Ch 7: Social Determinants of Health and the Role of Law in Optimizing Health
determinants of health (4)
>biological factors >psycho-social factors >behavioral factors >social factors
Examples of Social determinants of health
Access to high quality educational opportunities (likelier to get higher income jobs with insurance) Access to medical care services (afford/live close to medical providers) Access to social media and other technologies (health related resources) Availability of community-based resources an opportunities for recreational activities (living healthier lives) Availability of resources to meet daily needs (local food markets) Culture (synergistic effects) Language/literacy (translations barrier) Public safety (dangerous neighborhoods remain indoors) Residential segregation (lack of health care facilities nearby) Social norms and attitudes (discrimination and racism) Socioeconomic conditions (greater wealth=lower rates of morbidity and longer life spans) Transportation options (missing appointments because they cannot afford private transportation)
Health in All Policy (HIAP) strategy
Collaborative governmental approach to health improvement by incorporate health consideration into an array of policy decisions, and by engaging governments and other stakeholders in a multi-sector approach to shaping the economic, physical, and social environments in which people live, work, and play Ex: Dept of Ag-protects food
Upstream innovation
First MLP:1990s by a boston hospital to invervene on behalf of pediatric patients with chronic conditions suffering because of inadequate housing
Right to Criminal Legal Representation
Government required to provide legal counsel to all federal defendants who are unable to afford their own attorneys (Sixth Amendment to the U.S. Constitution) Ex: Gideon vs Wainwright
I-HELP
Income-resources to meet basic needs Housing-healthy physical environments Education-opportunity to work and learn Legal status-ability to work Personal & family stability-exposed to violence
Combating Health-Harming Social Conditions Through Medical-Legal Partnership
Medical-legal partnerships function as a patient care team that includes both medical and legal professionals Goal is to help crate an interconnected care system that focuses on the whole patient, including the ways in which myriad social conditions factor into individual and population health how doctors can remedy the poor life circumstances of their patients
Civil Legal Assistance
No right to the assistance of a lawyer in civilmatters, even when the most basic human needs are at stake ex: immigration status, domestic violence, housing needs-can have life altering consequences
social determinants of health
The conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels
4 ways laws can be a social determinant of health
The law can be used to design and perpetuate social conditions that can have terrible physical, mental, and emotional effects on individuals and populations ex: jim crow laws The law can be utilized as a mechanism through which behaviors and prejudices are transformed into distributions of well-being among populations. ex:black &white drug use and incarceration rate Law can be determinant of health through their under-enforcement ex:enforcing Residential Lead-Based Paint Hazard Reduction Act of 1992 The law can be used to structure direct responses to health-harming social needs that result from things like impoverishment, illness, market failure, and individual behavior that harms others ex:EMTALA in medicare requiring hospitals, Texting and Driving
health disparity
a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage
health care disparities
differences among populations in the availability, accessibility, and quality of health care services
US spends _______ on social services
less than other 1st world countries 1:0.9 vs 1:2
MLP Approach
train and identify--> treat patients --> transform clinic practice-->improve population health
health equity
when all people have the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of their social position or other socially determined circumstance
Medical Legal partnerships lawyer
works to create interconnected care
