Social environment and health: 50% of the influence of the environment
I. Fundamentals of the relationship: social environment and its components
Human health is a comprehensive concept covering physical, mental and social well -being. Traditionally, the emphasis was on biological and genetic factors that determine the predisposition to diseases. However, modern science recognizes the significance of the social environment as a determinant of health. The social environment, in a broad sense, includes all the social, cultural, economic and political conditions in which a person lives and interacts. It is this environment that has a deep and multifaceted effect on its health, well -being and life expectancy.
I.1. Definition and versatility of the social environment
The social environment is not a monolithic education. It consists of many interconnected components acting at various levels. To understand the mechanism of the influence of the social environment on health, it is necessary to clearly distinguish between these components and their interaction. The key elements of the social environment include:
- Family environment: This is the primary social group that has the earliest and intensive effects on the formation of personality and health. It includes the structure of the family (complete/incomplete), socio-economic status, the educational level of parents, the style of education, the presence of violence or abuse, as well as an emotional climate in the family.
- Social support and social ties: Covers a wide range of human relations with other people, including friends, colleagues, neighbors, community members, etc. The presence of strong social ties provides emotional support, a sense of belonging, access to information and resources, and also stimulates a healthy lifestyle.
- Socio-economic status (SES): One of the most powerful predictors of health. It includes income level, education and profession. Low SES is associated with an increased risk of developing chronic diseases, infections, mental disorders and premature death. Inequality of income also has a negative impact on the health of society as a whole.
- Working environment: Working conditions, organization of the work process, level of stress, social support from colleagues and leadership, as well as opportunities for professional growth and development. Adverse working conditions can lead to the development of occupational diseases, mental disorders and a deterioration in general well -being.
- Place of residence and environment: It includes the geographical location, quality of air and water, the availability of green areas and recreational facilities, the level of noise and pollution, safety and the availability of infrastructure (transport, shops, medical institutions). An unfavorable environment can lead to the development of respiratory diseases, cardiovascular diseases, cancer and other health problems.
- Cultural environment: It includes values, norms, traditions, beliefs and practices accepted in society. Cultural factors affect food habits, attitude to health, behavior in relation to health, use of medical services, etc.
- Political environment: State policy in the field of healthcare, education, social security, employment, etc. Political decisions have a significant impact on the availability of medical services, the level of inequality, social support and other factors affecting public health.
- Health system: Organization, financing and availability of medical services. An effective healthcare system provides timely diagnosis and treatment of diseases, the prevention of diseases and strengthen public health.
I.2. Hierarchy of influence: micro-, meso- and macro-levels
The influence of the social environment on health occurs at various levels:
- Microe: The direct environment of a person: family, friends, colleagues. Primary social ties are formed here, values and norms of behavior are assimilated, and emotional support turns out to be. At this level, the most important role is played by interpersonal relationships and individual characteristics of a person.
- Mesouver: Communities, organizations, schools, workers. Social networks are formed here, rules and norms of behavior are established, resources and services are provided. At this level, a social organization, social capital and the availability of resources play an important role.
- Macro level: Society as a whole, the political system, economic structure, cultural norms and values. Here social policy is formed, resources are distributed, rules and norms of behavior are established that affect the health of the entire population. At this level, social inequality, discrimination, poverty, political stability and cultural factors play an important role.
The relationship between these levels is complex and multifaceted. The macro level forms the conditions in which the mesouver and micro levels function. Mesouver mediates the influence of the macro level on the micro level. And finally, the micro level forms individual experience and behavior that can affect human health.
II. Influence mechanisms: how the social environment affects health
The social environment affects human health through many different mechanisms that can be divided into several main categories:
II.1. Behavioral factors:
The social environment has a strong influence on human behavior in relation to health.
- Smoking, drinking alcohol and drugs: The social environment, especially friends and colleagues, can exert pressure on a person, pushing him to use harmful substances. Also, socio-economic stress and the lack of prospects can contribute to the development of addictions. Cultural norms and values also play a role in the formation of attitude to alcohol and drugs.
- Nutrition: The availability of healthy foods, food prices, advertising, cultural norms and traditions, as well as social pressure, affect the choice of food and food habits. In areas with low socio-economic status, limited access to fresh fruits and vegetables and high accessibility of fast food is often observed, which contributes to the development of obesity and other diseases.
- Physical activity: The availability of safe places for sports, the availability of recreational facilities, social support from friends and family, as well as cultural norms and values affect the level of physical activity. In areas with high crime and the lack of safe places for walking and playing sports, people, as a rule, lead a more sitting lifestyle.
- Compliance with the recommendations of doctors and preventive measures: Trust for doctors, the availability of medical services, the level of education, social support, as well as cultural norms and values affect compliance with the recommendations of doctors and participation in preventive programs. People with a low level of education and limited access to medical services, as a rule, are less likely to contact doctors and do not comply with recommendations for the prevention of diseases.
II.2. Psychological factors:
The social environment has a significant impact on human mental health.
- Stress: Socio-economic stress, discrimination, social isolation, interpersonal conflicts, as well as adverse working conditions can lead to the development of chronic stress. Chronic stress has a negative effect on the immune system, cardiovascular system and mental health.
- Social support: The presence of strong social ties and social support has a protective effect against stress and contributes to mental well -being. Social support can be emotional (support, sympathy), information (advice, information) or instrumental (assistance in solving problems).
- Self -esteem and self -confidence: The social environment, especially family and friends, affects the formation of self -esteem and self -confidence. Positive social interactions and support contribute to the development of positive self -esteem, and negative interactions and discrimination can lead to the development of low self -esteem and depression.
- Feeling of control and self -efficiency: Social conditions that allow a person to feel that control his life and affect the environment contribute to the development of a sense of self -efficiency. A sense of self -efficiency is associated with the best mental and physical health.
- Depression and anxiety: Socio-economic stress, social isolation, discrimination, lack of access to resources and opportunities can lead to the development of depression and anxiety.
II.3. Biological factors:
The social environment can have a direct effect on biological processes in the human body.
- Immune system: Chronic stress, social isolation and depression can suppress the immune system, making a person more susceptible to infections. Social support and positive social interactions can strengthen the immune system.
- Cardiovascular system: Chronic stress, social inequality and discrimination can lead to an increase in blood pressure, cholesterol and the risk of developing cardiovascular diseases. Social support and positive social interactions can reduce the risk of developing cardiovascular diseases.
- Endocrine system: Chronic stress can lead to a violation of the regulation of stress hormones (cortisol) and other hormones, which can negatively affect various body functions.
- Genetic expression: Studies show that the social environment can affect the expression of genes, that is, which genes turn on and turn off. This means that the social environment can change the biological predisposition to diseases.
II.4. Access to resources and capabilities:
The social environment determines human access to resources and opportunities necessary to maintain health.
- Medical services: The availability of medical services, the quality of medical services, the cost of medical services, the availability of medical insurance, as well as cultural barriers can limit access to the necessary medical care.
- Education: The level of education has a strong effect on health. People with a higher level of education, as a rule, have more knowledge about health, healthier habits and the best access to resources and opportunities.
- Work and employment: The presence of stable work with good wages provides financial safety, access to medical insurance and opportunities to improve health. Unemployment and unstable employment are associated with an increased risk of developing depression, anxiety and other health problems.
- Housing: The availability of high -quality and safe housing is an important factor in health. Life in crowded, unsafe or unhealthy housing conditions can lead to the development of respiratory diseases, infections and other health problems.
- Nutrition: The availability of healthy foods, food prices, as well as the availability of food safety are important factors affecting food habits and health.
- Transport: The availability of public transport, as well as the ability to use personal transport, provide access to work, medical services, education and other resources and opportunities.
III. Vulnerability and stability factors: who is most affected
Not all people are equally affected by the social environment. There are factors of vulnerability and stability, which determine the degree of influence of the social environment on human health.
III.1. Vulnerability factors:
Vulnerability factors increase the risk of negative influence of the social environment on health.
- Low socio-economic status: People with a low level of income, education and profession are more affected by negative factors of the social environment, such as poverty, lack of access to resources and capabilities, discrimination and social isolation.
- Childhood in a dysfunctional family: Children who grew up in families with violence, abuse, mental disorders in parents or other problems have an increased risk of health problems in the future.
- Discrimination: People who are discrimination on the basis of race, ethnicity, gender, sexual orientation, disability or other signs have an increased risk of stress, depression, anxiety and other health problems.
- Social isolation: People who do not have strong social ties and social support are more susceptible to stress, depression and other health problems.
- Mental disorders: People with mental disorders are more vulnerable to the negative impact of the social environment and may experience difficulties in establishing and maintaining social ties, as well as access to resources and capabilities.
- Disability: People with disabilities can face discrimination, social isolation and limited access to resources and opportunities, which can negatively affect their health.
III.2. Stability factors:
Sustainability factors reduce the risk of negative influence of the social environment on health.
- High socio-economic status: People with a high level of income, education and profession have more opportunities to protect their health and access to resources and capabilities.
- Strong social ties and social support: The presence of strong social ties and social support has a protective effect against stress and contributes to mental well -being.
- Positive personal qualities: Optimism, self -confidence, a sense of control and self -efficiency contribute to resistance to the negative influence of the social environment.
- Developed skills in overcoming difficulties: People with developed skills in overcoming difficulties are better to cope with stress and adapt to adverse social conditions.
- Access to resources and capabilities: Access to medical services, education, work, housing and other resources and opportunities contributes to resistance to the negative impact of the social environment.
- Active participation in society: Participation in public life, volunteering and other forms of social activity contribute to the development of social ties, a sense of belonging and self -efficiency.
IV. Approaches to improve: impact on the social environment to improve health
Improving the health of the population requires an integrated approach, which includes not only medical interventions, but also changes in the social environment. There are many different approaches to improving the social environment that can be implemented at various levels:
IV.1. Political and legislative measures:
- Social policy: Development and implementation of social policy aimed at reducing inequality, combating poverty, ensuring the availability of education, healthcare, housing and other resources and opportunities.
- Legislation: The adoption of laws that protect the rights and interests of vulnerable population groups prohibit discrimination, regulating the labor market and ensure safe working and living conditions.
- Tax policy: The use of tax policy to redistribute income and financing of social programs.
IV.2. Public initiatives:
- Community development programs: Implementation of community development programs aimed at improving infrastructure, creating jobs, developing education, healthcare and other social services.
- Disease prevention programs: Implementation of diseases prevention programs aimed at changing health behavior, increasing awareness of risk factors and strengthening public health.
- Environmental improvement initiatives: The implementation of initiatives to improve the environment aimed at reducing air and water pollution, the creation of green areas and recreational facilities, as well as ensuring safe living conditions.
- Initiatives to strengthen social ties: The implementation of initiatives to strengthen social ties aimed at creating opportunities for communication and interaction, supporting social networks and developing social skills.
IV.3. Individual and family interventions:
- Family support programs: Implementation of family support programs aimed at improving relations between parents and children, reducing the level of stress in the family and developing education skills.
- Social skills development programs: Implementation of programs for the development of social skills aimed at teaching people’s communication skills, conflict resolution, stress and self -efficiency.
- Psychological support programs: The provision of psychological support to people experiencing stress, depression, anxiety or other mental health problems.
- Healthy lifestyle programs: Implementation of a healthy lifestyle aimed at changing health behavior, such as smoking, drinking alcohol, nutrition and physical activity.
IV.4. Intersectoral cooperation:
Improving the health of the population requires intersectoral cooperation between various departments and organizations such as healthcare, education, social security, employment, housing construction, transport and environmental protection. Intersectoral cooperation allows you to develop and implement complex approaches to improving the health of the population, which take into account all aspects of the social environment.
V. Problems and challenges: overcoming obstacles to a healthy social environment
Despite the fact that the influence of the social environment on health has been well studied, there are significant problems and challenges on the way to creating a healthy social environment.
V.1. Social inequality:
Social inequality is one of the main obstacles to a healthy social environment. The uneven distribution of resources and capabilities leads to the fact that some people have more opportunities to protect their health, while others have less. The fight against social inequality requires an integrated approach, which includes political, economic and social measures.
V.2. Political will and resources:
The implementation of programs and initiatives aimed at improving the social environment requires political will and significant financial resources. The lack of political will and resources may impede the implementation of effective measures to improve public health.
V.3. The complexity and versatility of the social environment:
The social environment is a complex and multifaceted system, which complicates the development and implementation of effective measures to improve public health. It is necessary to take into account all aspects of the social environment and their interaction with each other.
V.4. Dimension and evaluation influences:
Measurement and assessment of the influence of social factors on health is a difficult task. It is necessary to develop and use reliable methods for assessing the effectiveness of various measures to improve the social environment.
V.5. Sustainability of changes:
Ensuring the stability of changes in the social environment is an important task. It is necessary to develop and implement programs and initiatives that will be stable in time and will be able to have a long -term effect on the health of the population.
VI. Prospects and future directions: new research and approaches
Studies in the field of social environment and health continue to develop, opening up new prospects and directions to improve public health.
VI.1. Epigenetics:
The study of the epigenetic mechanisms through which the social environment affects the expression of genes, opens up new opportunities for understanding the biological mechanisms of the influence of the social environment on health.
VI.2. Neuronauka:
The study of the influence of the social environment on the development of the brain and the functioning of the nervous system allows you to better understand how social experience forms human behavior and health.
VI.3. Big data and analysis of social networks:
The use of big data and analysis of social networks allows you to study social ties and their effect on health on a large scale.
VI.4. Development of new social interventions:
The development and evaluation of the effectiveness of new social interventions aimed at improving the social environment and strengthening the health of the population is an important area of research.
VI.5. Integration of social determinants of health into a healthcare system:
The integration of social determinants of health into the healthcare system, that is, taking into account social factors in the diagnosis, treatment and prevention of diseases, is an important step towards improving the health of the population.
VII. Global context: social environment and health in different countries
The influence of the social environment on health varies depending on the country and the region. Socio-economic conditions, cultural norms and values, the political system and healthcare system have a significant impact on the health of the population.
VII.1. High income countries:
In countries with a high level of income, the main problems are social inequality, stress, social isolation, as well as problems associated with the way of life, such as smoking, alcohol and unhealthy nutrition.
VII.2. Countries with an average income:
In countries with an average income, the main problems are poverty, lack of access to resources and capabilities, adverse working and living conditions, as well as infectious diseases.
VII.3. Low income countries:
In countries with low income, the main problems are poverty, hunger, lack of access to pure water and sanitation, infectious diseases and maternal and child mortality.
VIII. Examples of successful programs: what works in improving the social environment
There are many successful programs aimed at improving the social environment and strengthening public health.
VIII.1. Early development programs of children:
Programs of early development of children, such as Head Start in the United States, are aimed at improving the health, education and social well -being of children from low -income families.
VIII.2. Family support programs:
Family support programs, such as Sure Start in the UK, are aimed at improving relations between parents and children, reducing the level of stress in the family and developing education skills.
VIII.3. Community development programs:
Community development programs, such as Harlem Children’s Zone in the United States, are aimed at improving infrastructure, creating jobs, developing education, healthcare and other social services in dysfunctional areas.
VIII.4. Poverty fighting programs:
Poverty fighting programs, such as Bolsa Familia in Brazil, are aimed at providing financial assistance to low -income families and improving their access to education, healthcare and other social services.
IX. The role of individual specialists: the contribution of various professions
Improving the social environment and strengthening the health of the population requires the participation of specialists from various professions.
IX.1. Doctors and medical workers:
Doctors and medical workers should take into account social determinants of health in the diagnosis, treatment and prevention of diseases.
IX.2. Social workers:
Social workers provide assistance to people who have difficulty in connection with poverty, unemployment, social