Question

Discuss the relationship between social determinants of health, health promotion, and prevention. How do these factors impact health status and outcomes?

Answer 1

Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Conditions in these various environments and settings.have been referred to as place. In addition to the more material attributes of place the patterns of social engagement and sense of security and well-being are also affected by where people live. Resources that enhance quality of life can have a significant influence on population health outcomes. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency or health services, and environments free of life-threatening toxins.

Understanding the relationship between how population groups experience place, and the impact of place, on health is fundamental to the social determinants of health including both social and physical determinants.

Examples of social determinants are

a) Availability of resources to meet daily needs

b) Access to educational, economic, and job opportunities

c) Access to health care services

d) Quality of education and job training

e) Availability of community-based resources in support of community living and opportunities for recreational and leisure-time activities

f) Transportation options

g) Public safety

h) Social support

i) Social norms and attitudes (e.g., discrimination, racism, and distrust of government)

j) Exposure to crime, violence, and social disorder.

Health promotion is the process of empowering people to increase control over their health and its determinants through health literacy efforts and multisectoral action to increase healthy behaviors. This process includes activities for the community-at-large or for populations at increased risk of negative health outcomes. Health promotion usually addresses behavioral risk factors such as tobacco use, obesity, diet and physical inactivity, as well as the areas of mental health, injury prevention, drug abuse control, alcohol control, health behavior related to HIV, and sexual health.

Disease prevention and health promotion share many goals, and there is considerable overlap between functions. On a conceptual level, it is useful to characterize disease prevention services as those primarily concentrated within the health care sector, and health promotion services as those that depend on intersectoral actions and or are concerned with the social determinants of health.

Disease prevention, understood as specific, population-based and individual-based interventions for primary and secondary prevention, aiming to minimize the burden of diseases and associated risk factors.

Primary prevention refers to actions aimed at avoiding the manifestation of a disease ,this may include actions to improve health through changing the impact of social and economic determinants on health; the provision of information on behavioral and medical health risks, alongside consultation and measures to decrease them at the personal and community level; nutritional and food supplementation; oral and dental hygiene education; and clinical preventive services such as immunization and vaccination of children, adults and the elderly, as well as vaccination or post-exposure prophylaxis for people exposed to a communicable disease.

Secondary prevention deals with early detection when this improves the chances for positive health outcomes ,this comprises activities such as evidence-based screening programs for early detection of diseases or for prevention of congenital malformations; and preventive drug therapies of proven effectiveness when administered at an early stage of the disease.

It should be noted that while primary prevention activities may be implemented independently of capacity-building in other health care services, this is not the case for secondary prevention. Screening and early detection is of limited value and may even be detrimental to the patient. if abnormalities cannot be promptly corrected or treated through services from other parts of the health care system. Moreover, a good system of primary health care with a registered population facilitates the optimal organization and delivery of accessible population based screening programs and should be vigorously promoted.

Impacts.

Disease prevention

Primary prevention services and activities include:

1) Vaccination and post-exposure prophylaxis of children, adults and the elderly;

2) Provision of information on behavioural and medical health risks, and measures to reduce risks at the individual and population levels.

3) Inclusion of disease prevention programmes at primary and specialized health care levels, such as access to preventive services.

4) Nutritional and food supplementation; and

5) Dental hygiene education and oral health services.

6) Secondary prevention includes activities such as:

7) Population-based screening programmes for early detection of diseases;

8) Provision of maternal and child health programmes, including screening and prevention of congenital malformations.

9) Provision of chemo-prophylactic agents to control risk factors.

Health promotion

1) Policies and interventions to address tobacco, alcohol, physical activity and diet.

2) Dietary and nutritional intervention should also appropriately tackle malnutrition, defined as a condition that arises from eating a diet in which certain nutrients are lacking, in excess , or in the wrong proportions.

3) Intersectoral policies and health services interventions to address mental health and substance abuse.

4) Strategies to promote sexual and reproductive health, including through health education and increased access to sexual and reproductive health, and family planning services.

5) Strategies to tackle domestic violence, including public awareness campaigns; treatment and protection of victims; and linkage with law enforcement and social services.

Health promotion and disease prevention programs focus on keeping people healthy. Health promotion programs aim to engage and empower individuals and communities to choose healthy behaviors, and make changes that reduce the risk of developing chronic diseases and other morbidities.