Phelan, social conditions as fundamental causes of disease, journal of health and social behavior, extra issue 1995. They persistently link social conditions to health and disease 2. Social conditions as fundamental causes of disease. Public health should address principally the fundamental causes of disease and requirements for health, aiming to prevent adverse health outcomes. Our fundamental social causes approach argues that, when a population develops the wherewithal to avoid disease and death, individuals ability to benefit. This book is an elegant and clear exposition of the thesis that some disease is caused directly by social factors. Social conditions as fundamental causes of disease pdf.
Mckeown and the idea that social conditions are fundamental. The theory of fundamental social causes offers a useful framework for understanding why large disparities have emerged over the last few decades in the u. Social conditions as fundamental causes of disease created date. Ses is a fundamental cause of health inequalities because it demonstrates four essential features.
Pdf mckeown and the idea that social conditions are. Social conditionslink and phelan social conditions as. Aug 26, 20 considerable evidence now indicates, however, that social and economic conditions apart from access to and quality of medical care, which have undeniable importance play a fundamental, powerful, and pervasive role in the health of populations in both resourcepoor and resourcerich countries. Law operates as a pathway along which fundamental social causes of disease have their effect. Law in a social determinants strategy centers for disease.
A role for genomics in addressing health disparities. According to link and phelan 1995, a fundamental social cause of health inequalities has four essential features. This article critiques the effort to disentangle genetic from social causes of disease, but also argues that rough assessments of the relative effect each set of factors makes in shaping patterns. Pdf social conditions as fundamental causes of disease. Second, it affects these disease outcomes through multiple risk factors. Social sources of racial disparities in health health. In order for a social variable to qualify as a fundamental cause of disease and mortality, link and phelan 1995. First, it influences multiple disease outcomes, meaning that it is not limited to only one or a few diseases or health problems. Soc 234 social demography of health flashcards quizlet. Principles of the ethical practice of public health 1. Law contributes to the development and maintenance of unhealthy social conditions. More than any other global health endeavour, the commission focuses on the causes of the causes the fundamental structures of social hierarchy and the socially determined conditions these structures create in which people grow, live, work and age the social determinants of health. We return to the trend mckeown focused uponpostmckeown and postcolgroveto indicate how and why social conditions must continue to be seen as fundamental causes of disease. Such social conditions are viewed as a fundamental social cause of disease because they influence access to resources e.
Pdf social conditions as fundamental causes of health. Social causes of health and disease quotes by william c. These fundamental causes include factors such as social environment during infancy, level of education, income, economic and social policies, and education policies. Public health should achieve community health in a. Advancing health equity by addressing the social determinants. Cockerham, a leading medical sociologist, assesses the evidence that social factors such as stress, poverty, unhealthy lifestyles, and unpleasant living and work conditions have direct causal effects on health and many diseases. Health of washington state report social and economic. Social determinants of health sdoh are the conditions under which people are born, grow, live, work, and age, and include factors such as socioeconomic status, education, employment, social. Microbialresilience social, environmental and economic factors, linked to a host of human activities, often accelerate and amplify the natural phenomena that modify infectious disease patterns in humans. A fundamental cause approach to the study of disparities. Policies to promote healthier homes, neighborhoods, schools and. Social conditions as fundamental causes of disease bruce g. Link and phelan originally referred to social conditions, including social class, race, income, and educational attainment, as fundamental causes of disease because these conditions govern access to resources that influence health and disease.
Behavioral science, social science, and public health in. This focus on more proximate links in the causal chain may be. Social conditions achieve this status not because they are independent from and dominate over human agency but rather because they shape. Mckeown and the idea that social conditions are fundamental causes of disease. Link, and parisa tehranifar journal of health and social behavior 2010 51. A fundamental cause approach to the study of disparities in. Social conditions, health equity, and human rights health. Institute on trauma and traumainformed care at the university at. Nov 01, 2010 this essay from a journal of health and social behavior supplement presents key findings that support the fundamental causes theory. People of lower ses were exposed to these conditions to a greater degree and had much higher. We then outline the sorts of fundamental interventions that physicians might make in order to address the fundamental causes. We analyze the association between ses and lung cancer and pancreatic cancer mortality in each sociodemographic. Phelan, social conditions as fundamental causes of disease, journal of health and social behavior extra issue 1995. Social factors, which tend to be more distal causes of disease, have received far less attention.
The social determinants of health and infectious disease. Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks. Second, we argue that social factors such as socioeconomic status and social support are likely fundamental causes of disease that, because they embody access to important resources, affect multiple disease outcomes throughmultiple mechanisms, and consequently maintain an association with disease even when intervening mechanisms change. This essay from a journal of health and social behavior supplement presents key findings that support the fundamental causes theory. Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and qualityoflife outcomes and risks. Journal of health and social behavior, 35 extra issue. According to the fundamental cause idea, this dynamic reproduction of the association between ses and disease occurs because the flexible nature of resources of knowledge, money, power, prestige, and beneficial social connections allows the association to be. Policies to promote child and youth development and education. Public health should achieve community health in a way that respects the rights of individuals in the community. Principles of the ethical practice of public health. Oct 01, 2005 according to the fundamental cause idea, this dynamic reproduction of the association between ses and disease occurs because the flexible nature of resources of knowledge, money, power, prestige, and beneficial social connections allows the association to be reproduced in widely varying circumstances. A scientific debate separates those who believe that psychosocial. Phelansocial conditions as fundamental causes of disease. We first describe fundamental cause theory and how it makes the social causes of disease and health visible.
Yet differences in death rates and life expectancy by sep persist, suggesting something fundamental about this association despite changing causes of. In the past 100 years, the major causes of death nationally and in washington have shifted from infectious diseases to chronic conditions, such as cardiovascular disease, cancer and diabetes. Disadvantage, inequality, and social policy health affairs. Our fundamental social causes approach argues that, when a population develops the wherewithal to avoid disease and death, individuals ability to benefit from that wherewithal is shaped by resources of knowledge, money, power, prestige, and beneficial social connections. Social conditions as fundamental causes of disease core. Second, we argue that social factors such as socioeconomic status and social support are likely fundamental causes of disease that, because they embody access to important resources, affect multiple disease outcomes through multiple mechanisms, and consequently maintain an association with disease even when intervening mechanisms change. Fundamental social causes of health inequalities principles. A fundamental cause approach to the study of disparities in lung cancer and pancreatic cancer mortality in the united states. Link and phelan maintain that social conditions are fundamental causes of disease. For this reason, social conditions have been, are, and will continue to be irreducible determinants of health outcomes and thereby deserve their appellation of fundamental causes of disease and death.
570 1048 9 1471 1046 1115 1554 334 1506 1525 559 1070 1195 821 440 225 1565 894 876 1101 1502 955 673 865 414 13 804 649 1216 422 812 734 776 109 1386