Sunday, December 23, 2018

The Social Determinants of Chronic Diseases

Life quality depends in no small extent on education and social environment. According to the World Health Organization, diseases also have a significant social element. The conditions in which people are born, grow, work, and live, determine their attitude and ability to maintain health, which modulates proneness to disease, and survival. 

Life Course Theory

Beginning in childhood, socioeconomic conditions accumulate over the life course and impact health in old age. Life course theory considers how the social and material environment, income inequality, stress, nutrition, lifestyles, gene-environment interaction, public safety, and various other factors determine health. Socioeconomic advantages over a person’s lifetime lead to better elderly health. 

Fundamental Cause Theory

Socioeconomic status (SES) influences multiple diseases in multiple ways; for centuries, people in higher social strata have lived longer and had better health, in proportion to the class gradient. The level of socioeconomic resources, such as money, education, status, power, and social connections, either help protect one’s health or promotes sickness and premature mortality. People with control over their lives typically feel good about themselves, cope with stress better, and have the capability and living situations to adopt healthy lifestyles. People in higher SES have a better chance of survival from preventable causes of death. Resources consisting of money, knowledge, power, prestige, and social connections are vital to maintaining health. An absence or shortage of these resources causes poor health outcomes and earlier deaths. 

Social Capital

Groups or social networks form social capital. Group/network memberships, including online groups and cybernetworks, provide social support and access to group resources in times of need. The more involved in a group or network, the more people benefit from a sense of belonging, shared norms, reciprocity, and trust. As a concept, social capital has both subjective (cognitive) and objective (structural) components. Its personal element is the positive feeling stemming from belonging to a community, which promotes a sense of well-being. The objective part is the actual provision of assistance when in need, such as advice, looking out for one another, help when sick, law enforcement, options for emergency financial support, and the medical and social welfare services. Social capital affects health: through a direct extension of resources to an individual via reciprocity exchange (e.g., caregiving, transportation to medical appointments, financial assistance to access medical services), through its effect on health-related behaviors (e.g., tobacco and alcohol use, diet, exercise), or by education or employment. Social capital also affects health by mitigating the threat of stress-inducing circumstances.
Cohesion allows group members to collectively pursue health benefits, such as passing a non-smoking ordinance, placement of bike lanes and farmers markets, or preventing drug abuse. Finally, social capital influences health through the diffusion of important health-related information or health-promoting innovations within the network.
Social capital is vital for self-management of chronic disease, regardless of socioeconomic background and fosters adherence in care regimens involving diabetes, and other chronic diseases. Social cohesion can improve depressive symptoms and other health-related behaviors. Unfortunately, bad social networks can have an unhealthy influence.

Health Lifestyle Theory

Social rules determine what is appropriate or inappropriate. People generally choose along class lines and by other social aggregates. Lifestyle choices and personal routines are characteristic of specific groups and classes. The collective behavior becomes part of the mental make-up, subconsciously directing situational attitude and behavior. 

Structural variables, namely class circumstances; age, gender, and race/ ethnicity; social networks associated with kinship, religion, politics, the workplace, and others, living conditions (e.g., quality of housing, access to basic utilities, neighborhood facilities, public safety) provide the social context for socialization and experience that influence life choices. These structural variables also collectively constitute a person’s life chances (the chances one has in life to achieve one’s goals, needs, and desires). Choices and possibilities interact and form a disposition to act, leading to practices (action), such as alcohol use, smoking, dietary habits, and other health-related activities. 

Conclusion: your social class can make you sick and can lower your chances of a longer life.  

The above post has been based on the scientific study, The Social Determinants of Chronic Diseasesupported by the National Institute of Health. 

Picture credit: Created by Macrovector -

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