Introduction
One of the key research directions devoted to studying the state of health in the contemporary world could be considered the analysis of the formation mechanisms of social-based inequities in health. Reducing these inequities in health could be regarded as an inseparable composite part of state policies, directed toward supporting and developing health in the society. It is important to understand that although medical care can improve health and prolong life, in general, socio-economic conditions, under the influence of which people become ill, need medical assistance and die, are more important for the population’s health. For example, taking income as one factor, “[E]ven in the most affluent countries, people who are less well off have substantially shorter life expectancies and more illnesses than the rich.” (Wilkinson and Marmot) In that regard, this paper analyzes these factors as social and societal determinants of health that shape the health disparities in the world.
Analysis
Analyzing the health determinants, a distinction should be established between the terms social and societal. Social determinants can be considered the factors depending “primarily on interrelations among individuals, while societal determinants are concerned with health inequities which “involve systematic differences in health across population subgroups” (Starfield, 2006). In other words, societal determinants are embedded in social structures (Graham, 2004a).
The social factors defining the state of health as to the certain degree the inhabitancy factors, are transformed through the outlook of the person, through the mentality and are shown in the form of corresponding mental phenomena (mental processes and conditions), therefore the psycho-physiological approach to health includes also its social determinants. Such factors can include social status, material resources, behaviors, and chronic stress. The latter can be explained in the context of social interaction, where good relations, social support, and trust promote preserving the state of health. The lack of social connections and trust in society can lead to people feeling isolated and vulnerable, which in turn leads to an increase in stressful situations, and depressions. Societal factors, on the other hand, comprise such resources as education, employment opportunities, political influences, financial stability, and might include individual elements as cultural perception and traditions.
Inequalities in health refer mostly to the unequal distribution of the aforementioned factors among the population, leading to “differences in health which … are considered unfair and unjust.” (Graham, 2004b). In that sense, it should be noted that there are distinctions in assessing health inequality where there is an impact on the distribution of health as well as the average health.
In a way of remedying such gaps in health, the main aspect could be considered in taking improving the health conditions of the groups that are the most affected by the social and societal determinant, as “the lowest socioeconomic groups and the poorest communities who are ‘suffering inequality’.” (Graham, 2004b). Implementing such remedies implies the approach that considers not only bringing the health level of the poorest communities to the average level but rather bringing all the population to the highest standards of health as a main human right.
Conclusion
It can be seen that the interest in health’s social and societal determinants cannot be overestimated as it takes the health problem to its roots. Limiting health to medical assistance is ignoring the cause and concentrating merely on the visible effects.
References
GRAHAM, H. (2004a) Social Determinants and Their Unequal Distribution: Clarifying Policy Understandings. The Milbank Quarterly, 82, 101-124.
GRAHAM, H. (2004b) Tackling Inequalities in Health in England: Remedying Health Disadvantages, Narrowing Health Gaps or Reducing Health Gradients? Journal of Social Policy, 33, 115-131.
STARFIELD, B. (2006) Are social determinants of health the same as societal determinants of health? Health Promotion Journal of Australia, 17, 170-173.
WILKINSON, R. & MARMOT, M. (Eds.) (2003) Social determinants of health: the solid facts, Copenhagen, WHO Regional Office for Europe.