Reflective essay

Discussion:

Determinants of health are the factors that contribute to a person’s health status. The factors include socioeconomic, physiological, behavioral, psychological and social. My journal focuses on three topics namely: Gender, Ethnicity and social determinants as social and behavioral determinants of health. Gender is the socially defined roles, behaviors, attributes and activities that are considered appropriate for women and men in different societies (WHO, nd). Ethnicity is where a group of people are characterized by the social and cultural traditions they maintain. Social determinants are complex and overlapping structures that contribute to health inequities and they include: the social environment, health services, physical environment, and structural and societal factors (CDC, nd).  All these factors play an important role in determining health and attention should be given to each one of them. Clear policies should be developed to promote health through these determinants.

The topic on gender was very informative and I got a new perspective on some of the issues. Men and women suffer from different diseases at different ages (WHO) and they also experience and respond to health programs and their outcomes differently. As a health determinant, gender refers to the interrelated dimensions between psychological and biological differences and social experience.  The focus on gendered programs is important because women suffer more from inequalities. Even though women have biological advantages over men, they have greater social disadvantages. This means that while women have better health practices, coping skills and self concept that increases their life expectancy, men have better social, economic, political and cultural advantages which also cancel out the biological advantage of women. Past experience has shown that women have a longer life expectancy than men. What I found interesting about this topic was the role of socioeconomic factors in determining women’s health. Employment is crucial in determining the health status of women, but so many factors influence women employment such as age at what women can be employed, family responsibilities, and their social class, what work they can undertake and under what conditions. Most women are not employed or work part time and do not earn as much as their male counterparts in many societies. Fewer women are also found in managerial positions compared to men. This therefore means that they have less money to cater for their health needs such as medical care and insurance and may be more prone to illnesses such as stress. This means that as a health professional, I should be involved in developing policies that work at improving women’s health through health promotion programs. Areas of interest include reproductive and sexual health, mental and emotional health, violence and caring (Kehler, 2004). Women are prone to mental breakdowns due to stress and depression associated with family roles and employment. Violence against women is also high in many societies, making the woman vulnerable. Focus should be on investment in health care systems that cater for women and especially the most vulnerable women in society. Besides genetic disparities sexual orientation functionalities, ethos and individual trait controls how men and women; boys and girls have access to health services. According to the world health organization (WHO) this equally determines how the healthcare systems react to their demands. My new perspective is that upstream strategies should be employed in research, policy and practice to address the economic, cultural and social obstacles that prevent women from achieving their potential. Health promotion should be taken seriously to reduce health inequalities. I would like to know what more I can do as a health professional to promote women’s health (Egede, 2006).

Ethnicity

Ethnicity was an interesting topic because of the many different ethnic groups in our societies and the effects on health is a significant problem. Evidence shows that ethnic and racial minorities tend to receive lower quality care than non minorities (Egede, 2006). Ethnicity has an influence on health status of a person, with most ethnic minorities being at higher risk of disease prevalence and mortality rates. Different ethnic groups have different health needs as some are more predisposed to certain illnesses than others e.g. Afro-Caribbean’s have higher risk of developing sickle-cell anemia than white Europeans while Europeans have higher risk of hemophilia. Most ethnic minorities usually settle in areas where there is poverty, deprivation, and health and social risks. This means that they have low access to health care, insurance, and other factors that influence health such education, employment, and social class. They also tend to get risky jobs where chances of getting injury or falling sick are high.

Culture of an ethnic group plays a role in determining their health status e.g. there is high prevalence of heart diseases among Indians associated with their use of high amounts of ghee and fats. An interesting aspect is that Indian women and men chew tobacco and consume beetle nuts which increase their risk of throat and mouth cancer.  Culture can have both negative and positive influence on health. Discrimination has also been linked to factors contributing to ethnic disparities in healthcare. This results in minorities not receiving preventative services.

By and large, ethnicity is associated with low socioeconomic status. Socioeconomic factors influence the rates of morbidity and mortality and are considered hand in hand with ethnicity. In America, black Americans are more likely to suffer from ill health than whites as their socio economic class is far apart. Whites have better access to good education, resulting in good and better paying jobs and better access to health services compared to black Americans.

Influence of ethnicity on health is so great that researches have pointed out that in the United States, some people live 20 more years than others depending on their ethnicity, socioeconomic status or where they live. Black Americans are noted to have worse health than Whites. It is even suggested in some studies that for every life saved through medical intervention, five lives could be saved if African Americans had the same mortality rates as whites (North Carolina Institute of Medicine, n.d).

The information gained from this topic will help me deal better with ethnic minorities as I have understood their problems better. As a health profession, I will be involved in developing policies that address ethnicity and how we can bridge the gap in health care between minorities and non minorities. Questions that arise from this topic include: how health systems should be improved to cater for minorities and how we can reduce the effects of factors influencing ethnicity and health. I would be interested in learning more about how ethnicity in risk prevention and patient preferences influence medical decisions and outcomes (Wilkinson & Marmot, 2003).

The study of Social determinants of health is complex and is concerned with people’s working conditions, living conditions and lifestyles. It is also concerned with the economic and social policies and their implications on health and how the policies can bring about health benefits. Social determinants of health are usually shaped by distribution of money, power and resources. They include: social gradient, work, unemployment, stress, food, transport, social exclusion, and social support. In social gradient, it is the poor who are at the bottom of the ladder who suffer more from health issues. Poor social economic status usually affects health throughout life. It is interesting to learn that the effects of the social gradient do not only apply to the poor but even in employment where low ranking officers will suffer more health risks than higher ranking officers. Social disadvantages are also more common among the poor, creating a chain of misery and ill health. Stress is a condition that can be detrimental to health and can even lead to death if not checked. It is usually caused by social and psychological factors and is more common in people of low socioeconomic status. Early life influences adulthood and as such, mothers and young children should be supported (Keleher, 2004). Evidence shows that slow growth and poor emotional support contribute to increased risk of poor health and decreased physical and cognitive and emotional functioning in adulthood. It is therefore important to improve access to health services and education to better the life of mothers and children and create better adults. Poverty, social exclusion and deprivation affect health and even lead to premature death in some social groups. Exclusion could result from hostility, discrimination, unemployment and stigmatization. Poverty leads individuals to engage in risky behaviors, which contribute to death or disability, low income earners also experience barriers to health services or delayed services. Wealth is what contributes to better health since individuals have assets, can afford a good life with basic needs and luxury.

Unemployment results meager earnings, scarcity of healthcare facilities and misery and in turn poor health. People in unemployment may develop low self-esteem and seclude themselves increasing their risk of stress and ulcers. In worse cases, they could develop depression and get suicidal. Job security on the other hand creates good health. Good working environments should also be created to reduce stress developed from at the workplace. Good nutrition is important for god health. Individuals with high socioeconomic status have better access to nutritious and fresh foods than poor individuals.

Policies should be developed to reduce unemployment, create job security, reduce stress and create wealth for individuals across all social economic levels. Good health will only result if inequalities are reduced and eliminated, education and access to education is improved, improving housing, reducing unemployment and involving the society in the social, economic and cultural life of their societies (Kaufer, nd)

From this topic I have developed a new perspective on the social determinants of health and how we should handle individuals from all socioeconomic status. My role will be to be involved in policy development to address these issues.

Conclusion

Health is influenced by gender, ethnicity and social determinants. They all have their roles and policies should be developed to enhance this role while eliminating the negative aspects in each. As a health professional, I will be involved in developing and implementation of these policies to ensure a healthy society.

References

Egede, E. L. 2006. Race, Ethnicity, Culture and Disparities in Health care. J Gen Intern Med

Vol. 21. No 6: 667-669. Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC1924616/

Kaufer, A. P. (nd). Gender as a Determinant of Health.pdf Retrieved from

www.people.stfx.ca/accamero/Gender and Health/ gender as a determinant

Keleher, H. 2004. Why build a health promotion evidence base about gender?

International Oxford Journals Vol. 19, No. 3: 277-279. Retrieved from

www.heapro.oxfordjournals.org/content/19/3/277.full

Social Determinants of Health. Retrieved from

www.cdc.gov/socialdeterminants/Definitions.html

Social Determinants of Health: Ethnicity Fact Sheet-Minority Health and Health Equity Archive.

Retrieved from www.health.qld.gov.au/ph/Documents/sphs/20397.pdf

Wilkinson,R.G & Marmot,M.G. 2003. Social determinants of health: the solid facts. World

Health Organization Retrieved from http://books.google.com/books?hl=en&lr=&id=QDFzqNZ…

North Carolina Institute of Medicine (nd). Socioeconomic Determinants of Health: Chapter 11

Retrieved from www.nciom.org/

World Health Organization, (nd). Gender Retrieved from www.who.int/topics/gender/en

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