Social Determinants of Health

Social Determinants of Health - Beyond The Clinic

• SDH: Non-medical factors influencing health outcomes. Conditions where people are born, grow, live, work, age.
• WHO Definition: "The conditions in which people are born, grow, live, work and age."
• Importance: Majorly impact health status; addressing them is key to health equity (fair health opportunities for all).
• Framework: WHO's CSDH (Commission on Social Determinants of Health) framework provides a conceptual model.

⭐ According to WHO, SDH are responsible for the bulk of health inequities, the unfair and avoidable differences in health status seen within and between countries.

Social Determinants of Health - Life's Core Conditions

SDH are non-medical factors-conditions where people are born, grow, live, work, and age-shaping health. 📌 Mnemonic for domains: Eat Every Healthy Nutritious Snack (Economic, Education, Healthcare, Neighborhood, Social & Community).

Social Determinants of Health - India's Health Canvas

• Key factors shaping health beyond healthcare access.

• India-specific SDH:

  • Poverty: Affects nutrition, housing, education.
  • Caste & Gender: Discrimination impacts access & outcomes.
  • Urbanization: Overcrowding, sanitation challenges.
  • Sanitation & Hygiene: Open defecation, waterborne diseases.
  • Nutrition: Malnutrition (under & over), micronutrient deficiencies.
  • Regional Disparities: Significant variations in health indicators (e.g., IMR, MMR) across states.

• Key Government Interventions:

  • Ayushman Bharat (PMJAY): ↑ Healthcare access, financial protection.
  • Swachh Bharat Mission: ↑ Sanitation coverage.
  • PDS (Public Distribution System): Food security.

⭐ NFHS data consistently shows significant rural-urban and interstate variations in health outcomes linked to SDH, such as IMR <30 in Kerala vs >40 in some northern states (illustrative, check latest NFHS).

Social Determinants of Health - Action For Equity

• Key Actions for Health Equity:
  • Intersectoral Coordination: Health sector collaborates with education, housing, employment for synergistic health improvements.
  • Policy & System Changes: Implement policies and structural reforms reducing health disparities and promoting fairness.
  • Community Empowerment: Involve communities, especially marginalized groups, in planning, implementing, and evaluating initiatives.
  • Role of Health Professionals: Advocate for equity, address SDH in practice, contribute to research.
• Health in All Policies (HiAP): Collaborative approach integrating health considerations into policymaking across sectors to improve population health and advance equity.

⭐ Intersectoral collaboration is key to effectively addressing the complex nature of SDH, fostering comprehensive solutions.

High-Yield Points - ⚡ Biggest Takeaways

• SDH: Non-medical factors (e.g., socio-economic status, education, housing) shaping health outcomes.
• They are the primary drivers of health inequities and disparities.
• Key Indian SDH include poverty, caste, gender discrimination, and literacy levels.
• The Dahlgren & Whitehead "Rainbow Model" is a widely recognized framework.
• Addressing SDH requires intersectoral coordination and upstream interventions.
• Examples of Indian programs addressing SDH include ICDS and MGNREGA.