A colleague of mine recently dug up on old piece on the social determinants of health which I thought was just fantastic. It originally came from “Social Determinants of Health: Canadian Perspectives” (2004) edited by Dennis Raphael. The contrast it draws from traditional health tips to the health tips that are beyond one’s control (social determinants) provides a creative way of explaining the impact of the social determinants of health. The piece is as follows:
The messages given to the public by governments, health associations, and health workers are heavily influenced by the ways in which health issues are understood. Contrast the two sets of messages provided below. The first set is individually-oriented and assumes individuals can control the factors that determine their health. The second set is societally-oriented and assumes the most important determinants of health are beyond the control of most individuals. Which set of tips is most consistent with the available evidence on the determinants of health?
The traditional 10 Tips for Better Health
- Don’t smoke. If you can, stop. If you can’t, cut down.
- Follow a balanced diet with plenty of fruit and vegetables.
- Keep physically active.
- Manage stress by, for example, talking things through and making time to relax.
- If you drink alcohol, do so in moderation.
- Cover up in the sun, and protect children from sunburn.
- Practice safer sex.
- Take up cancer-screening opportunities.
- Be safe on the roads: follow the Highway Code.
- Learn the First Aid ABCs: airways, breathing, circulation.
The social determinants 10 Tips for Better Health
- Don’t be poor. If you can, stop. If you can’t, try not to be poor for long.
- Don’t have poor parents.
- Own a car.
- Don’t work in a stressful, low-paid manual job.
- Don’t live in damp, low-quality housing.
- Be able to afford to go on a foreign holiday and sunbathe.
- Practice not losing your job and don’t become unemployed.
- Take up all benefits you are entitled to, if you are unemployed, retired or sick or disabled.
- Don’t live next to a busy major road or near a polluting factory.
- Learn how to fill in the complex housing benefit/asylum application forms before you become homeless and destitute.
What an excellent and creative way of explaining the way our society – and our socio-economic place within it – determines our health outcomes.
Now imagine if we saw poverty prevention and elimination as a means to save on health costs.