
communities present another striking disparity in health outcomes. While nurses conduct their
daily duties, they witness these inequalities. However, other than caring patients, they can get
involved in many ways.
One of the ways nurses can challenge this health disparity is arming themselves with
facts. Much literature exists on this pertinent subject which nurses can use for their advantage.
Should nurses get informed on these disparities and inequalities, they can educate health boards,
co-workers, other professional organizations, the media, and the public, about the causes, impact
and implications of health inequalities to people’s lives (Marmot, 2017). This will be helpful to
raise public awareness to ensure that every citizen and stakeholder is taking action against health
inequalities in Canada to ensure a healthy nation.

HEALTHCARE 7
Furthermore, nurses can get involved through challenging the existing belief about the
individual’s responsibility for health. In Canada, there is a consensus that good health is
determined by personal choices and actions which are guided by knowledge and mindset about
health (Oickle & Clement, 2019). However, this kind of thinking does not acknowledge the
socio-economic aspect of people’s lives but only focuses on the mental issues of people's beliefs,
knowledge, circumstances and will. Nurses can come out and challenge this thinking by citing
the health inequalities caused by unequal access to resources required to facilitate healthy living
(Reading & Greenwood, 2018). Also, they can focus on highlighting the psychological effects
these health inequalities cause people because of the unequal opportunities to stay healthy.
Nurses can assert that trying to change people's behaviour without changing the context in which
these people operate in society is a total waste of time and resources.
Another way nurses can get involved is through joining hands with their organizations to
promote equity considerations, the health policy and the planning of health. The promotion of
health and diseases must be easily accessible and be responsive to the leading causes of
preventable infections (Raphael, 2016). This reduces instances of exclusion of the socially
disadvantaged groups in these healthcare programs. In order to prevent increased health
inequalities in less advantaged communities, there is a need for nurses to develop targeted and
universal interventions to curb this incidence (Marleen Thornton PhD, 2018). There are many
tools nurses can familiarize within an effort to enhance healthy considerations for social justice
and equity among its disadvantaged population. These tools include the New Zealand
government’s Health Equity Assessment Tool and the CAN’s social justice gauge (Raphael,
2016). With these tools, nurses can contribute positively to the enhancement of equity in health
care, thereby reducing the existing health disparities and inequalities.

HEALTHCARE 8
Lastly, nurses can cause considerable social change if they choose to. Nurses stand in
better positions to create positive social change through their individual and collective
responsibilities. They can achieve this by drafting policies in the eras of employment, housing,
childcare, income support, and education (Donkin et al., 2018). This aims at creating social
justice and equity. Besides, nurses can also get involved in the transfer of knowledge to people in
the communities and groups to enable them to run advocacy for social changes within the
communities (Jackson & Huston, 2016). Nurses have a great chance to get support from their
employers. They can also borrow knowledge and skills from their pre-license practice as well as
their continuing education to gain effective skills for advocacy for social justice and equity. Both
in and out of the workplace, nurses can effectively deliver these responsibilities.
Reflection on cultural competence
Nurses need cultural proficiency in addressing the inequalities and the social
determinants of health. Cultural competence enables nurses to easily integrate other approaches
to handle the problem of health inequalities in Canada effectively. I have determined that
through practice, cultural competence can help nurses use motivational interviewing and
empathic inquiry as they help patients without developing stereotypes. Motivational interviewing
and empathic enquiry can help nurses to develop skills needed to promote healthcare in
communities among the less fortunate communities. I found it easy when dealing with the
community of the Aboriginal people when I helped them develop self-awareness and come up
with sustainable actions that are helpful in the long-run (Donkin et al., 2018). Besides, cultural
competence eliminates any doubts in nurses pertaining to their patients. They can offer quality
care regardless of the patient's background. Further, it helps nurses to determine the social

HEALTHCARE 9
determinants of health from where the patient comes from. Thus, it is easier to determine the
cause of illness in patents and the best possible prescription.
Conclusion
From the outgoing discussion, it is clear that health inequalities and disparities among the
Canadian citizens are intense. The social determinants of health include education, job security
and unemployment, stress and body illness, income and income distribution. The social
determinants of health address the current inequalities and disparities in health among Canadian
citizens. Through social justice, health disparities can be addressed adequately through
collaboration with the community and other professionals. Also, using relevant practical
research, knowledge and skills can help nurses play an essential role in addressing these
inequalities.

HEALTHCARE 10
References
Adler, N. E., Cutler, D. M., Jonathan, J. E., Galea, S., Glymour, M., Koh, H. K., & Satcher, D.
(2016). Addressing social determinants of health and health disparities. Discussion Paper,
Vital Directions for Health and Health Care Series. National Academy of Medicine,
Washington, DC. https://nam. edu/wp-content/uploads/2016/09/addressing-social-
determinantsof-health-and-health-disparities. pdf.
Andermann, A. (2016). Taking action on the social determinants of health in clinical practice: a
framework for health professionals. Cmaj, 188(17-18), E474-E483.
Batterham, R. W., Hawkins, M., Collins, P. A., Buchbinder, R., & Osborne, R. H. (2016). Health
literacy: applying current concepts to improve health services and reduce health
inequalities. Public health, 132, 3-12.
Blair, A., Siddiqi, A., & Frank, J. (2018). Canadian report card on health equity across the life-
course: Analysis of time trends and cross-national comparisons with the United
Kingdom. SSM-population health, 6, 158-168.
Daniel, H., Bornstein, S. S., & Kane, G. C. (2018). Addressing social determinants to improve
patient care and promote health equity: an American College of Physicians position
paper. Annals of internal medicine, 168(8), 577-578.
Donkin, A., Goldblatt, P., Allen, J., Nathanson, V., & Marmot, M. (2018). Global action on the
social determinants of health. BMJ global health, 3(Suppl 1), e000603.
Greenwood, M., De Leeuw, S., Lindsay, N. M., & Reading, C. (Eds.). (2015). Determinants of
Indigenous Peoples' Health. Canadian Scholars’ Press.

HEALTHCARE 11
Iwelunmor, J., & Airhihenbuwa, C. (2017). Culture, a Social Determinant of Health and Risk:
Considerations for Health and Risk Messaging. In Oxford research encyclopedia of
communication.
Jackson, B., & Huston, P. (2016). Advancing health equity to improve health: the time is
now. Health promotion and chronic disease prevention in Canada: research, policy and
practice, 36(2), 17.
Kansas Department of Health and Environment (DOHE). (2015). Economic instability, a social
determinant of health: 2013 Kansas behavioral risk factor surveillance system [PDF file].
Retrieved from https://bit.ly/2FVVVIm
Khoja, A. T., Aljawadi, M. H., Al-Shammari, S. A., Mohamed, A. G., Al-Manaa, H. A.,
Morlock, L., ... & Khoja, T. A. (2017). The health of Saudi older adults; results from the
Saudi National Survey for Elderly Health (SNSEH) 2006–2015. Saudi Pharmaceutical
Journal.
Marleen Thornton PhD, R. N. (2018). Preparing today's nurses: Social determinants of health
and nursing education. Online Journal of Issues in Nursing, 23(3), 1-9.
Oickle, D., & Clement, C. (2019). Glossary of health equity concepts for public health action in
the Canadian context. J Epidemiol Community Health, jech-2018.
Marmot, M. (2017). Social justice, epidemiology and health inequalities. European journal of
epidemiology, 32(7), 537-546.
Raphael, D. (2016). Social determinants of health: Key issues and themes. Social determinants of
health: Canadian perspectives, 3, 3-31.

HEALTHCARE 12
Reading, C., & Greenwood, M. (2018). Structural determinants of Aboriginal peoples’
health. Determinants of Indigenous Peoples' Health: Beyond the Social, 1.
Sharma, M., Pinto, A. D., & Kumagai, A. K. (2018). Teaching the social determinants of health:
A path to equity or a road to nowhere?. Academic medicine, 93(1), 25-30.