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(詳細はhealth and health inequality. Inequalities in health stem from the conditions of people's lives, including living conditions, work environment, age, and other social factors, and how these affect people's ability to respond to illness.〔 These conditions are also shaped by political, social, and economic structures.〔 The majority of people around the globe do not meet their potential best health because of a "toxic combination of bad policies, economics, and politics".〔 Daily living conditions work together with these structural drivers to result in the social determinants of health.〔 Poverty and poor health are inseparably linked.〔 Poverty has many dimensions – material deprivation (of food, shelter, sanitation, and safe drinking water), social exclusion, lack of education, unemployment, and low income – that all work together to reduce opportunities, limit choices, undermine hope, and, as a result, threaten health.〔Charlotte Loppie Ph.D. and Fred Wien Ph. D. National Collaborating Centre for Aboriginal Health. Health Inequalities and Social determinants of Aboriginal People’s Health. (University of Victoria, 2009)< http://www.nccah-ccnsa.ca/docs/social%20determinates/NCCAH-loppie-Wien_report.pdf> http://www.nccah-ccnsa.ca/docs/fact%20sheets/social%20determinates/NCCAH_fs_poverty_EN.pdf〕 Poverty has been linked to higher prevalence of many health conditions, including increased risk of chronic disease, injury, deprived infant development, stress, anxiety, depression, and premature death.〔 According to Loppie and Wien, these health afflictions of poverty most burden outlying groups such as women, children, ethnic minorities, and the disabled.〔 Social determinants of health – like child development, education, living and working conditions, and healthcare〔World Health Organization. Commission on Social Determinants of Health. (Closing the Gap in a Generation- Health equity through action and the social determinants of health ). Geneva: World Health Organization. 2008. Accessed 14 March 2012.〕- are of special importance to the impoverished. According to Moss, socioeconomic factors that affect impoverished populations such as education, income inequality, and occupation, represent the strongest and most consistent predictors of health and mortality.〔Gender equity and socioeconomic inequality: a framework for the patterning of women's health; Social & Economic Patterning of Women''s Health in a Changing World; Nancy E Moss; Center for AIDS Prevention Studies; Social Science & Medicine; Volume 54, Issue 5, March 2002, Pages 649–661; http://www.sciencedirect.com/science/article/pii/S0277953601001150〕 The inequalities in the apparent circumstances of individual’s lives, like individuals’ access to health care, schools, their conditions of work and leisure, households, communities, towns, or cities,〔 affect people’s ability to lead a flourishing life and maintain health, according to the WHO. The inequitable distribution of health-harmful living conditions, experiences, and structures, is not by any means natural, “but is the result of a toxic combination of poor social policies and programmes, unfair economic arrangements, and bad politics.”〔 Therefore, the conditions of individual’s daily life are responsible for the social determinants of health and a major part of health inequities between and within countries.〔 Along with these social conditions, “Gender, education, occupation, income, ethnicity, and place of residence are all closely linked to people’s access to, experiences of, and benefits from health care.”〔 Social determinants of disease can be attributed to broad social forces such as racism, gender inequality, poverty, violence, and war.〔Farmer PE, Nizeye B, Stulac S, Keshavjee S (2006) Structural Violence and Clinical Medicine" ''PLoS Med'' 3(10) e449. doi:10.1371/journal.pmed.0030449. Accessed 14 March 2012. < http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0030449>〕 This is important because health quality, health distribution, and social protection of health in a population affect the development status of a nation.〔 Since health has been considered a fundamental human right, one author suggests the social determinants of health determine the distribution of human dignity.〔Influence of socioeconomic status, wealth and financial empowerment on gender differences in health and healthcare utilization in later life: evidence from India; Kakoli Roya, Anoshua Chaudhurib; Centers for Disease Control and Prevention; Social Science & Medicine; Volume 66, Issue 9, May 2008, Pages 1951–1962; http://www.sciencedirect.com/science/article/pii/S0277953608000415〕 ==Definitions and measurements== Social determinants of health in poverty reveal inequalities in health. Health is defined “as feeling sound, well, vigorous, and physically able to do things that most people ordinarily can do”.〔John Mirowsky and Catherine E. Ross, Education, social status, and health (New York: Walter de Gruyter, Inc., 2003), 1-50.〕 Measurements of health take several forms including subjective health reports completed by individuals and surveys that measure physical impairment, vitality and well being, diagnosis of serious chronic disease, and expected life longevity.〔 According to the World Health Organization, social determinants of health include early child development, globalization, health systems, measurement and evidence, urbanization, employment conditions, social exclusion, public health conditions, and women and gender equality.〔 More generally, the WHO considers the circumstances of daily life and structural drivers, which determine health outcome differentials, as the social determinants of health.〔 Different exposures and vulnerabilities to disease and injury determined by social, occupational, and physical environments and conditions, result in more or less vulnerability to poor health.〔 Structural drivers, on the other hand, include stratification in society, biases and societal norms, economic and social policy, and governance.〔 These themes are condensed into a distinct structure of defining the social determinants of health in poverty. The World Health Organization’s Social Determinants Council recognized two distinct forms of social determinants for health- social position and socioeconomic and political context. The following divisions are adapted from World Health Organization’s Social Determinants Conceptual Framework for explaining and understanding social determinants of health. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Social determinants of health in poverty」の詳細全文を読む スポンサード リンク
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