ADDRESSING THE SOCIAL 1

DETERMINANTS OF HEALTH:
BEYOND GENETICS & GENDER

Fall 2017

WEEK 1

CALIFORNIA STATE UNIVERSITY NORTHRIDGE

HSCI 439

JULIE FRIEDMAN, MPH

 SOCIAL
DETERMINANTS 2

OF HEALTH
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.
- World Health Organization
 Despite genetics or gender, health is often determined by
economics, lifestyle, sexual orientation, environment,
culture and behavior.
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Picture Source: "Social Determinants of Health." Center for Health Care Strategies..
“Maybe It Will Go Away….”

“Fence Sitters”:
those who hesitate
to seek medical help
and may become
immobilized by fear.

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“Worried Well”:
Those that are
jumping on the
latest health fad
and seek medical
attention at
minimum levels
of discomfort.
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 Social Determinants of Health

"Social Determinants of Health." Social Determinants of Health | Healthy People 2020. Healthy People 2020.
 7

Davis, Rachel. Measuring What Works to Achieve Health Equity: Metrics for the Determinants of Health. Rep. Prevention Institute, June 2015.
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Davis, Rachel. Measuring What Works to Achieve Health Equity: Metrics for the Determinants of Health. Rep. Prevention Institute, June 2015.
 Determinants of Health and Health Outcomes for Women in Los
Angeles County by Federal Poverty Level (FPL), 2015

< 100% FPL 100-199% FPL 200-299% FPL ≥ 300% FPL

45 42
42
40 • Poverty is linked to
35 33 higher food insecurity
and women reporting
Percent of Women

30
26 26 living in unsafe
25 23 22 neighborhoods.
20 18
14
• Low-income women
15 12 12
9
have higher prevalence
10
6 6 6 of obesity and diabetes
5 than women living at
0
higher incomes.
9
Food insecurity*
Neighborhood not safe from crime
Obesity Diabetes

* Food insecurity reported for adults with Source: 2015 Los Angeles County Health Survey; Dr.
household incomes < 300% FPL only Rita Singhal
 Self-Reported Health Status

Fair or Poor Health among

Women by Race/Ethnicity
• About 22% of women in LA
30% 28% County report a fair or poor
25% health status.
22% 23%
20%
20%

15% • A significantly higher percent of

15%
Latinas report a fair or poor
10% health (28%).

5%
• Among those living in poverty,
0%
37% report a fair or poor health
All LA Asian Black Latina White 10
County status.
Women
Source: 2015 Los Angeles County Health Survey; Dr.
2011 Los Angeles County Health Survey Rita Singhal
Percent of single female household renters that spend more than 30%
of their gross income on rent

90
Percent of Single Female Household Renters

80
72 72 • 70% of women
70 70
70 64 63
compared with
60 57 58% of men who
are single family
50
householder
40 renters are
30
spending more
than 70% of their
20 gross income on
10 rent
0
U.S. CA LA Asian Black Latina White 11
Women Women County
Women

Source: 2014 American Community Survey, US Census Bureau; Dr. Rita

Singhal
 Percent of Women with Overweight or Obesity and High Blood
Pressure in Los Angeles County by Race/Ethnicity, 2011-2014

Overweight or Obese High Blood Pressure

90 • AI/AN women have the
78
80
73
highest rates of poor
70 65
health outcomes such as
overweight or obesity
Percent of Women

60
50 and high blood pressure.
50 45
43
40 • Mortality rates from
29 29
30
23
coronary heart disease
22
20 and diabetes are higher
among AI/AN women
10
that women of other
0
race/ethnic groups.
AI/AN Asian Black Latina White
12

Source: California Health Interview Survey, 2011-2014 Pooled

Data; Dr. Rita Singhal
 The Canadian Facts - Social
Determinants of Health
December 2012
13.37 minutes
https://www.youtube.com/watch?v
=IZZA4SSHm1k

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 World Health Organization video:
Social Determinants of Health
16 minutes
https://www.youtube.com/watch?v
=ES1IX3Mam20

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 Colorado 2013
10 minutes
https://www.youtube.com/watch?v
=I7iSYi3ziTI

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 Why Place Matters in Health?
November 12, 2016
Anthony Iton, MD, JD, MPH
Senior Vice President of Healthy
Communities
https://youtu.be/6u9_CndNNJs

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