watch the video and answer the 8 questions
the video link
Unnatural Causes Discussion
Q1. Dr. Adewale Troutman says that he promotes individual responsibility, but always within the context of social determinants. Why does he link the two? What is missing if we focus exclusively on individual responsibility? How does this affect possibilities for change?
Q2. Dr. Ichiro Kawachi observes that the ability to avoid smoking and eat a healthy diet depends on access to “income, education, and the social determinants of health.” Do conditions in your community promote or hinder healthy choices? What policies shape those conditions?
Q3. Angelique Anderson says: “I always wanted to have a house with a big back yard…” Corey adds: “I want to own a house so that if anything happened to me, she wouldn’t be put out on the street.”
1. What health benefits might derive from affordable, quality and secure housing?
2. How does home ownership (or its lack) affect conditions in your community?
3. How easy or difficult is it to find quality, affordable housing in your community?
Q4. Some chronic stressors mentioned in the film are: being on guard all the time, having little control at work, living in an unsafe neighborhood, being uncertain about where food will come from, and worrying about one’s children.
1. What additional stressors can you think of?
2. How does exposure to stressors – and resources available to manage them – vary with class position?
3. Describe the societal forces that create and reinforce these stressors.
4. What additional set of stressors might racism impose?
Q5 . Dr. Troutman says: “There’s almost a cultural demarcation in the city where on one side of this particular street, Ninth Street, there’s a tremendous amount of new development going on, condos rising up…And right across the street is where the public housing projects begin…Every city has a Ninth Street.”
1. Where is the Ninth Street, the dividing line, in your city or area?
2. How would you characterize either side of the line? List and compare the health promoters and health threats.
3. Who lives there and who doesn’t? Why?
4. Were these areas different in the past? What government, land use, development and other investment decisions changed them?
Q6. Dr. Jack Shonkoff, when talking about early childhood, says, “The concept here is the pile-up of risk, the cumulative burden of having things that are increasing your chances of having problems, as opposed to the cumulative protection of having things in your life that increase the likelihood that you can have better outcomes.” What are examples of the “pile up” of cumulative advantage – and disadvantage?
1. Sociologist David Williams says, “Economic policy is health policy.” How has the U.S. influenced health inequities and health outcomes? What kinds of economic policies might reduce health inequities and improve the overall health of most Americans?
Q7. The film notes that sweeping social reforms made during the Progressive Era, the New Deal, and the Civil Rights Movement improved population health.
1. Why would changes that promote greater equity translate into population health improvements?
2. What do you notice about whether those policies or programs emphasized medical advances, greater individual responsibility, new programs and services, or structural and social change?
3. Should knowing about the health effects of social policies change the value that Americans place on these kinds of policies? Why or why not?
Q8. Whitehall study director Sir Michael Marmot says, “If inequalities in health were a fixed property of society, then you’d say ‘We can’t do anything about it.’ But that’s not the case. The magnitude of inequalities in health changes over time. It can get rapidly worse, and if it can get rapidly worse, it ought to be possible to make it rapidly better.” Describe how the policies below might promote better health for everyone. What other policies or social changes might you add to this list?
Existing: | Potential: |
8-hour work day | Guaranteed paid vacation |
Minimum wage | Living wage |
Unemployment insurance | Job training and placement |
Free K-12 public education | Paid parental leave |
Affirmative action (limited) | Housing assistance |
Social security | Universal health care |
Expert Solution Preview
Introduction:
The Unnatural Causes documentary sheds light on the social determinants of health and how they impact health outcomes. As a medical professor, it is important for students to understand the influence of social factors on health. In this assignment, students are required to watch the video and answer eight questions related to the topics covered in the documentary.
Q1: Dr. Adewale Troutman links individual responsibility and social determinants of health as he recognizes that both play a critical role in maintaining a healthy lifestyle. Focusing only on individual responsibility would neglect the impact of social and environmental factors on health outcomes. Lack of access to adequate healthcare, education, employment, and safe living conditions adversely affect health and well-being. Policies and interventions that address social determinants of health are essential to promote health and reduce health disparities.
Q2: Healthy choices are influenced by access to income, education, and social determinants of health. In some communities, living conditions hinder healthy choices, negatively impacting health outcomes. Policies such as zoning and urban planning contribute to these conditions.
Q3: Affordable, quality, and secure housing can provide health benefits such as reduced stress levels, lower risk of chronic illness, and improved mental health. Homeownership provides greater stability for individuals and families, leading to better health outcomes. The lack of affordable housing is a significant issue, and policies that improve access to affordable housing are essential for promoting health.
Q4: Besides the mentioned stressors, financial burdens, discrimination, and social isolation are additional stressors that impact health. Access to stress management resources varies based on social class position, leading to more significant disparities in health outcomes. Societal forces such as racism, poverty, and discrimination contribute to the creation and reinforcement of stressors that negatively impact health.
Q5: Dividing lines such as Ninth Street present stark differences in living conditions, with one side having more health-promoting conditions than the other. Policies and investments enable these differences, and understanding the root causes can inform policy interventions.
Q6: Cumulative advantage/disadvantage refers to the compounded effects of social determinants of health over time. The existence of certain conditions, such as living in poverty or experienced discrimination, adds to an individual’s disadvantage in health outcomes. Economic policies that reduce health inequities are necessary for better health outcomes for most Americans.
Q7: Changes that promote equity translate into improved population health outcomes. Policies and programs that emphasize structural, social change have been proven to improve population health outcomes significantly. It is essential to recognize the link between social policies and health outcomes.
Q8: Implementation of policies such as a living wage, job training, universal healthcare, and affordable housing can significantly promote better health outcomes for everyone. Other policies that may contribute to better health include access to free or low-cost education and environmental policies promoting clean air and water.
Conclusion:
Understanding the social determinants of health is essential for medical professionals, and ensuring that students understand how social policies and practices impact health is crucial. The Unnatural Causes documentary emphasizes the importance of considering social factors when addressing health outcomes, and students must recognize the impact of policies and interventions on promoting equitable health outcomes.