SOCIAL DETERMINANTS OF HEALTH

Social Determinants of Health

Abstract

Over numerous years the term “health” has been characterised in diverse ways. Nevertheless it is broadly acknowledged that wellbeing is a “multi-dimensional” concept that transcends the meagre absence of illness. Our experience of health and wellbeing is contributed to by employment/income, social status, education/literacy, housing and environment, early life experiences and genetics, access to nutritious food, individual behaviours and lifestyle factors and access to appropriate and effective “primary health care”.

Social Determinants of Health

To acknowledge and investigate the influence social and environmental factors have on the health of individuals and groups are not a recent concept. Advances in medical treatments and in the human lifespan over the last 150 years have been greatly influenced by improved living and working conditions in the Western world. It is important to note however that the gains enjoyed by many thereby have not been felt by all within society. Despite unprecedented economic gains both nationally and in South Australia, the gap between rich and poor is widening, and health care, education and other human services are struggling to cope with demand.

Governments in developed nations are increasingly embracing the concept of the communal determinants of health and wellbeing, and are cognizant of the role they play in ameliorating the social impediments contributing to social inequity. Health advancements both in Australia and overseas are progressively being aimed at at those at greatest risk. However to recognize the impacts on South Australians' health of all government policies, across all portfolios, a more holistic approach to health policy development is needed.

The health and health care of South Australians continues to be a growing and increasingly complex set of competing priorities from various perspectives: from the individual, across local, State and Federal governments, to health care professionals and the health care system. This complexity and competing interest is to be expected in a sector that costs Australia over 9% of its gross domestic product, or over $3,500 per person per year (Bond, 1994).

Health is a multi-dimensional notion that transcends the meagre absence of illness. Much of primary health care's focus stems from the Declaration of Alma-Ata, released following the International Conference on Primary Health Care in Alma-Ata USSR, September 1978. The Declaration set out a focus that is still embraced in varying forms today, and underpins the social determinants of health. The principles contained within the Declaration encompass notions such as:

Health inequity within a country is socially, politically and economically unacceptable and is therefore a concern both for government and wider society.

Individual and community participation in the planning and implementation of their health care.

Governments should adopt cross sectoral strategies as part of national primary health care plans to address the health of all citizens.

Governments have a responsibility for the health of its citizens and this can only be achieved by the provision of adequate health and social measures.

Primary health care systems should be developed that are based upon sound scientific and socially acceptable methods and ...