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We Live in Public was screened six times at the 2009 Sundance Film Festival before being awarded the Grand Jury Prize award in the U.S. Documentary category. Timoner is the first director in the Sundance Film Festival's history to win the Grand Jury Prize award twice. Her first win was for the widely acclaimed documentary, DIG! The Uncertain Hour podcast from Marketplace dives into one topic each season to investigate the surprising origin stories of public policy and our economy.

The social determinants of health represent aspects of people’s social identity, their social environment and their social position. It’s a broad topic and includes issues like justice, inequality, health inequity, poverty and human rights.

The WHO states that, “the social determinants of health (SDH) are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems. The SDH network across WHO supports action on the SDH. The SDGs provide a comprehensive blueprint for human development and for systematically addressing the social determinants of health.”

Transcript

Welcome back to this Global Health YouTube channel. Today we’re going to be talking about the social determinants of health. What I’m going to do is I’m going to share with you a framework that I’ve developed for thinking about the social determinants of health. My framework is relatively simple, and the reason is this: we’re basically just going to look at two things. We’re going to say, “Look, let’s try and understand what it is that we mean by the word social, and then let’s look at the reasons that people get sick, and let’s see if we can join the dots between these two buckets.”

So let’s start by thinking about what it is that we mean by the word social. And of course we all have an intuitive sense of what the word means, but I’ve divided the word social or the idea of social into three different categories or three different buckets, and I want us to look at each of these. So the three ways that we can think about this idea of social are firstly our social environment, secondly, our social identity, and thirdly, our social position or what we sometimes call our socioeconomic position. And let’s look at each of these in a little bit more detail.

So if we start with the social environment, this is the political, economic, and cultural setting in which we live. So you might live in a country whose health policy includes providing free access to healthcare. You might live in an affluent or a deprived neighborhood. You might live in a culture that accepts and encourages gender equity or you may not, as the case may be. Now let’s talk about your social identity. Social identity is a function of the groups that you either voluntarily or involuntarily are a part of. In other words, that you identify with or that you are identified with. It could be your family, your gender, your ethnicity, your race, citizenship, the tennis club that you belong to, your language group, et cetera, et cetera. And for each of these groups, there are a set of rules that society has adopted and applied to the us, those that are a part of the group, and the them, those that are not part of the group.

So in some parts of the world, whether or not you can access education depends on your gender. In other parts of the world, you might be denied access to clean water or housing or healthcare because of your ethnicity or race. And in each of these cases, your access to certain freedoms and certain opportunities is effected by the groups or the social delineations with which you are identified.

Now let’s look at the idea of socioeconomic status or your social position. Of course, our gut feeling is that socioeconomic status is just about how much money you have. And while that’s a big part of it, it’s not the whole picture. Think for a minute about what money does for you. It’s a sort of a discretionary resource that you can exchange for whatever you can afford, and it gives you the power over resources and opportunities. In other words, it gives you options. You have a degree of what we call personal agency, but there are other things that contribute to that agency, things like education, occupation, social status, et cetera. And when we see differences in socioeconomic status across these social groups or these social delineations that we talked about earlier, we call that inequality. When that difference is because of a systematic unfairness in the rules that apply to those groups, like racial or gender discrimination, we call that inequity. So let me just summarize. Inequality is the unequal distribution of goods and opportunities and freedoms across social groups, and inequity is the unfairness that leads to inequality.

Download old roblox version. Okay, so now we’ve got a good sense of what it is that we mean by the word social. Next we’re going to take a look at the health and what are the things that cause people to be healthy or unhealthy as the case may be, and then we’re going to join these two groups up and see how they relate to each other. But before we carry on, a big thank you to USC for sponsoring this video. Here’s a quick message from USC, and then we’re going to get back into the teaching.

Dr. Shubha Kumar: Hello from Sunny California. I’m Dr. Shubha Kumar, and a professor and Director of the Master of Public Health Online Program at USC. The USC online MPH program is 100% online and delivered through state-of-the-art technology that allows students to engage with classmates and professors in live online sessions. We have a fantastic curriculum with lots of choices and taught by world-class faculty. This program can prepare you for an exciting career in public health. So if you’re interested, just click on the link below this video to learn more. We offer three start dates per year and look forward to welcoming you.

Dr. Greg Martin: So we’ve looked at the idea of social. Now we’re going to look at health, and we’re going to ask the question, why do people get sick or why do people remain healthy as the case may be? And then we’re going to look at these two ideas and see how they can connect up.

Firstly, there’s simply your biology, your age, your sex, your genes, et cetera. Next, your access to things like nutritious food, safe drinking water, clean air, shelter. Next, exposure to hazards, things like violence, conflict, war, natural disasters, infectious disease agents. Then of course there are unhealthy behaviors, things like poor diet, smoking, sedentary lifestyle. Then there’s your access to health services, and of course that includes services to treat you if you’re sick, and it includes preventative services like vaccination services and health promotion. And finally, there are psychosocial factors. So let’s take a look at each of these and ask the question, what are the social determinants that can affect them?

The first determinant of health is of course your biology, your age, your sex, your genes, et cetera. Now this is the one determinant of health that is not really affected by your social environment, your social position, your social identity, et cetera. So we’re not going to talk a lot about your biology as a determinant of health because it’s kind of quite disconnected from the social determinants except to say that some of your biology like your age or your sex can have implications for your social identity, your social position, and your social environment, as can any of the other determinants of health. In fact, even being healthy or unhealthy or disabled can impact on your social identity, your social environment, your social position, et cetera.

So I want you to see how this interaction can actually happen in both directions. Access to nutritious food, safe drinking water, clean air, shelter

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