What are the Social Determinants of Health

Income, a key indicator of economic capital, has been commonly found to be associated with the population health and risk of diseases since it enables people to pay for the medical service and insurance plan, to live in a health-promoting, supportive and safe neighborhood and to choose healthier, often more expensive food (Abel, 2008). Also, material resources are often required to gain access to health-promoting programs like sports clubs and hiring exports for notorious advice. While financial resources determine the range of health-enhancing options, they fall to include other factors like class, gender and personal values that could vary the health behaviors and contribute to the differences in health outcomes. Those social factors such as gender and racial inequities at a macro-structural level and personal values, lifestyle patterns and doctor- patient relationships at an interpersonal level (Watkins-Hayes, 2014)interact with each other, set the boundaries of social resources and create privileges and disadvantages for different individuals, consequently leading to various health outcomes. Gender inequalities structurally posit women at a more vulnerable place than men, in a man- dominant modern medical system which most medical researchers have been conducted by men and in the interest of men (Ehrenreich, 1976).

The lack of female authorities, female working at less prestigious positions (Ehrenreich, 1976) , and the studies representing female personal experience like childbirth, period pain, and pregnancy permeates health-care industries and put women at a disadvantage position. Besides the neglect of female identities and perspectives in a patriarchal health-care industry, women are likely to face more cultural demands and restrictions, contributing to gender-based inequities in women's experiences of health and health care. The pervasiveness of women and girls to pursue thinness has been enhanced by the health promotion programs. Those programs set an ideal of female body images that symbolize ‘resistance to the rounded, maternal body’ (Bordo, 1993), associating with powerlessness and induce issues like body image dissatisfactions. More seriously, some girls and women suffer from eating disorders and depressions as they are shamed to be different than what they are expected to be. There is also evidence that those eating problems and phycological damages caused by the negative body images reduce the quality of women’s lives, resulting in a high mortality rate and severe consequence for health (Association, 2000).

Not only do women are posited at more inferior places in medical practices, but also, they are more exposed to cultural restrictions that could have adverse effects on their health. Thus, gender at a macro-scale contributes to the inequalities of health outcomes. Another factor that could determine the health outcome of a large number of people is race. Race, interconnecting with other social factors like gender, class, and ethnicity, has navigated privileges and disadvantages among social groups and influenced an individual’s dominant ways of thinking and behaving (P., 1990). Sometimes, race could be dominant determining a group of people’s living situation and thus affecting their health conditions. Studies of the human immunodeficiency virus (HIV), the virus that attacks specific cells of the immune system and reduces the body’s ability to fight infections (Watkins-Hayes, 2014), have demonstrated how minorities in the United States meet more obstacles to maintain healthily. Evidence has shown that black people, making up only 14% of US population minorities face the most severe burden of HIV, comprising 44% of new infections and people living with HIV in 2010. The reasons that blacks are so vulnerable to this disease can be that black people often live in low-income communities, have limited access to the medical institutions and cause untimely treatments which contribute to the lower survival rates after an AIDS diagnoses.

Besides, the massive increase in both size and population of prisoners in the US over the last 30 years, has disproportionately impacting black and Latino communities (M., 2010), particularly exposing them to higher risks of getting infected. Studies have found that the HIV infection rate among prisoners is five times higher than the general populations. Such a high number not only affects prisoners but also could place potential threats to their families. Thus, the disadvantageous situation of the minorities has been further reinforced via higher possibilities to engage with prisoners. With higher risks to be infected by life-threatening diseases like HIV, minorities are facing more threats to their health and lacking resources and accessibilities to treatments. Therefore, racial differences, compounding with other social factors, can hugely impact the health conditions among different groups of people and increase the unfairness concerning health.

Besides the contributors like gender and race which could affect the health outcome of a large amount of people, personal values, norms and social connections with other can account for the variances of health outcome among individuals. The notion, cultural capital from the work of the French Sociologist Pierrer Bourdieu (Bourdieu, 1986), can illustrate how personal social resources can link with the individual’s health. Cultural capital comprises people’s social abilities and competence for action, including their perception, values, norms, cognitive and operating skills, accumulated via education and socialization. Applying Bourdieu’s notion to health research enables to define the cultural-based resources that are available to individuals to act in favor of their health. For example, people actively engaging social activities like support groups and clubs benefit from social networking in health matters, since socializations offer the opportunities to facilitate the use of social capitals for health gains, promote feelings of belongings and provide access to the interpersonal support system (Abel, 2008).

Cultural techniques, the abilities to approach others properly, to use appropriate language and communication style, and to share values with others, are curial when participating in social activities to explore potential gains from socialization. Furthermore, nutritional behavior and patterns of physical activities which contribute mainly to the constructions of the eating and physical activity habits can be referred as the values attached to health, knowledge about health effects about food and norms guiding health behavior. Those cultural resources structure people’s preferences, encourage or re-enforce health choices, such as keeping a balanced diet, participating clubs and joining the health-promoting program and form common patterns of health behavior and orientations (Abel, 2008). Also, through class-specific health lifestyle, cultural capital is not merely a determinant for individual’s health, but a crucial contribution to the reproduction of health inequalities. As people tend to interact with those who share similar values and personal experience, the cultural norms have been further enhanced and generated distinct behavior patterns of different social classes (T., 2007). Cultural sources, thus, act at an interpersonal level, influencing not only personal health behaviors but also the distributes non- material resources available to different social groups, reinforcing the inequalities of health outcome.

While factors like gender and race have determined the accessibilities to health-promoting resources like more effective and efficient medical care which guarantee the prevention of severe disease and faster recovery from illness, the risk of exposure to infections and deadly diseases like HIV, the burden of social expectations that could affect people mentally and physically at a large scale, individuals’ social capital, the cultural resources they have to make health decisions, like their abilities to engage in conversations properly, their preferences to choice lifestyle patterns, their health concern knowledges to prevent get infections during flu seasons, account for the variance in health-related quality of life, at an interpersonal level. Those personal values and norms could further have a more significant impact via the interactions among people who share similar values, social classes, cultural background, and similar skills, thus placing a vital part in enhancing the inequalities of health outcome among different groups. Although social factors alone cannot account for all determinants for health outcome, margining with financial factors and the interconnections among those factors could provide a more comprehensive picture of the factors determining health. References Abel, T. (2008). Cultural capital and social inequality in health.

Journal of epidemiology and community health, 3. Association, A. P. (2000). American Psychiatric Association. Washington: DC: American Psychiatric Association. Bordo, S. (1993). Unbearable weight: Feminism, Western culture and the body. Berkeley: University of California. Bourdieu, P. (1986). The forms of capital. Connecticut: Greenwood Press. Ehrenreich, B. a. (1976). Witches, Midwives and Nurses?: a History of Women Healers . London: Writers and Readers Publishing Cooperative. M., A. (2010). The New Jim Crow: Mass Incarceration in the Age of Colorblindness. New York: New Press Altice F, Mostashari F, FriedlandG. 2001. P., C. (1990). Black Feminist Thought: Knowledge, Consciousness, and the Politics of Empowerment. New Work: Routledge. T., A. (2007). Cultural capital in health promotion. New York: Springer. Watkins-Hayes, C. (2014). Intersectionality and the Sociology of HIV/AIDS: Past, Present, and Future Research Directions. Annual Review of Sociology, 431. What is wrong with arguing that educational achievement is the result of natural talent? The education system has boomed since the late eighteen centuries, along with a massive increase in size and complexity of the education system, the number of enrollments and national educational expenditures (John W. Meyer, 2012).

The booming has indicated some evolution in education; however, specific issues, like the efficiencies of the schooling system, the uneven accessibilities for the different class of students and the unfair distribution of teaching resources, remain. In order to improve the current educational conditions for children, knowing the factors that determine their educational achievements is essential, since the findings would direct researchers to look at the real issues and to come up with solutions correspondingly. Several perspectives have illustrated different ways to explain the factors. Notably, a naturalist approach explains how an individual’s educational attainment merely is determined biologically; one’s academic performance results from the innate and biological genes, the natural abilities including gender, ethnicities, social classes and intelligence (Van Krieken, 2014), and those impacts of socialization can be neglected. However, this approach has been extensively criticized since it is implausible to ignore the role of human and social agencies in affecting school performance, and other approaches are required to address a more comprehensive explanation how children’s educational achievements are determined. Internalist explanations investigate factors within the education system that could explain the differences in students’ educational outcome since it is reasonable to link the place students spend most time off and receiving most academic knowledge from to their educational attainments (Van Krieken, 2014).

Studies have found that different educational experiences could influence the performance and provide shreds of evidence that uncover important school- level effects on academic achievements. One important aspect of educational experiences includes daily participation in school, including attending every class, completing school homework, be active in classes discussions and participating in extracurricular activities. Another one is students’ attachments to school, which describe how they feel about school, their sense of belongings and membership in the social order of the school (Monica Kirkpatrick Johnson, 2001). Those two components often are related to each other and achievements. Students who feel more embedded in their school are more willing to devote efforts to engaging in school activities and participating in class discussions and to taking more seriously about homework. Meanwhile, those who actively interact with teachers and their peers are more likely to develop positive feelings about their school. Via the positive associations among engagements, attachments, and achievements, those efforts and the sense of belongings result in better academic achievements. Vice versa, better academic results further encourage students to put more efforts in the future and draw students more closely into the school order (Finn, 1989).

The interconnections between schooling experience, students’ engagements, and attachments to be specific, and achievements provide some insights on how daily school life plays a role in generating differences in academic performance. Beyond schooling experience, evidence has suggested strong associations between students’ success in school work and the status of their parents and family. Studies of children’s educational achievements over time demonstrate that educational success depends strongly on the socio-economic status of their parents (Graetz, 1995). Socioeconomic status refers to a person’s social position determined by the attainments both economically and socially (Ainley, 1987). Families where parents are advantaged socially, educationally and economically, in other words at higher socioeconomic status, foster a higher level of achievements in their children. Those parents can provide more psychological support, more attention to supporting their children’s studies, and more resources available to their children to pursue higher academic accomplishments and constructing positive environments that encourage the development of skills necessary for success at school (Williams, 1980). Also, closely connected with socioeconomic status is family structures which could positively or adversely affect children’s performance at school.

Pieces of evidence have demonstrated that solo-parent family could have a negative impact on children’s educational outcome. As single-parent families on average have a lower level of income and lower parents’ educational attainments (Rich, 2000), a lower SES, the custodial parent may need to work harder to support family daily expense and the children’s education and would have less time spending on the supervision of children’s schoolwork and the disciplining children. As a result of lack of the low SES of the families, those children may face more economic burden, for instance, some need to work part-time, take responsibilities to take care siblings and housework and even drop off from school to support family financially, and those additional pressures could impede the time available for study. Besides they are more likely to face emotional and behavioral problems, due to lack of communications to parents and role models (Buckingham, 1999). Those emotional and economic responsibilities adversely associate with educational attainments (Gillian Considine, 2002).

Through parents influences, families’ SES have influenced the outcome of educational accomplishments. Not only the factors like school experience and family interactions which students are intimately related to, the introduction of new technology and the trending of globalization, the factors outside educational system, could affect the wag students engaging and performing at school. Studying overseas have become very common in China recently, and those study internationally face utterly different teaching styles compared to those study in China. Differentiating from passively accept facts, follow authorities and incline to conformity (Ballard, 1991), the Western education system encourages independent learning and critical thinking (Ballantyne, 1999). It is plausible to connect those cultural clashes would place difficulties for Chinese students to adapt to the Western learning environment and encountering those obstacles which are missing for those studying domestically could result in different outcomes of their academic performance. Besides, online teaching has been introduced into Western education and has places more challenges for Chinese students to pursue higher degrees internationally. Studies found that compared to traditional teaching style, learning online lacks the face-to-face connections between professors and students, the direct discussions among peers, the enforcement of learning by the teacher (Tsai-Hung Chen, 2008).

The absences of opportunities to establish the social relationship between students and mentors, engaging in a learning community and immediate feedback to questions students ask, challenge international students more, considering they face questions like language barriers, cultural conflicts, and different cultural norms. They find it difficult to engage in online discussions and comprehend reading materials without the help of their mentors, and they often loss passions after finding they misunderstand the reading materials and failing to improve even putting efforts. Those negative feelings like depression, anxiety, and discomfort in studying and additional challenges introduced from online learning, increase the burdens on Chinses students, resulting in less ideal academic performance.

Therefore, the shifts in studying methods and environments could also contribute to educational attainments. We acknowledge that academic achievements are related to children’s innate abilities, and those natural talents may account for some degree of variances in educational outcomes. However, the interpretation of the naturalism is misleading and subject to debates, since both a child's heritable characteristics and their environment are related and coexist in complex and significant ways and neglect of the social factors that mutually influence and be constricted by innate abilities could cause incorrectness when finding explanations to variances in academic performances. Therefore, other approaches like the internalist perspectives to investigate what roles school activities’ play in determining academic accomplishments, how influential families and parents’ engagements account for success in the classroom, and how adoptions to the introduction of new teaching technique and the emerging of multicultural education system may shift the performance of the students. In order to have a more comprehensive understanding of factors attributable to educational attainment and to find the direction of further improvements of the educational system, different aspects of researches are needed to address this issue.

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