Social Determinants of Health Essay Example

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7Social Determinants of Health

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This essay will look into social determinants of health and how they predispose a person to diabetes. Diabetes is condition where the blood sugar of an individual remains high above normal. There are two types of diabetes type 1 and type 2. Diabetes is correlated to social determinants of health (NIH, 2015). Generally Raphael (2009 Ch 1), the health of an individual, the jurisdictions and communities is shaped by social and economic conditions termed as social health determinants. It is those determinants that are fundamental in determining the health status of an individual (healthy or ill). In reference to social determinants of health it refers to the amount of resource availed to citizens and the quality inherent in them that may deter or predispose a person to diseases. Some of these resources include social services, health, working conditions, employment, housing, food, education availability and quality, income, and childhood conditions. Various policies can help in promoting good health or ill health as well. Global Health Watch (2014, E1) an example is the Bolivian Family, Community and Intercultural Health Policy (FCIH) that promoted “the living well” principle. Living well refers to abundant life, full of harmony with oneself, the community and government at large. The policy seek to ensure improved health services, ensure friendly, good-quality, supportive, equitable and inclusive system that allows the doctors in the first generation be trained in intercultural, community and family healthcare. The interaction of these social determinants can either promote disease prevention or development outcome as in figure 1. This essay, however, will look into socio-economic conditions, psychological stress and social exclusion as fundamental elements that deter or promote diabetes.


Figure 1: social determinants of health and the pathways to health and illness

Raphael (2009 Ch 2) socio-economic conditions in any given society is fundamental indicator of the availability or unavailability of materils across the lifespan. Such material refers to access to social service, and health, occupation quality and hazards, unemployment and employment among the adults, housing and quality nourishment or deprivation during childhood. Whether quality material is available and accessible can be used to explain the variation in disease development through the poor to the wealthy continuum. Mikkonen & Raphael (2009) this variation is lined with developemnt of diabetes as poverty is associated with poor food intake with high cabohydrate diet and little access to recreational services to necessitate physical exercises. Also, diabetes is prevalent among the wealth who are not informed on good diet, physicalexercise and lead sedentary life, leading to overweight and obesity conditions that predispose the individual to the disease.

Raphael (2009 ch2) presence or absence of psychological stress that threatens health emanates from the living conditions that a person lives in. As a person handles dangerous and sudden environmental threat evolves a reaction refered to as the fight-or-flight. The body reponds to such reaction as either fleeing or fighting, of which such activation involves interplay of various bodily systems. A chronic reaction to response to a prolonged existing threat that come as a result of social determinants of health being of poor quality, like in cases of food insecurity, poor housing, insecure employment and low income the response impacts negatively on health. The fight-or-flight reaction of chronic elicitation dirupts the metabolic sytems, neuroendocrine and weaknes the system of immunity predisposing the body to chronic ty 2 insulin-resitand diabetes and cardiovascular diseases. Psychological stress predisposes a person to bad behavior such excesive smoking, alcohol intake, reduced or lack of physical exercise, suagr and fat intake in high amount. Such behavior aggrevate the chances of developing adult-onset diabetes.

Mikkonen & Raphael (2010) social exclusion is used in Canada to refer to segregated groups of certain groups not to participate in some aspects of Canadian life. Such include the people with disabilities, women, recent immigrants, Canadians of color and aboriginal Canadians. Social exclusion in Canada leads to marginalization of certain groups of people as well as hindering their access to economic, cultural and social resources. Allan & Smyle (2015) these groups face uneven access to health care services. As a fact that they belong to the socially excluded groups for example race can deter an individual from getting treatment or get poor health services aggravating the body system to develop diabetes. Socially excluded groups they lack an opportunity to participate in civil affairs to get their legal rights and they are also pressed by law. Mikkonen & Raphael (2010) social exclusion forces an individual to live in conditions and environment and personal experiences that puts the person’s health in danger. In addition, the minorities face problems in education. Social exclusion makes a person feel depressed, hopelessness, powerlessness and reduce the chances of being included in society. In Toronto City, the neighborhood is highly concentrated with visible minorities and report increasing rates of diabetes and poverty. Global heath Watch (2014 E3) in Venezuela however, social inclusion model did impact the health sector greatly. Health is both a human right and a social right that should be accessed by all. Heath systems and infrastructures that deters citizens from accessing quality health care predisposes them to poor living healthy status and conditions and they are likely to develop chronic and cardiovascular disease including type-2-diabetes.

In conclusion, to address inequality and health issues established in this essay, the following policy agenda ought to be put into consideration. First, the Canadian government at all levels should review regulations and laws and enforcement them to protect the minority groups rights pertaining anti-discrimination in health care and general living conditions aspects and employment rights. Policies should address the health needs of the minority groups to ensure quality health care accessibility and affordable is attainable for universal, quality and accessible health provision hence fight diabetes occurrence (Mikkonen & Raphael, 2010). Secondly, following the unequal Medicare consideration that fails to favor the low income earners and the poor the government should come up with a reliable program of pharmacare. It should also increase nursing home and home care costs coverage to ensure quality universal health care services to all. In addition, the health policy makers and health authorities in the country should focus on the inequities currently in the health care sector in reference to identity and health care access and remove all health care barriers (Mikkonen & Raphael, 2010). Thirdly, countries should develop single health system that is free and public. Such health system policies should put efforts to ensure the poorest in the nation access quality health care services and reduce the existing inequalities in healthcare to promote a free diabetes population(Global Health Watch, 2014 A3).


Allan B. & Smylie J. (2015).First Peoples, Second Class Treatment: The Role of Racism in the Health and the well being of Indigenous Peoples in Canada. Toronto, ON: the Wesselley Institute

Global Health Watch, (2014). Chapter A3-Social Struggle, Progressive Governments and Latin America, In Global Health Watch 4: An Alternative Health Report. London: Zed Books.

Global Health Watch (2014). Chapter E1-Reframing Health in Bolivia around the Concept of “Living Well”, In Global Health Watch 4: An Alternative Health Report. London: Zed books

Global heath Watch (2014). Chapter E3-Venezuela: The Impact on Health of Social Change, In Global Health Watch 4: An Alternative Health Report. London: Zed Books

Mikkonen, J. & Raphael, D. (2010).Social Determinates of Health: The Canadian Facts. Toronto: York University School of Health Policy Management.

NIH (2015) National Institute of Diabetes and Digestive and Kidney Diseases . Retrieved 10/7/2015, from

Raphael D. (2009). Chapter one-social determinats of health: an overview of key issues and themes, in Dennis raphael (ed) Socialdeterminants of Health-2nd edition. Toronto: Canadian Scholars Press.

Raphael D.(2009). Chapter two-social structure, living conditions and health, in Dennis Raphael (ed). Social Determinats Of Health 2nd edition. Toronto: Canadian Scholars Press.