Social Determinants of Health--论文代写范文

加拿大被联合国确定为世界上最宜居的国家。加拿大是世界上最有钱的国家之一，这掩盖了贫困的现实,社会排斥和歧视,就业质量等问题。加拿大人民没有医疗或健康的生活方式选择。这篇essay代写范文继续进行论述。

Introduction
  We have known for a very long time that health inequities exist. These inequities affect all Canadians but they have especially strong impacts upon the health of those living in poverty. Adding social sciences evidence – the understanding of social structures and of power relationships – we have now accumulated indisputable evidence that “social injustice is killing people on a grand scale.” When the World Health Organization’s Commission on Social Determinants of Health published its final report (containing the quote above) that demonstrated how the conditions in which people live and work directly affect the quality of their health, we nodded in agreement. 

  Everyone agrees that populations of Bangladesh, Sierra Leone or Haiti have low life expectancy, are malnourished, live in fearful and unhealthy environments, and are having a terrible time just trying to survive. But what does that have to do with us in Canada? For years, we bragged that we were identified by the United Nations as “the best country in the world in which to live”. We have since dropped a few ranks, but our bragging continues. We would be the most surprised to learn that, in all countries – and that includes Canada – health and illness follow a social gradient: the lower the socioeconomic position, the worse the health. The truth is that Canada – the ninth richest country in the world – is so wealthy that it manages to mask the reality of poverty, social exclusion and discrimination, the erosion of employment quality, its adverse mental health outcomes, and youth suicides. While one of the world’s biggest spenders in health care, we have one of the worst records in providing an effective social safety net.

  The primary factors that shape the health of Canadians are not medical treatments or lifestyle choices but rather the living conditions they experience. These conditions have come to be known as the social determinants of health. The importance to health of living conditions was established in the mid-1800s and has been enshrined in Canadian government policy documents since the mid-1970s. In fact, Canadian contributions to the social determinants of health concept have been so extensive as to make Canada a “health promotion powerhouse” in the eyes of the international health community. 

  Recent reports from Canada’s Chief Public Health Officer, the Canadian Senate, and the Public Health Agency of Canada continue to document the importance of the social determinants of health. But this information – based on decades of research and hundreds of studies in Canada and elsewhere – tells a story that is unfamiliar to most Canadians. Canadians are largely unaware that our health is shaped by how income and wealth is distributed, whether or not we are employed, and if so, the working conditions we experience. 

  Furthermore, our wellbeing is also determined by the health and social services we receive, and our ability to obtain quality education, food and housing, among other factors. And contrary to the assumption that Canadians have personal control over these factors, in most cases these living conditions are – for better or worse – imposed upon us by the quality of the communities housing situations, our work settings, health and social service agencies, and educational institutions with which we interact. There is much evidence that the quality of the social determinants of health Canadians experience helps explain the wide health inequalities that exist among Canadians. 

  How long Canadians can expect to live and whether they will experience cardiovascular disease or adult-onset diabetes is very much determined by their living conditions. The same goes for the health of their children: differences among Canadian children in their surviving beyond their first year of life, experiencing childhood afflictions such as asthma and injuries, and whether they fall behind in school are strongly related to the social determinants of health they experience. Research is also finding that the quality of these health-shaping living conditions is strongly determined by decisions that governments make in a range of different public policy domains. Governments at the municipal, provincial/territorial, and federal levels create policies, laws, and regulations that influence how much income Canadians receive through employment, family benefits, or social assistance, the quality and availability of affordable housing, the kinds of health and social services and recreational opportunities we can access, and even what happens when Canadians lose their jobs during economic downturns. 

  These experiences also provide the best explanations for how Canada compares to other nations in overall health. Canadians generally enjoy better health than Americans, but do not do as well as compared to other nations that have developed public policies that strengthen the social determinants of health. The World Health Organization sees health damaging experiences as resulting from “a toxic combination of poor social policies and programmes, unfair economic arrangements, and bad politics”. Despite this evidence, there has been little effort by Canadian governments and policymakers to improve the social determinants of health through public policy action. Canada compares unfavourably to other wealthy developed nations in its support of citizens as they navigate the life span. Our income inequality and poverty rates are growing and are among the highest of wealthy developed nations. Canadian spending in support of families, persons with disabilities, older Canadians, and employment training is also among the lowest of these same wealthy developed nations.（essay代写)

 STRESS, BODIES, AND ILLNESS
  People who suffer from adverse social and material living conditions also experience high levels of physiological and psychological stress. Stressful experiences arise from coping with conditions of low income, poor quality housing, food insecurity, inadequate working conditions, insecure employment, and various forms of discrimination based on Aboriginal status, disability, gender, or race. The lack of supportive relationships, social isolation, and mistrust of others further increases stress. At the physiological level, chronic stress can lead to prolonged biological reactions that strain the physical body. Stressful situations and continuing threats provoke “fight-or-flight” reactions. These reactions impose chronic stress upon the body if a person does not have enough opportunities for recovery in non-stressful environments. Research evidence convincingly shows that continuous stress weakens the resistance to diseases and disrupts the functioning of the hormonal and metabolic systems. Physiological tensions provoked by stress make people more vulnerable to many serious illnesses such as cardiovascular and immune system diseases, and adult-onset diabetes.（essay代写)

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