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Q1. The Social determinants of health is the observed social, economic, mental and environmental health factors that affect the quality of life of society or its people. The basic formation of these factors have been separated and placed into 10 different categories social gradients, stress, early life, social exclusion, work, unemployment, social support, addiction, food and transport (WHO Regional Office for Europe, 2010). One example of a social determinant of health is the social gradient. The social gradient is a socio-political theory that places people on a social ladder and categorises them based on their overall financial, social and hierarchical standing in society (WHO Regional Office for Europe, 2010). The social gradient demonstrates that life expectancy is shorter and affliction of disease is higher if you reside further down the social ladder (Marmot & Wilkinson, 2006). The social gradient demonstrates the effect of social standing on people and how it effects quality of life, therefore making it a Social Determinant of Health.
Q2. Causes of the causes is a term used to describe the social determinants of health for each category and how it may impact upon the other categories. For example Marmot and Wilkinson state that it is not an accident that people regularly consume food with high saturated fat and salt content. What causes this to occur is food availability, culture, affordability and culture as well as many other possible external influences (Marmot & Wilkinson, 2006). Then if healthy food prices were to escalate, poorer citizens would struggle to purchase healthy food. The poorer citizens then resort to purchasing cheaper and unhealthier food which contain unhealthy amounts of sugar and fats. These sugar and fats then cause obesity, heart problems and many other diseases and illnesses that effect these people of lower socio-economic status (WHO Regional Office for Europe, 2010). This demonstrates that one category caused an effect in another.
In Fig. 8. in the book EN: Social determinants of health it shows the mortality rate from coronary heart disease in comparison to fruit and vegetable supply in selected European countries. (WHO Regional Office for Europe, 2010) This graph demonstrates that a decrease in health food supplies in kg/per person/per year causes an increase in standardised death rates aged 35-74. There is a direct effect of food prices going up as lack of supply, these items would become less affordable as well as vice versa. A good diet and adequate food supply are main areas of health promotion and overall well-being of a person. (WHO Regional Office for Europe, 2010) These cause and effect issues are the main issues in dealing with health problems as one change could drastically effect the lives of Australian citizens, particularly those who are in a lower socio-economic standings. (WHO Regional Office for Europe, 2010)
Q3. Barbara is a 52 year old unemployed, single mother who has fallen on hard times. She receives inadequate payments from the government via the Newstart allowance scheme, and struggles to pay off her car loan and rent. Barbara has many problems, however the main focus of this question will be on her social support, her ability to cope with the mental and physical stresses of her life and her health issues involving her current unemployment. Barbara describes her social life as being ‘non-existent’ as a result of her financial difficulties and doesn’t normally get to see her friends, now simple socialising events such as grabbing a coffee with her friends is seen as a luxurious expenditure (Thompson & Ramsay, 2013).
Socialising is an important experience within our lives, without the help and support and friendship of others, maintaining quality of life would be near impossible. Lack of a social life can even lead to physical problems as explained in the book ‘Social Determinants of Health the Solid Facts’ on the graph Fig. 6 (WHO Regional Office for Europe, 2010). The graph shows results gathered of both male and females in America, Where the age-adjusted mortality rates are compared with level of social integration. The graph demonstrates a correlation of when there is a decrease of social integration, it results in an increase of age-adjusted mortality rate (WHO Regional Office for Europe, 2010). This highlights that we are a social species, isolation can be very damaging and could cause a variety of mental anguish and mentals issues such as depression or even physical problems like an increase of disability from chronic diseases (WHO Regional Office for Europe, 2010). As evident in Fig. 6, lack of social integration can cause physical harm to our bodies and is a quintessential in maintaining our physical health (WHO Regional Office for Europe, 2010). Therefore, Barbara’s lack of social behaviour increases her risk of dying slightly, as small as the increase is, these small Health factors can easily pile up and cause large changes in quality of life.
Barbara’s stress mainly forms from her recent unemployment and her increasing debt of her car loan, which escalated to be more than the actual car is worth (Thompson & Ramsay, 2013). This emotional strain can be observed on Barbara’s face as she received a Coles gift card for 60 dollars from the Spiers Centre employee (Thompson & Ramsay, 2013). Barbara becomes emotional and continually thanks the Spiers centre employee for helping her with her current situation, she highlighted that she would for once be able to pay for her own groceries and toiletries instead of resorting to borrowing them. Barbara’s Stress could also can activate the flight or fight response in the body, resulting increase in heart rate and alertness by stored energy from diverging blood to the muscles, this is known as the stress response (WHO Regional Office for Europe, 2010). Turning on this stress response “diverts energy and resources away from physiological processes important to long-term health maintenance” (WHO Regional Office for Europe, 2010). Therefore, during periods of long durations of continued stress can lead to increase vulnerability of a wide range of conditions and diseases such as “diabetes, high blood pressure, heart attack, stroke, depression and aggression” (WHO Regional Office for Europe, 2010).
The major cause of the Barbara’s other two issues stated can be linked back to her unemployment. Due to her lack of income, she has resorted to many desperate attempts to keep herself afloat financially. This includes buying items based on budget instead of necessity. The fact that she lost her job as a result of poor health indicates that she was having health issues even before finance and employment were specific problems in her life (Thompson & Ramsay, 2013). Therefore, the current events would only aggravate her situation of stress and social isolation she currently is experiencing.
Q4. The basic fundamentals of stress can be outlined by what are the causes of stress in the first place and what can be done to remedy these stress factors? According to the Australian Psychological Society, “Australians aged 18-25 and 46-55 reported the lowest levels of wellbeing” (The Australian Psychological Society, 2014). Stress is caused by many factors, majority of these factors are the result of financial and family issues which is the leading cause of stress amongst Australian citizens (The Australian Psychological Society, 2014). Similar to all previous surveys conducted, issues involving health concerns are frequently rated as sources of stress to people who experience personal health issues, problems with maintaining their healthy and active lifestyle and also issues where a close person’s health has been compromised (The Australian Psychological Society, 2014). With this information you can easily target particular age groups that are experiencing these issues more than others, and try to involve not just informative ways of creating prevention and improvement but also with the use of practical techniques.
Stresses in life come from expectations we have for ourselves, as well as expectation from others for us. In a radio interview with Terence Cheng a researcher from the University of Melbourne’s Institute of Applied Economic and Social Research, studied and identified statistics that proved the existence of a midlife crisis, Ashley Hall a reporter for the ABC asked about his findings into. Terence Cheng’s study shows that after the age of 18 there is a gradual decline in happiness until the age of around 40 to 42 years old (Hall, 2014). The stresses in life occur where many events can cause huge outcomes in the happiness of a person, events such as marriage, losing one’s job, illness and death of a close loved one can cause major swings in the happiness and stress of the person experiencing these life events (Hall, 2014). Alan Oster the National Australia Bank’s chief economist conducted a survey that had similar results from the National Australia Bank’s Quarterly Australian Wellbeing Index. Alan Oster states that “what we’ve had is that the lowest tended to be in the 18 to 29 year olds, where I think there was a lot of stress in terms of unemployment” (Hall, 2014).
These ages indicate where stress is becoming most of a problem, The Australian Psychological Society and Alan Oster both state that slumps in happiness as well as wellbeing occur around the age of 18 to mid-20s because of unemployment. Australia has an unemployment rate of 6.1% which is 115th in the world (Australian Bureau of Statistics, 2015; Trading Economics, 2015). We could attribute this to our aging population where there is a total increase of one person every 1 minute and 21 seconds (Australian Bureau of Statistics , 2015). Jobs are drying up as a result of this population increase and therefore my project proposal is to decrease unemployment rates in Australia through funding small and large business, as well as implementing a bonus stimulus for people who have one child or less, in an attempt to slow population growth. The small and large business proposal will be funding small and large businesses for use only allowed on expansion amongst city and urban areas of Australia. This is hoped to create more venues for jobs, allow expansion of companies creating new section for workers, and thus decrease the unemployment rate in Australia.
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