Determinants of Health

Transcription

1 Determinants of Health Understanding the Australian Institute of Health and Welfare Conceptual Framework for the Determinants of Health

2 Learning goal By the end of today s session you will have an understanding of the Australian Institute of Health and Welfare Conceptual Framework for the Determinants of Health and be able to apply it to enhance understanding of health issues.

3 Disclaimers This presentation focuses on the Australian Institute of Health and Welfare conceptual framework for the determinants of health as it is identified as an overarching framework used across all stages of the inquiry process in the new subject Health. The methods of use presented are one interpretation. I encourage you to seek others.

4 But first

5 River of Life

6 Healthy decision.. Is a movement towards a position of ease Is the correct access and use of an appropriate resource

7 Why are unhealthy decisions made? When we access and use a resource, we will either move towards a position of ease or a position of disease. Use of a resource may not be correct, intentional or appropriate. Access to a resource may not be possible, purposeful, incidental or appropriate.

8 How do determinants fit in? As barriers or enablers in the access and use of a resource Barrier inhibit access and use of resources that facilitate a movement towards a position of ease Enablers enhance access and use of resources that facilitate a movement towards a position of ease

9 Sample learning How PBC introduces these concepts to students

10 Understanding health River of Life

11 But not everyone is not in the same river.

12 Good health is necessary for human well-being and pursuit of the joys of life. But good health does more than that. It is important in allowing individuals to exercise a range of human rights including personal security, political participation, employment, education and family life. Just as important, health is necessary for well functioning societies. If a population does not have a decent level of health, it is very difficult to ensure economic prosperity, political participation, collective security and advancement. The WHO Commission on the Social Determinants of Health concluded that the social conditions in which people are born, live and work are the single most important determinants of good health or ill health, of a long and productive life, or a short and miserable one It is good to imagine a world where society maximizes health and closes the health gap; where everyone agrees and works together; and where individuals accept personal responsibility. Yet, societies often fail to ensure basic health needs and health care. We often fail to agree on health priorities, acting in selfinterest rather than the common good. And often individuals experience barriers to improving health. Bulletin of the World Health Organization 2011;89:78-78.

13 So why do different individuals and different populations experience different health?

14 Social Justice. All people have the right; - to optimal health - to access care and information - to receive information with dignity The social justice framework allows us to focus on the structures and practices in a specific population, and understand how they differ from others and create health inequities.

15 Three principles of the social justice framework. 1. Diversity - the variety within population groups, in particular needs. 2. Equity - concern for welfare, rights and dignity of all people - minimising the differences 3. Supportive environments - the surrounding environment, our interaction with it and how this encourages health behaviours

16 Clarification: Equity vs equality Equality = providing the same resources Equity = providing the same outcome

17 Examples. 1. Diversity - teachers and students have different rights, responsibilities and needs within the school environment 2. Equity - indigenous Australians experience more poor health than other Australians 3. Supportive environments - family behaviours with alcohol inform an adolescent s choices in alcohol use

18 So what makes it different?

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20 Determinants of health in more depth: Determinant category Broad features of society Environmental factors Socioeconomic characteristics Knowledge, attitudes and beliefs Health behaviours Psychological factors Safety factors Biomedical factors Definition A reference to how an individual s place in and interaction with society is considered. Examples include culture, language and media Physical location and structures An individual s progression through society and community. Examples include education, family and wealth Health literacy how well an individual can access and use correct information for health choices Choices made by the individual. Examples include diet, physical activity and drug use External forces such as stress and trauma Likelihood of injury occurring Measurable health factors such as cholesterol levels

21 End of sample learning

22 Initial conceptualisation

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24 To understand Remember that determinants are either enablers or barriers in the River of Life, and that they inhibit or enhance access and use of resources that facilitate a movement towards a position of ease. Option 1: backwards map for targeted action Option 2: forward map for predicted outcome Option 3: smorgasboard for reasoning Option 4: focused view for research

25 Backwards mapping 1. Start with a position of dis-ease. 2. Relate to a concept in Health and wellbeing over time 3. Determine biomedical influences on that concept. 4. Determine health behaviours, psychological factors or safety factors that contribute to the biomedical factor 5. And so on and so back

26 Forward mapping 1. Select a concept in broad features of society or environmental factors 2. Predict how this could influence socio-economic characteristics or knowledge, attitudes and beliefs. 3. And so on and so forth until an outcome is predicted

27 Smorgasboard 1. Consider the stimulus Shane is a 15 year old male with biliary atresia. He lives on a remote farm currently struggling to cope with drought conditions. His condition was discovered soon after birth, however the operation to re-establish bile flow was not 100% effective. 2. Identify determinants that you consider significantly influence the issue.

28 Focused 1. View a stimulus outlining a health concern or issue. 2. Select a determinant and investigate to establish its significance on the concern or issue.

29 Paramedics face unique mental health challenges, like no other job. While the line of work can be extremely rewarding, the psychological strain is high. Paramedics are among one of the professions with the highest suicide rates, second only to veterinarians. Trauma, isolation, long hours, and stress contribute to high mortality rates. Paramedics are often the first on the scene of major accidents, often involving gruesome deaths. People s lives depend on their quick reaction and care. Add to this the physical stress of the job, and it s not hard to see why paramedics need to be proactive about their own health, mental and physical. What we know so far Paramedics face higher levels of depression, anxiety, post-traumatic stress disorder (PTSD), and fatigue. Workers experience higher levels of organisational stress in comparison to other occupations, due to shift work, long hours, repeated exposure to death, difficult interactions, and high levels of responsibility. In Victoria alone, the average annual suicide rate for paramedics is 35.6 per 100,000 workers more than three and a half times higher than police, firefighters, and other emergency workers.

30 In summary Remember that determinants are either enablers or barriers in the River of Life, and that they inhibit or enhance access and use of resources that facilitate a movement towards a position of ease. Option 1: backwards map for targeted action Option 2: forward map for predicted outcome Option 3: smorgasboard for reasoning Option 4: focused view for research

31 Where can I find more information? QCAA portal syllabus and resources Health network based discussion. me for access srobe63@eq.edu.au