Jun 7, 2011

Social Determinants of Health


It is now clear that economic, and social variables – more than individual behaviour – are the most salient factors in determining people’s well-being. Working and living conditions, the distribution of wealth, and where we live are some of , “the primary factors that shape the health of Canadians” (CCPA Monitor, June 2010).

Almost everything that is vital to a healthy community, from life expectancy to levels of depression to crime rates, is affected by inequality. This is true in both rich and poor countries.  (The Spirit Level: Why Equality is Better for Everyone, by Richard Wilkinson and Kate Pickett).

Social factors begin to affect us at conception, so that life in the womb and the perinatal period can affect well-being later on.  Even if exposed to stress in the womb, however:

A nurturing environment after birth can provide the child with enormous potential to change their course of development. This is known as “developmental plasticity,” which means that the brain can adapt and change as the child grows with a positive environment.

The important message here is in how we as a community support pregnant women. Stressful lives are most often linked with socioeconomic disadvantage. This research shows we should be targeting these women with support programs to ensure the stress does not negatively affect the unborn child.  (Repeated Stress in Pregnancy Linked to Children’s Behavior)

Poverty can even cause brain damage. Researchers discovered that U.S. children from “low socioeconomic environments” displayed a response in their pre-frontal cortex that was similar “to the response of people who have had a portion of their frontal lobe destroyed by a stroke” (Poor Children’s Brain Activity Resembles That Of Stroke Victims, EEG Shows).

The damage may result from conditions such as poor nutrition, lack of time with over-worked and over-stressed parents, or fewer opportunities for intellectual stimulation – all of which may affect the quality of care that a child receives.  This does NOT mean that all poor children are so afflicted, but the average poor child is more likely to suffer.

Every dollar invested in the young not only saves lives and prevents illness, but it will also save at least $7 dollars in future social costs. For instance, lead poisoning, ADHD, and autism resulting from toxic chemicals and pollution in the United States cost $77 billion annually. Globally, almost 350,000 women die each year in childbirth – most of whom could be saved for the cost of just six fighter jets. Even worse: over 22,000 children under the age of 5 die every day from hunger and preventable diseases – almost 9 million every year. This year’s U.S. military budget is around $800 billion, and the world spends twice that on war. The simplest change would be to redirect wasteful military spending to end the worst elements of global poverty.

In 2009, the combined net worth of the world’s 1,011 billionaires increased to $3.6 trillion, up $1.2 trillion in just one year. This NEW wealth alone could end global poverty.

Perhaps the most important point is that none of these social, economic, and environmental problems are necessary. All scarcities, as Murray Bookchin pointed out over 40 years ago, are artificial. We possess the knowledge and the wealth to eliminate the worst of these afflictions. Why aren’t we doing so?

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