social and community networks

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14:24 .11 11-`social and community networks for health protection and promotion. This chapter introduces the reader to concepts such as social support, social capital and social dominance and discusses how these variables mediate health status. This chapter draws upon Marmot’s and Wilkinson’s (and others’) work on autonomy, control and the role of psychosocial pathways in explaining health gradients. The features of healthy communities are also explored, with the chapter debating what a healthy community is and how important this is for individuals living within such environments. The next layer of the model points to the importance of living and working conditions and food supply (among others) that are needed for the maintenance of health. Therefore chapter 10 pays attention to the physical environment as a health determinant. The chapter explores various aspects of living and working conditions based upon the rainbow model. The chapter analyses several different aspects of our living and working environments such as housing, health-care services, water and sanitation, and unemployment and employment. The chapter also considers broader issues such as agriculture and food production. Finally, Dahlgren and Whitehead (1991) identify the economic, cultural and environmental aspects of society as overall mediators of population health in the outer layer of the model. Hence, chapter 11 discusses policy as a health determinant. The chapter gives a general overview of social policy and then demonstrates that the many facets of policy that exist within our social environment combine to influence and determine our health in a number of ways. This chapter explores how social policy is related to health in a number of ways, looking at how policy is made, discussing the importance of ideology within policy and outlining the concept of healthy public policy. Fiscal policy is analysed too. The chapter also demonstrates the importance of the broader policy environment in determining good health, considering how a number of policy sectors can all have health impacts. Chapter 12 then turns to the global context in which health is situated. Although Dahlgren and Whitehead (1991) do not specifically identify the global context of health within their model, there is a case to be made for the importance of the global environment in determining some aspects of health. Chapter 12 therefore explores how health is influenced by globalization in a number of ways. The chapter examines how being part of a global society affects our health in both positive and negative ways, using the concept of globalization as a mechanism to explore global health issues, global patterns of health and disease, global inequality and global health governance. The final chapter in this book, chapter 13, Synthesizing Perspectives: Case Studies for Action, draws on material from the rest of the book to provide detailed case studies in order to explain how understanding the determinants of health can aid the development of public-health strategies and action. Each case study is linked to the Dahlgren and Whitehead (1991) model to demonstrate the range of determinants influencing the health issue. Through the case studies, this chapter gives examples of how to address contemporary public-health issues using a range of different approaches and methods. The case studies highlight key issues that feature throughout the book and are designed to provide insight and understanding for public-health practitioners. Finally, this chapter provides detailed discussion of the Dahlgren and Whitehead model, outlining its strengths and weaknesses and analysing its application to the understanding of public-health issues.

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