HS869-7-AU-CO:
Social Determinants of Health
2023/24
Health and Social Care (School of)
Colchester Campus
Autumn
Postgraduate: Level 7
Current
Thursday 05 October 2023
Friday 15 December 2023
15
25 September 2023
Requisites for this module
(none)
(none)
HS887
(none)
HS856
MSC L43912 Global Public Health
The social environment we live in is widely recognised as shaping patterns of health and illness within and across populations. In the UK and beyond the importance of understanding the factors, processes and institutions through which these patterns are shaped and (ill)health produced is necessary for developing appropriate policy and systems responses for well-being.
This module explores the relationship between the multiple determinants of individual and population health and health inequalities.
Students will be asked to explore health issues from various scholarly perspectives, to reflect critically on the role of determinants in different societies, and to engage in classroom debate on a broad and varied range of scholarly literature.
This Module examines the social-economic, cultural, political, ecological and commercial factors that determine health and well-being, and the theories underlying unfair and avoidable differences in distribution of these determinants in society.
The Module will provide students with a critical understanding of the multi-demographic and socioeconomic variables and distribution of resources and power at global, national, and local levels. It will also have students explore policy interventions and civil society actions to reducing health inequalities, nationally and globally (e.g. community audits, citizens hearings, commercial taxation…). The module will also provide students with the opportunity to develop their research and presentation skills through engaging in an innovative research assignment.
1. Understand the range of factors that influence health at population level including social, economic, and political factors
2. Be able to appreciate and critically apply major theoretical perspectives- historical and contemporary- to the explanation and analysis of health inequalities and the social determinants of health.
3. Demonstrate an evidence-based understanding of disparities in the distribution of health and its fundamental social causes.
4. Be aware of contemporary debates regarding the causes of health inequalities between population groups categorised by socioeconomic position/social class, ethnicity, gender, place and other social divisions.
5. Have a critical understanding of different approaches to improving health and reducing health inequalities, including their theoretical and empirical underpinnings.
6. Employ innovative investigative approaches to identifying health gaps and present the results of their research.
Introduction: What are the Social Determinants of Health?
Utilizing Classical and Contemporary Theory to Understand Health Inequalities
Individual & Societal level:
The Social Gradient in Health – Examining Class and Socio-Economic position
Sex, Gender and Health
Race/Ethnicity/Indigeneity and Health
Institutional & Macro level:
Political and Economic Context
Commercial Determinants of Health
Environmental Conditions and Health
Migration Marginality, Citizenship and Health
Policy Approaches and Civil Society Actions to Improve Health and Reduce Health Inequalities
An intersectionality- informed EDI framework by Prof. Kapilashrami guides the teaching and learning cycle in which the module design and delivery are embedded. The framework adopts intersectional thinking and principles and applies these to three stages of the teaching and learning cycle- content design, classroom delivery, and wider institutional contexts – to ensure inclusivity, diversity and responsibility in teaching practices.
To deliver on these objectives this module will include a blend of learning and teaching methods. Sessions will begin with an expert led lecture which will then transition to guided debates and smaller group learning opportunities. The expert led group debates on the key topic covered in each lecture will be integral to the learning experience. They will ensure that students have the opportunity to learn from one another’s’ diverse experiences and help students move beyond theory and apply their reading and classroom learning to analysing diverse challenges in local, national and/or global health. In addition, several sessions will include specific topic discussions, which will be student lead, providing students with the opportunity to develop presentation and discussion skills.
As expanded on below, the structure and pedagogical approach in this module will contribute to decolonising the public health academy. For this module the readings include both “mainstream” perspectives and those that challenge the dominant narratives. In addition, at least one session will include an expert speaker from other faculties helping to bring a diverse disciplinary perspective to the session.
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John Ashton and Lowell Levin (2021)
Public Health Explored. Critical Publishing. Available at:
https://ebookcentral.proquest.com/lib/universityofessex-ebooks/detail.action?docID=6550593.
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Bambra, C., Hill, S. and Smith, K.E. (2016)
Health inequalities?: critical perspectives. Oxford: Oxford University Press. Available at:
https://doi.org/10.1093/acprof:oso/9780198703358.001.0001.
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Arcaya, M.C., Arcaya, A.L. and Subramanian, S.V. (2015) ‘Inequalities in health: definitions, concepts, and theories’,
Global Health Action, 8(1). Available at:
https://doi.org/10.3402/gha.v8.27106.
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World Health Organisation Social Determinants of Health (no date). Available at:
https://www.who.int/health-topics/social-determinants-of-health.
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Marmot, M. and Allen, J.J. (2014) ‘Social Determinants of Health Equity’,
American Journal of Public Health, 104(S4), pp. S517–S519. Available at:
https://doi.org/10.2105/AJPH.2014.302200.
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Ashton, J. and Levin, L. (2021) ‘The world is a fast flowing river’, in
Public Health Explored: 50 stories to change the world. Critical Publishing. Available at:
https://ebookcentral.proquest.com/lib/universityofessex-ebooks/reader.action?docID=6550593&ppg=28.
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McMahon, N.E. (2022) ‘Framing action to reduce health inequalities: what is argued for through use of the “upstream–downstream” metaphor?’,
Journal of Public Health, 44(3), pp. 671–678. Available at:
https://doi.org/10.1093/pubmed/fdab157.
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McKinlay, J.B. (1975) ‘A Case for Refocusing Upstream: The Political Economy of Illness’,
Applying Behavioral Science to Cardiovascular Risk: Proceedings of a Conference. Edited by A.J. Enelow and J.B. Henderson, pp. 7–17. Available at:
https://iaphs.org/wp-content/uploads/2019/11/IAPHS-McKinlay-Article.pdf.
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Göran, D. and Margaret, W. (2007) ‘Policies and strategies to promote social equity in health.’ Institute for Futures Studies. Available at:
https://core.ac.uk/works/2606994.
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Elliot, E., Popay, J. and Williams, G. (2016) ‘Chapter 16: Knowledge of the everyday: Confronting the causes of health inequalities’, in
Health Inequalities: Critical Perspectives. Oxford: Oxford University Press. Available at:
https://academic.oup.com/book/7138/chapter/151688272.
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Whitehead, M. (2007) ‘A typology of actions to tackle social inequalities in health’,
Journal of Epidemiology & Community Health, 61(6), pp. 473–478. Available at:
https://doi.org/10.1136/jech.2005.037242.
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Dahlgren, G. and Whitehead, M. (2021) ‘The Dahlgren-Whitehead model of health determinants: 30 years on and still chasing rainbows’,
Public Health, 199, pp. 20–24. Available at:
https://doi.org/10.1016/j.puhe.2021.08.009.
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DIDERICHSEN, F., Evans, T. and Whitehead, M. (no date) ‘The Social Basis of Disparities in Health’, in T. Evans et al. (eds)
Challenging Inequities in Health: From Ethics to Action. Available at:
https://doi-org.uniessexlib.idm.oclc.org/10.1093/acprof:oso/9780195137408.003.0002.
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Marmot, M.
et al. (no date) ‘Health Equity in England: The Marmot Review 10 Years On.’ Institute of Health Equity. Available at:
https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on.
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‘Closing the gap in a generation: health equity through action on the social determinants of health - Final report of the commission on social determinants of health’ (no date). Available at:
https://www.who.int/publications/i/item/WHO-IER-CSDH-08.1.
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Hawkes, S. and Buse, K. (2013) ‘Gender and global health: evidence, policy, and inconvenient truths’,
The Lancet, 381(9879), pp. 1783–1787. Available at:
https://doi.org/10.1016/S0140-6736(13)60253-6.
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Heise, L.
et al. (2019) ‘Gender inequality and restrictive gender norms: framing the challenges to health’,
The Lancet, 393(10189), pp. 2440–2454. Available at:
https://doi.org/10.1016/S0140-6736(19)30652-X.
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Ostlin, Piroska (2004) ‘Paying attention to gender and poverty in health research: content and process issues.’,
Bulletin of the World Health Organization, 82(10), pp. 740–745. Available at:
https://apps.who.int/iris/handle/10665/269247.
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Sen, G. and Iyer, A. (2012) ‘Who gains, who loses and how: Leveraging gender and class intersections to secure health entitlements’,
Social Science & Medicine, 74(11), pp. 1802–1811. Available at:
https://doi.org/10.1016/j.socscimed.2011.05.035.
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BRADBY, H. (2003) ‘Describing Ethnicity in Health Research’,
Ethnicity & Health, 8(1), pp. 5–13. Available at:
https://doi.org/10.1080/13557850303555.
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Nazroo, J.Y. (1998) ‘Genetic, Cultural or Socio-economic Vulnerability? Explaining Ethnic Inequalities in Health’,
Sociology of Health & Illness, 20(5), pp. 710–730. Available at:
https://doi.org/10.1111/1467-9566.00126.
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Krieger, N. (2001) ‘A glossary for social epidemiology’,
Journal of Epidemiology & Community Health, 55(10), pp. 693–700. Available at:
https://doi.org/10.1136/jech.55.10.693.
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Farmer, P. (2004) ‘An Anthropology of Structural Violence’,
Current Anthropology, 45(3), pp. 305–325. Available at:
https://doi.org/10.1086/382250.
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Browne, A.J. (2017) ‘Moving beyond description: Closing the health equity gap by redressing racism impacting Indigenous populations’,
Social Science & Medicine, 184, pp. 23–26. Available at:
https://doi.org/10.1016/j.socscimed.2017.04.045.
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RAMA BARU, ARNAB ACHARYA, SANGHMITRA ACHARYA, A K SHIVA KUMAR and K NAGARAJ (no date) ‘Inequities in Access to Health Services in India: Caste, Class and Region’,
Economic and Political Weekly, 45(38). Available at:
https://www.jstor.org/stable/25742094.
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Bauld, L. (2019) ‘Tobacco control: new resources, existing treaties, and emerging challenges’,
BMJ [Preprint]. Available at:
https://doi.org/10.1136/bmj.l4161.
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‘Costa Rica’s implementation of the Framework Convention on Tobacco Control: Overcoming decades of industry dominance’ (2016)
Salud publica de Mexico, 58(1). Available at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4758506/.
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Lencucha, R., Drope, J. and Labonte, R. (2016) ‘Rhetoric and the law, or the law of rhetoric: How countries oppose novel tobacco control measures at the World Trade Organization’,
Social Science & Medicine, 164, pp. 100–107. Available at:
https://doi.org/10.1016/j.socscimed.2016.07.026.
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Mamudu, H.M., Hammond, R. and Glantz, S.A. (2011) ‘International trade versus public health during the FCTC negotiations, 1999-2003’,
Tobacco Control, 20(1), pp. e3–e3. Available at:
https://doi.org/10.1136/tc.2009.035352.
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Labonté, R. (2019) ‘Neoliberalism 4.0: The Rise of Illiberal Capitalism Comment on “How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention”’,
International Journal of Health Policy and Management [Preprint]. Available at:
https://doi.org/10.15171/ijhpm.2019.111.
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Glasgow, S. and Schrecker, T. (2015) ‘The double burden of neoliberalism? Noncommunicable disease policies and the global political economy of risk’,
Health & Place, 34, pp. 279–286. Available at:
https://doi.org/10.1016/j.healthplace.2015.06.005.
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The Health Crises of Neoliberal Globalisation (2014)
Global Health Watch 4: An Alternative World Health Report. London: People’s Health Movement. Available at:
https://doi.org/10.5040/9781350220447.0007.
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Lencucha, R. and Thow, A.M. (2019) ‘How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention’,
International Journal of Health Policy and Management, 8(9), pp. 514–520. Available at:
https://doi.org/10.15171/ijhpm.2019.56.
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Smith, K.E., Bambra, C. and Hill, S.E. (eds) (2016)
Health inequalities: critical perspectives. Oxford: Oxford University Press. Available at:
https://dx.doi.org/10.1093/acprof:oso/9780198703358.001.0001.
The above list is indicative of the essential reading for the course.
The library makes provision for all reading list items, with digital provision where possible, and these resources are shared between students.
Further reading can be obtained from this module's
reading list.
Assessment items, weightings and deadlines
| Coursework / exam |
Description |
Deadline |
Coursework weighting |
| Coursework |
Group Assignment |
|
25% |
| Coursework |
2,500 word Essay |
|
75% |
Exam format definitions
- Remote, open book: Your exam will take place remotely via an online learning platform. You may refer to any physical or electronic materials during the exam.
- In-person, open book: Your exam will take place on campus under invigilation. You may refer to any physical materials such as paper study notes or a textbook during the exam. Electronic devices may not be used in the exam.
- In-person, open book (restricted): The exam will take place on campus under invigilation. You may refer only to specific physical materials such as a named textbook during the exam. Permitted materials will be specified by your department. Electronic devices may not be used in the exam.
- In-person, closed book: The exam will take place on campus under invigilation. You may not refer to any physical materials or electronic devices during the exam. There may be times when a paper dictionary,
for example, may be permitted in an otherwise closed book exam. Any exceptions will be specified by your department.
Your department will provide further guidance before your exams.
Overall assessment
Reassessment
Module supervisor and teaching staff
Prof Ewen Speed, email: esspeed@essex.ac.uk.
Student Programme Administrator: Ashwini Bharambe
E: gph@essex.ac.uk
No
No
Yes
Prof Theodore Schrecker
Population Health Sciences Institute, Newcastle University
Professor of Global Health Policy
Available via Moodle
Of 35 hours, 35 (100%) hours available to students:
0 hours not recorded due to service coverage or fault;
0 hours not recorded due to opt-out by lecturer(s), module, or event type.
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