Social Determinants Model of Health

A social determinants model of health is a framework for thinking about health. Within this framework, improvements in health and wellbeing are achieved by addressing the social and environmental determinants of health, in tandem with biological and medical factors (Aged, Community and Mental Health Division, 1998). Underpinning and supporting this is the Alma Ata declaration and the World Health Organisation definition of health:

Health is a complete state of physical, mental and social wellbeing, not merely the absence of disease or infirmity (World Health Organisation, 1958).

The social determinants of health are the conditions of daily living that determine a person’s chances of maintaining good health. So the overall life circumstances of some population groups - their social, economic and environmental conditions - mean they have a much poorer chance of achieving their full health. The most disadvantaged groups have the poorest health and the highest exposure to health-damaging risk factors (Roe, 1995).

Recognising the significant impact that these social determinants have on health is part of working in a health promoting way. It recognises that services that aim to improve health and wellbeing and to reduce and prevent disease need to be concerned not only with the individual, but also with the broader areas of public policy, environmental influences, group and family influences and the community context (Victorian Department of Health and Community Services , 1991).

The life circumstances or determinants of health (including people’s social and economic circumstances, indigenous status and ethnicity, stress, gender, early life development and experiences, social exclusion, work and unemployment, and social supports) of people experiencing disadvantage restrict them ‘making healthy choices the easy choices’ (Marmot, 1999)(Marmot & Wilkinson, 1999). So the system needs to address the access to appropriate services and programs for diverse groups so that it does not create inequalities in health.

References:

1. Aged, Community and Mental Health Division (1998), A stronger primary health and community support system: policy directions, Victorian Department of Human Services, Melbourne.
2. World Health Organisation 1958, cited by Wass, A. (2000), Promoting health: the primary health care approach, Second edition, Harcourt Saunders, Sydney, p. 7.
3. Roe, M. (1995), Working together to improve health: a team handbook, Centre for Primary Health Care, University of Queensland, Brisbane.
4. Victorian Department of Health and Community Services (1991), Promoting health and preventing illness in Victoria, Melbourne.
5. Marmot, M. (1999), ‘The solid facts: the social determinants of health’, Health Promotion Journal of Australia, vol. 9, no. 2, pp. 133–9.
6. Marmot, M. and Wilkinson, R. (1999), Social determinants of health, Oxford University Press, Oxford.