The Impact of Social and Cultural Environment on Health DEFINING THE SOCIAL AND CULTURAL ENVIRONMENT Health is determined by several factors including genetic inheritance, personal behaviors, access to quality health care, and the general external environment (such as the quality of air, water, and housing conditions). In addition, a growing body of research has documented associations between social and cultural factors and health (Berkman and Kawachi, 2000; Marmot and Wilkinson, 2006). For some types of social variables, such as socioeconomic status (SES) or poverty, robust evidence of their links to health has existed since the beginning of official record keeping. For other kinds of variables—such as social networks and social support or job stress—evidence of their links to health has accumulated over the past 30 years. The purpose of this chapter is to provide an overview of the social variables that have been researched as inputs to health (the so- called social determinants of health), as well as to describe approaches to their measurement and the empirical evidence linking each variable to health outcomes. It should be emphasized at the outset that the social determinants of health can be conceptualized as influencing health at multiple levels throughout the life course. Thus, for example, poverty can be conceptualized as an exposure influencing the health of individuals at different levels of organization—within families or within the neighborhoods in which individuals reside. Moreover, these different levels of influence may co-occur and interact with one another to produce health. For example, the detrimental health impact of growing up in a poor family may be potentiated if that family
Posted on: Sat, 07 Sep 2013 15:34:28 +0000
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