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Unlocking the Social Determinants of Health
Uncovering the forces outside our individual control that determine how healthy we are
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Maryland's Health Enterprise Zones: A Policy Model?

Maryland's Health Enterprise Zones: A Policy Model? | Unlocking the Social Determinants of Health | Scoop.it

The California Endowment notes on their website that a person’s zip code determines their life expectancy. In Baltimore, studies show a 20-year gap in life expectancy between upper-income, predominantly white neighborhoods and poorer, predominantly minority neighborhoods. In thinking about ways in which to confront these pernicious facts, the General Assembly of Maryland in April of this year, passed a piece of legislation that flew under the radar next to Doomsday budgets, tax increases, marriage equality and casinos. This piece of legislation, known as Health Enterprise Zones (HEZ), aim to improve healthcare in minority communities and reduce health disparities in the state of Maryland. Essentially, the pilot program would offer tax breaks and other incentives to local health departments in the state, as well as, to community groups for their program operation in underserved and neglected areas labeled as HEZs. The General Assembly has set aside $4 million for physicians and community health providers dedicated to improving access and affordability to health services in these HEZs.

 

The genesis of these zones is the result of a work group chaired by University of Maryland School of Medicine Dean Dr. E. Albert Reece. Lt. Governor Anthony Brown and other state officials were looking for ways to address the disparities in the state that cost Medicare an extra $26 million annually, according to a 2006 report. This report notes that black residents in Maryland are nearly twice as likely to be hospitalized for asthma, hypertension, and heart failure. The infant mortality rate amongst African American babies is practically three times more than for white babies in Maryland.

 

While Maryland boasts some of the best teaching hospitals and the nation’s highest median household income, it ranks 33rd in geographic health disparities and receives equally poor marks for infant mortality, infectious diseases and health outcomes, according to data from the Maryland Health Quality and Cost Council.

 

A long-lasting solution to those problems will have to not only bring more health services to the under-served communities, but set up a framework to entice the providers of those services to stick around. HEZs are designed for just this purpose in that the Department of Health and Mental Hygiene in Maryland will set the boundaries of enterprise zones — areas where residents lack access to health care either because of proximity, cost or both — and accept applications from private physicians, community health organizations and local health departments that promise to dedicate their resources to serving the area.

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Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities

Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities | Unlocking the Social Determinants of Health | Scoop.it

In May, 2012, the President's Task Force on Environmental Health Risks and Safety Risks to Children released the Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities, which is an outcome of the collaborative interagency Asthma Disparities Working Group, co-chaired by HHS, EPA and HUD.

 

Did You Know?

 

Poor and minority children are more likely to have asthma and their health outcomes are worse. Black children are twice as likely to be hospitalized and four times as likely to die from asthma as white children. In addition, asthma is linked to school performance. Annually, 10.5 million school days are missed due to asthma.

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College Students Bridge Chasm Between Medical Care And Poverty

College Students Bridge Chasm Between Medical Care And Poverty | Unlocking the Social Determinants of Health | Scoop.it

Although study after study has linked poverty to poor health -- a 2006 report in the journal Pediatrics found that children whose families cannot pay their utility bills are 30 percent more likely to be hospitalized -- the medical and social service systems have long operated in largely separate and disconnected spheres. Too often, that results in a medical revolving door, as when doctors prescribe asthma medicines for children living in mold-infested apartments, only to have them wind up in the emergency room because their housing conditions were never addressed.

 

"Physicians don't ask these questions because they don't know what to do with the answers," said Children's social worker Alison Page. Most doctors, she added, have neither the time nor the expertise to deal with what health researchers call "the social determinants" of health.

 

Rx: Food

 

Health Leads attempts to bridge that chasm. Patients fill out a questionnaire that prompts doctors to ask about their unmet needs; using that information, physicians and other staff members can "prescribe" food, housing assistance or child care, among other things. Patients then take their prescriptions to Health Leads, where student volunteers attempt to fill them, helping tap local resources many clients don't know exist or have been unable to access.

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Accord refugees right to work - The Sun Daily

Accord refugees right to work - The Sun Daily | Unlocking the Social Determinants of Health | Scoop.it

Accord refugees right to workThe Sun DailyThis is evidenced in Health Equity Initiative's research report "Forced Labour, Human Trafficking and Forced Labour: The Experiences of Refugees and Asylum...

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Health Care Disparities Exist for Children with Autism Spectrum Disorders - Kansas City infoZine

U.S. News University Health Care Disparities Exist for Children with Autism Spectrum DisordersKansas City infoZineThe researchers found children with ASD paid more for health care than children with other conditions.
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MN Dept of Health Grant Programs Deadlines: June 8th

MN Dept of Health Grant Programs Deadlines: June 8th | Unlocking the Social Determinants of Health | Scoop.it

The purpose of the ELHDI is to eliminate lupus related health disparities among racial and ethnic populations through the dissemination of a national lupus education program to health professionals and student trainees 

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Fulton County opens new health center to address disparities

Fulton County opens new health center to address disparities | Unlocking the Social Determinants of Health | Scoop.it

Fulton County opens new health center to address disparitiesPublic Broadcasting AtlantaBy Michelle Wirth Fulton County opened a new regional health center in the Adamsville area of Southwest Atlanta Thursday to try and address health disparities.

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This Beauty Shop Isn't For Hair, It's For Your Health

This Beauty Shop Isn't For Hair, It's For Your Health | Unlocking the Social Determinants of Health | Scoop.it

Taylor, who is a National Institute of Health-Health Disparities Research Scholar and specialist in culturally appropriate community-based research methodology, hopes that her new initiative would have high levels of success in improving health outcomes for minority women. 

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Challenge #1 For Health Care Providers – Too Much Information And Too Little Communication With Patients

Challenge #1 For Health Care Providers – Too Much Information And Too Little Communication With Patients | Unlocking the Social Determinants of Health | Scoop.it

One of the biggest problems with health care today is that there is way too much information and way too little communications going on between providers and patients. 


Via callooh, shannon mcgarry
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Podcast About Pending Supreme Court Ruling on the Affordable Care Act

Podcast About Pending Supreme Court Ruling on the Affordable Care Act | Unlocking the Social Determinants of Health | Scoop.it

WASHINGTON and DANVERS, Mass., June 6, 2012 -- /PRNewswire/ -- Eliza Corporation today released a 17-minute Podcast to offer perspective about the pending Supreme Court Ruling on the Affordable Care Act. PODCAST LINK : http://origin-qps.onstreammedia.com/origin/multivu_archive/MNR/56647.mp3

 

TWEET: #HealthCare experts Jeff Goldsmith @ADrane @ElizaCorp give pending ACA ruling perspective [PODCAST] #SCOTUS #healthdata

 

Questions addressed in the Podcast discussion include:

 

1.  What will the Supreme Court decide about the Affordable Care Act?

2.  How will Congress react to the Supreme Court decision?

3.  How will the Supreme Court's decision impact Obama in an election year?

4.  How and when will this affect individual people?

5.  What are the implications of the Supreme Court's decision for health plans?

6.  How will the Supreme Court's decision affect the rampant purchase of Provider   

     Practices?

7.  How will the Supreme Court's decision impact ACOs?

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A new report highlights the cost of health inequalities: but what’s the real story? | Croakey

A new report highlights the cost of health inequalities: but what’s the real story? | Croakey | Unlocking the Social Determinants of Health | Scoop.it

A few years ago, a Canadian researcher, Professor Dennis Raphael, took a look around the world to see how various countries were addressing health inequalities and the social determinants of health.

 

He subsequently published two papers in Health Promotion International (let me know if you’d like a copy), comparing both the rhetoric and the actions of countries identified as liberal, social democratic, conservative or Latin welfare states.

Raphael, a professor of health policy at the School of Health Policy and Management at York University in Toronto, concluded that governments of liberal or social democratic welfare states are more likely to make explicit rhetorical commitments, but that liberal welfare state nations (like Australia) fall well behind other countries in implementing public policies that provide “the prerequisites of health”.

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The Garden of Eden: A Community Run Grocery Facility

The Garden of Eden: A Community  Run Grocery Facility | Unlocking the Social Determinants of Health | Scoop.it

The Garden of Eden is a community-run grocery like facility established to serve the African American community in St. Louis. The project was initiated because local advocates and researchers identified obesity as a major health concern. Further, Abraham's Children (AC), a project of Interfaith Partnership of Metro St. Louis working with more than 45 churches, recognized a lack of healthy foods, particularly in the city. At the suggestion of one health advocate from an AC church, a diverse alliance established the Garden of Eden.

 

Funded by the Centers for Disease Control and Prevention (CDC), the effort has been a partnership between Abraham's Children, St. Louis University School of Public Health, and Health Works, a local business in St. Louis. The three entities entered into a joint decision making process, which requires approval by all the partners before moving forward. It also capitalizes on the strengths of each entity. For example, all partners developed a plan and applied for grants to support the project. A church donated the space in its basement to house the market. Local businesses have guided the design and layout of the market. A local supermarket chain, SaveALot, trained community members. Abraham's Children, which has lay health workers in each of its member churches, provides health counseling and information to members of participating congregations. Further, community members have contributed their understanding of community needs and strengths to the staffing and management of running the store. For example, they recommended that seniors in the community could be trained as nutrition educators. State and local minority health agencies have also lent their expertise to the effort.

 

The Garden of Eden opened its doors in July 2003 and continues to run today. Even before opening, the effort had already achieved four major outcomes. These were: 1) increasing knowledge and skills regarding fruits and vegetables and physical activity; 2) job training for community residents; 3) empowering residents as demonstrated by reports from members of the participating groups that they feel motivated and organized to address other health concerns in their community after having successfully implemented this project. This was initiated by developing a community dialogue about the relationship between community resources (e.g. a market) and behavior (e.g. healthy eating); and 4) establishing a community-run grocery like facility, which holds the promise of improving fruit and vegetable intake among African Americans in St. Louis. Over time, this facility can result in improved health outcomes, including reduced risk of chronic disease.

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It Could Have Been Me…I Am Humbled

It Could Have Been Me…I Am Humbled | Unlocking the Social Determinants of Health | Scoop.it

When I entered the room, I was a graduate student from UCO, unaware of what these men had experienced or what may have brought them there. But as I sat and listened, as I talked with the inmate sitting next to me, who for privacy reasons I will call Mr. S, I learned that we came from the same places. I learned that he made some unwise decisions that lead him to this place but that it just as easily could have been me. I thought back to my past when I was growing up, poor, and reckless. I made some very unwise decisions but was fortunate enough not to get caught. Many of my friends ended up in jail and some died. I remember having friends that were drug dealers, thieves, gangsters, but I was never scared of them or fearful. They were my “homies” and I knew what they had to go through every day. I knew their lives were a constant struggle and although they made many bad choices, I knew they sometimes had no choice. I remember trying to talk to my friends about making lifestyle changes and feeling like it was futile because they couldn’t see a way through and out of the ghetto. Many of them tried to make a change after their first or second offense but were often working hard, staying on the right path and somehow wrongfully accused or unfairly scrutinized and ended up right back in the system.

This introspection coupled with the inmates comments made me think about all of the social injustices that are forced upon the nation’s most vulnerable citizens: the poor. Poor people are obviously more likely to be incarcerated and uneducated. This lack of opportunity and disparity is just one of the many issues poor people face. And it becomes cyclical and what do we do as a society? We turn a blind eye to it and forget that our duty as Americans is to take care of our fellow citizens and live by the philosophy from which this country was founded, that all people are created equal. Those who come from poverty are just like everyone else, with one exception, they are poor. But because they are poor, they are more likely to be incarcerated and less likely to live a long healthy life. What a vicious cycle. How do we get the heck out of it?

Well the answer seems so simple, yet the path is long, narrow, and scary. We know that policy change has a lot to do with the issues that the prison population faces. It also has a lot to do with the issues that poor people face. We have to have lasting policy change that cannot be overturned by some legal loophole or because of some special interest groups’ long money that pays to make a change take place or go away. We as citizens have to ask what it is that people need, truly listen, and actually do something about it.

 

Tonight’s experience humbled me; it made me thankful that I had a support system and that although I made a few bad decisions I am fortunate enough to be where I am now. I have seen some hard times, and definitely know about struggle. My parents came from developing countries and grew up in extreme poverty and when they came to the US, it was not much better. I know I am truly blessed and lucky to have made it as far as I have despite the many adversities I faced, of which the biggest was being poor. I am where I am because I had support but also because somehow I found a way out and never wanted to look back. But for those who didn’t have the same support or for those who couldn’t imagine a better day, I am empathetic. I have been where they started and remember how hard it was and is to get out. I hope and pray for a change and in the meantime will never forget this often forgotten group of people. They are prisoners but they are still people and should be treated with respect and humanity.

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The Measure of America 2010-2011: Mapping Risks and Resilience — Measure of America

The Measure of America 2010-2011: Mapping Risks and Resilience — Measure of America | Unlocking the Social Determinants of Health | Scoop.it

Check out the "Measure of America 2010-2011 Report: Mapping Risks and Resilience. The Measure of America is the first-ever human development report for a wealthy, developed nation.

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New Animated Videos Help Child Obesity Researchers

New Animated Videos Help Child Obesity Researchers | Unlocking the Social Determinants of Health | Scoop.it

The National Collaborative on Childhood Obesity Research (NCCOR) is excited to announce the release of two demonstration videos on NCCOR's online tools: the Catalogue of Surveillance Systems and the Measures Registry. The animated videos describe the purpose and functions of these tools and demonstrate how to navigate the Catalogue and Registry to search for relevant measures, data resources, or surveillance systems. Check out the videos at: http://nccor.org/resources/nccor/videos.php.

 

Designed to help researchers more easily investigate childhood obesity in America, the Catalogue provides one-stop access for users to review, sort, and compare more than 85 surveillance systems relevant to childhood obesity research and the evaluation of policy and environmental interventions. The Registry is a portfolio of more than 800 measures related to diet and physical activity. The tool allows researchers to more efficiently find and select measures that are critical to accelerating obesity prevention research.

We invite you to share these resources with your colleagues and others who might be interested in childhood obesity research. Please also consider posting these videos on your organization's website, Facebook page, or Twitter feed. Directions for embedding the videos can be found here: http://nccor.org/resources/nccor/videos.php.

 

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Capitalizing on Change: Building Leadership Competency in Public Health

Capitalizing on Change: Building Leadership Competency in Public Health | Unlocking the Social Determinants of Health | Scoop.it

While this is a resource developed for use in Quebec, many of the tools can be applied here in the States.

 

Extensive changes to the health structure in Québec meant that public health risked being lost in the shuffle. Legislation in November 2005 merged public health services, traditionally provided through community service locations, into regional centres that included long-term care facilities and hospitals. Seizing the opportunity, Dr. Jocelyne Sauvé, Public Health Director for the region of La Montérégie, developed a detailed training program to embed a population health approach in the new managers, many of whom had little or no experience in public health. Her program was a resounding success, and is now being implemented province-wide, instilling a population-health perspective into all health service delivery.

 

Use this resource to:

Develop leadership in public health and health equity.
Make inroads into health care by capitalizing on public health successes.
Make ‘systems change’ by building health equity into planning and performance indicators.

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Partnership for Social Change: Campaign Launch

Partnership for Social Change: Campaign Launch | Unlocking the Social Determinants of Health | Scoop.it

Together with dozens of community health advocates, officials representing the Indiana Minority Health Coalition (IMHC) and Purdue University today unveiled Heart Health Indiana -- a federal grant supported health education program designed to enable African Americans in Marion County to make informed decisions about their heart health and provide the ability to effectively compare different forms of treatment as a solution for creating better health outcomes and enjoy a higher quality of life.

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Fellowships help meet need for more African American and Latino physicians

Fellowships help meet need for more African American and Latino physicians | Unlocking the Social Determinants of Health | Scoop.it

As more patients from underserved populations start to enter the health care system through health care reform, there will be an increasing need to have more African-American and Latino physicians to help provide quality health care. Kaiser Permanente is working to address the shortage of physicians by expanding its relationship with National Medical Fellowships and contributing $1 million to support medical students through education and training programs.

"Kaiser Permanente understands the importance of having a health care workforce that will reflect the diversity of our ever-evolving population," said Yvette Radford, a member of the NMF board and Vice President for External and Community Affairs, Kaiser Permanente Northern California. "We recognize that there are insufficient numbers of African-American and Latino medical students, and our support for NMF is one way to help address this important issue."

 

According to U.S. Census data and the American Medical Association Physician Masterfile, African-Americans represent 14 percent of the U.S. population and only four percent of physicians. Meanwhile, Latinos represent 16 percent of the population and five percent of physicians.

 

Understanding and addressing health disparities is crucial to improving community health. Greater access to providers is the first place to start. When given the opportunity, minority patients often select a physician or health care professional of their own racial-ethnic and cultural background because there is a high level of confidence that the physician will understand the patient's unique health care needs. This will have a positive impact on health outcomes and provide equitable care to our communities.

 

"Every time a member walks through the door, we want them to feel that they are being heard and cared for by someone who understands. Whether they see a Latina surgeon, an African-American cardiologist who is fluent in Spanish, or their trusted family physician- we provide them culturally responsive care, the highest quality of care in the language the member prefers and with respect for their culture at every point of contact," said Frank Meza, MD, MPH, Family Medicine and Physician Ambassador, Kaiser Permanente Los Angeles Medical Center and 2007 Recipient of the NMF Distinguished Alumni Award.

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Social Media Strategy for Advocacy

Social Media Strategy for Advocacy | Unlocking the Social Determinants of Health | Scoop.it

If you are looking for advocacy tips, here is a great place to start:

 

Use the Pyramid of Social Media Strategy when conceptualizing any social media campaign (reconstructed below for your viewing delights).
Targeted engagement: WHO are you trying to reach…there are too many people in the social media world to reach them all!


Authenticity: you should be able to relate with your audience…post things in your social media that are honest and real


Integration within the whole organization: YOU cannot do this alone…to launch a good and successful social media campaign your whole org must be on board with the same messaging and plan and actively participating!


Quality content: This is in the center for a reason…make it worth your reader’s time…make them want to be SOCIAL with your media and get involved with YOU.

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Latinos in Georgia Face Growing Health Disparities

Latinos in Georgia Face Growing Health Disparities | Unlocking the Social Determinants of Health | Scoop.it
WXIA-TVLatinos in Georgia Face Growing Health Disparities, Report FindsPublic Broadcasting AtlantaBy Jim Burress And along with that growth comes ever-widening disparities related to Latinos' access to healthcare.
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More US Hispanics die waiting for heart transplants

Updated NewsMore US Hispanics die waiting for heart transplants: studyReuters"The knowledge of disparity is usually the first step in ultimately getting rid of it," said Tajinder Singh from Boston Children's Hospital, who led the study that...
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Obesity Epidemic Threatens to Bankrupt theNation

Obesity Epidemic Threatens to Bankrupt theNation | Unlocking the Social Determinants of Health | Scoop.it

The obesity epidemic in the U.S. will eventually bankrupt the nation if left unchecked, according to the Bipartisan Policy Center, which held a webcast Tuesday to outline its recommendations for curbing the crisis.

 

In its report, “Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future,” the Bipartisan Policy Center’s Nutrition and Physical Activity Initiative, co-chaired by former U.S. Secretaries of Agriculture Dan Glickman and Ann Veneman and former U.S. Secretaries of Health and Human Services Donna Shalala and Mike Leavitt, calls on the public and private sectors to collaborate in creating healthy families, schools, workplaces and communities.The report’s goal is to draw attention to the role obesity plays in the nation’s mounting healthcare spending, which is expected to reach $4.6 trillion dollars annually and consume 19.8 percent of the GDP by 2020, said Glickman.

 

“We Americans are a very overweight and unhealthy nation and as a nation we spend $2.6 trillion on healthcare (annually). Those costs are the primary driver of our nations’ debt,” said Glickman, adding that the current level of healthcare spending will “bankrupt our country.”

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National Plan Aims to Break Down Asthma Disparities

National Plan Aims to Break Down Asthma Disparities | Unlocking the Social Determinants of Health | Scoop.it

WASHINGTON, D.C. — U.S. federal agencies unveiled the Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities May 31.

White House Council on Environmental Quality (CEQ) Chairman Nancy Sutley, Environmental Protection Agency (EPA) Administrator Lisa P. Jackson, Secretary of Health and Human Services (HHS) Kathleen Sebelius and Secretary of Housing and Urban Development (HUD) Shaun Donovan discussed the new plan during an event at Town Hall Education Arts Recreation Campus (THEARC), which houses The Boys and Girls Club of Greater Washington, along with other community groups.

Nearly 26 million Americans are affected by this chronic respiratory disease, including 7 million children, especially minority children and children with family incomes below the poverty level.

 

Asthma rates of African-American children are at 16 percent, while 16.5 percent of Puerto Rican children suffer from the chronic respiratory disease, more than double the rate of Caucasian children in the United States.

The annual economic cost of asthma, including direct medical costs from hospital stays and indirect costs such as lost school and work days, amounts to approximately $56 billion.

 

“Across America, we see low-income and minority children and families at a disproportionately higher risk for asthma and respiratory illnesses,” Jackson said. “Air pollution and other challenges are having serious health effects, which compound economic challenges through medical bills and missed school and work days. As the mother of a child with asthma, I know what it means for our children to have clean and healthy air to breathe. This action plan enables federal agencies and our partners to work more collaboratively and comprehensively on tackling a major health threat, so that we can protect all Americans, no matter what community they call home.”

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Minority, young women in Connecticut avoid yearly checkups, survey says

Many Connecticut women aren’t getting annual preventive health care, and the problem is worse among minorities and young adults, according to a new survey.

 

The survey found that 28 percent of women had not had an ob-gyn exam in the past year. Among minority women, 38 percent had not had an ob-gyn exam in the past year; and for young women 18 to 29, the number was 36 percent. One in 10 minority women reported they had not seen a gynecologist or a primary care doctor in the past year. That is double the rate reported by white women. Young and minority women were also less likely to get pap smears on schedule.

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Prescription for better health: give the have-nots a hand up

Prescription for better health: give the have-nots a hand up | Unlocking the Social Determinants of Health | Scoop.it

It's a well established fact and most of us have at least heard of it. It's also a surprising fact. But it's a fact that doesn't get nearly as much attention as it deserves - not from our politicians, the media or the public.

 

It's known to social scientists and medicos as the ''social gradient'' or the ''social determinants of health''. And it means there's a strong correlation between socio-economic status and health. The higher your status, the better your health.

To put it the other way, the lower a person's social and economic position, the worse their health. And the health gaps between the most disadvantaged and least disadvantaged socio-economic groups are often very large.

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