Social Aspect of Health & Diseases

DR. A. M. Kadri, M.D. (PSM), Associate Professor, PDU Medical College, Rajkot

Individual & his environment

Health is no more considered as a physical or biological entity. "Human being is considered as a product of heredity and environment". In the second half of the twentieth century it was largely believed that besides biological make up of an individual there are many social factors which directly or indirectly influences the health and disease condition of the community.

This put forth a hypothesis of a dynamic equilibrium between man and his environment as a health, while a disease is a maladjustment of human organism to his environment.

There is a growing consensus on the importance of systematic differences in exposure to health hazards and risk conditions in the population. This means some groups in society have a much poorer chance of achieving their full health potential as a result of their life circumstances including political, social, economic and environmental conditions. Differences are observed in the health status of groups according to a range of socioeconomic indicators. The most disadvantaged groups have the poorest health and the highest exposure to healthdamaging risk factors.

There is evidence that poorer socioeconomic groups tend to have poorer nutrition, less physical activity in leisure time, greater prevalence of smoking and more damaging patterns of alcohol use. Poorer people live shorter lives and are more often ill than the rich. This disparity has drawn attention to the remarkable sensitivity of health to the social environment.

Social gradient in health, influence psychological and social and physical health and longevity. Political environment, Public Health Policy and Programms are most important social determinants of health today, which can play in shaping a social environment that is more conducive to better health. Policy and action for health need to address the social determinants of health, attacking the causes of ill health before they can lead to problems.

Definition of Health

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

Social Determinants

Income and social status Social support networks Education and literacy, i.e. health literacy Employment/Working conditions Social environments Physical environments

Social Determinants

Personal health practices and coping skills Healthy child development Biology and genetic endowment Health services Gender Culture

Social Development Approach For Health Promotion

Protective factors
Healthy conditions & environments Safe physical environments Supportive Economic & Social Conditions Regular supply of food & Water. Restricted access to tobacco & Drugs Healthy public policy & organization practices. Provision of meaningful, paid employment. Provision of affordable housing Psychosocial factors Participation in civic activities and social engagement Strong social networks Feeling of trust Feeling of power and control over life decisions Supportive family structure Positive self-esteem Effective health services Provision of preventative services Access to culturally appropriate health services Community participation in the planning and delivery of health services Healthy lifestyles Decreased use of tobacco and drugs Regular physical activity Balanced nutritional intake Positive mental health Safe sexual activity

Quality of life, functional independence, Wellbeing, Mortality, Morbidity, Disability

aRisk conditions

Psychosocial factors

Physiological

Behavioural

Quality of life, functional independence, Wellbeing, Mortality, Morbidity, Disability

aRisk conditions Poverty Low social status Dangerous work Polluted environment Natural resource depletion Discrimination (age, sex, race, disability) Steep power hierarchy (wealth, status, authority) within a community and workplace

Psychosocial factors Isolation Lack of social support Poor social networks Low self-esteem High self-blame Low perceived power Loss of meaning or purpose Abuse

Physiological risk factors High blood Pressure High cholesterol Release of stress hormone Altered levels of biochemical markers Genetic factors

Behavioural risk factors Smoking Poor nutritional intake Physical inactivity Substance abuse Poor hygiene Being overweight Unsafe sexual activity

Risk factors

Socio-cultural Aspects

Culture is defined as learned behaviour which has been socially acquired. Man is largely product of the cultural environment. Culture lays down norms of behaviour and provides mechanism which secure for an individual his personal and social survival. Culture stands for customs, beliefs, laws, religion and moral percepts etc. Man acquires behaviour, capabilities, skills as a member of society. Customs, cultures norms, habits, superstitions influence the behaviour formation and practice at community level.

Nutrition

Guthi is given to newborn baby immediately after birth. Jain & many Hindus in dont eat mutton, egg, fishes. Muslims consider pig as impure and dont consume it. Shikh consumes pig. Different community consumes different type of edible oil e.g. Gujarati -groundnut oil, South Indian-Coconut oil. Some foods are Hot and some are Cold Meat, fish, eggs, and jaggery are considered to generate heat in the body, while curd, milk, vegetables and lemon are considered cool foods. Muslims observe fasts in specific months. Hindus are observing on special days. Alcohol drinking is considered tabooed in muslims.

Pregnancy & Child rearing :

Early marriage & universal practice of marriage. Multi-sexual partner is considered immoral in the India. The pregnant lady is given Shira or similar type nutritious foods. Post delivery, for around six weeks, in many community women stays at their parents home. Infant are breastfed for more than one year. In India prolonged breastfeeding is universal culture. Colostrums is considered bad. Child is not breastfed for first three days and prelacteal food is given. Olabath, massage and exposure to the sunlight are the routine practices in rural community. Some foods are forbidden (eggs, green leafy vegetables etc.) during pregnancy.

Treatment seeking behaviour

Many ailments e.g. chickenpox, measles etc. are considered as a wrath of the god/goddess or black magic/evil eyes etc. For certain mental illnesses, people go to bhuva, ozas, sadhus, fakirs etc. Belief about Traditional methods are always better than allopathic care.
Daily tooth brushing and regular bathing are accepted practices. In many communities bathing naked is considered as taboo. Putting the Kajal on eyelids and Surma in eyes. Circumcision in males in Muslims. Joint family is preferred mode of staying and taking care of older persons in family is the common culture in India.

Others

Socio-economical Aspects

The word economics literally means house keeping. Individually, also socioeconomical conditions put the person at particular risk or advantage.

Socio-economical Aspects
Lower economical conditions indirectly affects...

Purchasing capacity of the foods, hence nutritional status of the individual and health, Education, hence illiteracy and lack of opportunity to health life skill. Living conditions : overcrowded-ill health houses, poor water and sanitation facility. Medical Care seeking : Unaffordability of the medical results in to delay seeking of the medical care, inadequate medical care, hence higher rate of adverse outcome. Population groups that suffer the worst health status also are those that have the highest poverty rates and the least education.

Higher Socio Economical Condition

Disparities in income and education levels are associated with differences in the occurrence of illness and death, It permit increased access to medical care, enable people to afford better housing and live in safer neighborhoods, and increase the opportunity to engage in health-promoting behaviors. Higher socio-economical conditions also influence the health of the individual because of the adoption of the some unhealthy life behaviours, like sedentary life style, junk-high fatty foods, stressful life etc. They develop heart disease, diabetes, obesity, elevated blood level, stress

Thank you