Social & Economic Determinants of Health

Social Implications

• Social stigma – patients isolated from family and community
• Discrimination – loss of social respect, difficulty in marriage
• Mental stress – fear, anxiety, depression, loneliness
• Family problems – family members fear infection, children's education suffers
• Workplace discrimination – employers may remove TB patients

Economic Implications

• Loss of income – unable to work regularly
• Cost of treatment – medicines, transport, nutrition expenses
• Poverty cycle – illness leads to unemployment and debt
• Reduced productivity – affects national economic output
• Burden on family – members leave work to care for patient

Health Effects

• Vector-borne diseases increase (malaria, dengue)
• Water-borne diseases (diarrhea, cholera from floods)
• Heat-related illness (heat stroke, dehydration, CVD)
• Malnutrition from crop failure and drought

• Respiratory diseases (asthma, COPD from air pollution)
• Mental health problems (stress, trauma, depression)
• Displacement – migration and poor living conditions

Causes of Failure

• Lack of toilet construction
• Poverty – cannot maintain toilets
• Lack of water supply → toilets unusable
• Poor awareness – traditional open defecation habits

• Weak monitoring – false reporting of ODF status
• Poor quality toilets – incomplete or damaged
• Social/cultural practices – belief open defecation is healthier
• Corruption and mismanagement – funds not reaching beneficiaries

Causes

• Poverty – poor families become vulnerable
• Unemployment – lack of jobs pushes risky migration
• Illiteracy – lack of awareness increases vulnerability
• Gender discrimination – women and girls more exploited
• Migration and border issues – West Bengal shares international borders

• Child marriage – girls trafficked under pretext of marriage
• Demand for cheap labour and prostitution
• Weak law enforcement – corruption and poor policing
• Family breakdown – orphans and runaway children vulnerable

Individual Factors

• Alcohol and drug abuse, aggressive personality, poor moral values

Relationship Factors

• Family violence, peer pressure, male dominance in relationships

Community Factors

• Unsafe public places, weak policing, gender discrimination

Societal Factors

• Patriarchal culture, objectification of women, gender inequality, weak law implementation

Media Influence

• Violent and sexual content may influence behaviour

Mechanisms

• Out-of-pocket expenditure – savings spent on hospitalization and medicines
• Debt and loans – borrowing at high interest rates
• Sale of property – land, jewellery, livestock

• Loss of income – sick persons cannot work regularly
• Catastrophic health expenditure – large bills push families below poverty line
• Neglect of basic needs – food and education spending decrease

Reasons for Increase

• Improved healthcare services – expansion of hospitals and PHCs
• Vaccination programs – reduction in infectious diseases
• Better maternal and child care – reduced IMR and MMR
• Improved nutrition – food security programs

• Better sanitation and safe water – reduced water-borne diseases
• Increased literacy – better hygiene and healthcare awareness
• Economic development – improved living standards and income
• Family planning – better reproductive health services

Relation Between Politics and Health

• Government health policies – budgets and services
• War and conflict – destroys healthcare systems
• Resource allocation – affects hospitals, medicines, staffing

• Social welfare programs – nutrition, sanitation, vaccination
• Human rights and equity – political systems influence healthcare access

Barriers

• Poverty – cannot afford consultation and medicines
• Lack of healthcare facilities – hospitals far away
• Illiteracy – poor awareness about disease seriousness
• Cultural beliefs – preference for traditional healers

• Fear and stigma – fear of diagnosis or discrimination
• Gender inequality – women may not receive priority
• Poor quality healthcare – lack of trust
• Transportation problems – remote areas lack transport

Interpretation

• Social factors – literacy and awareness influence treatment choice
• Economic factors – poor depend on low-cost or local healers
• Accessibility – remote areas lack qualified doctors
• Cultural beliefs – faith in traditional healing remains strong

Public Health Implications

• Delay in scientific treatment
• Risk of complications
• Need for stronger rural healthcare