In the United States there is an increase in awareness that medical care alone cannot improve health outcomes. The measurement of social factors has a direct impact on one’s health such as their geographical location and the life expectancy. While the social determinants of health (sdoh) are a hot topic amongst researchers, it is noted that more research still is needed over long periods of time to learn about the affects on the population’s health. Braveman et al. (2011), state that the expectation of one a single research study cannot adequately cover all the factors that affect our health. The complexity of this subject needs to be studied over time and over many geographical areas to capture the real essence of all inhabitants of the world. We need to learn more about how the medical system can effectively intervene to promote good health habits and interrupt the habits with negative health habits.
Braveman et al (2011) article stipulates the direct correlation between poverty and health. Social gradients in health can provide us with some insight and understanding the pathways for social factors. A neighborhood alone where a family lives can have a great impact on their health. The air and water they consume can be healthy or can be toxic if they live near hazardous facilities that produce waste. The house itself can have mold or dusts or other toxic material. The access to nutritious food, services, parks, gymnasiums in your neighbourhood all have a direct impact on your health status. Working conditions such as repetitive work and working overtime are some psychosocial aspects that affect your health. There are other sdoh that the article explores such as education and health, income wealth and health, race and health, and other social factors that I will not elaborate on in this summary, but are discussed in the article.
Downstream and upstream social determinants are at the forefront of the article in terms of explaining how it affects a population. Downstream factors are temporally and spatially close to health effects but are influenced by upstream factors which are fundamentals causes that lead to the downstream factors (Braveman et al (2011). This is all a complicated way of saying the two are inter-related. An example of such a concept is explained as a family that lives near a river that drinks the water from this river, but the water is contaminated. The drinking of the toxic water is a downstream affect, but those contaminating the water are of the upstream determinants (Braveman et al,2011).
The article concludes with stating that we need to address the current gaps in the knowledge about the social determinants of health. While we are aware they exist, more extensive research needs to be done to better understand what can be done about the disparities and how we can act on them to create a better, healthier population. With so many factors influencing health, this will not be an easy task to undertake, and it is suggested that longitudinal research needs to be conducted.
Reference
Braveman P, Egerter S, Williams DR. The social determinants of health: coming of age. Annu Rev Public Health. 2011; 32:381-98. doi: 10.1146/annurev-publhealth-031210-101218. PMID: 21091195.
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