For my week 6 activity post and for my final blog post, I have looked pretty deep into how social determinants affect Jamaican women and their overall health as well as how these determinant are partially responsible to huge crisis in Jamaica such as HIV/AIDS. Now when I am talking about social determinants, I am talking about factors such as early childhood events, poverty, drugs, working conditions, unemployment, social support, food and transportation, (WHO, 2003). A quick example that I spoke about a few weeks ago was about Jamaican women sex workers and their susceptibility to HIV/AIDS, and Jamaica is no exception to this. No sex worker, regardless on their ethnicity, race or culture, is going to reach out for help if consequences could lead to their arrest. Arrest means no money. Arrest means no more income for the family. Furthermore, political determinants can affect health regardless on if they are positive or negative (Mackenbach, 2014). The Caribbean region has definitely been susceptible in the past to HIV/AIDS. Thanks to social determinants, political factors as well as cultural variables, Jamaica, was responsible for the second most cases of HIV/ AIDS next to sub-Saharan Africa in 1999 (Gillespie-Johnson, 2008).
In my first article, “Social and Health Determinants of Well Being and Life Satisfaction in Jamaica,” a study was conducted where interviews were given to adults ranging between ages of 15 & 50. The goal was to measure a psychological Centre of Epidemiological Studies of Depression (CES-D) utilizing a Likert scale (Hutchinson, Simeon, Bain, Wyatt, Tucker & Lefranc, 2004). Information was collected and analyzed. The total amount of Jamaican participates was just over 2500 (approximately ⅔ women), and it was concluded that women had lower levels of psychological well being, (Hutchinson, Simeon, Bain, Wyatt, Tucker & Lefranc, 2004). This analysis went hand and hand with illness. Moreover, these Jamaican women had an overall lower level of satisfaction with their lives, (Hutchinson, Simeon, Bain, Wyatt, Tucker & Lefranc, 2004). This was best predicted by age, employment and marital status. The correlations that these topics have are not concrete, but based on what I have read, all of these variables, as well as social determinants, could be vital for future progression of health prevention. Even though the findings in this article concluded that social variables were more vital to understanding the idea of life satisfaction, and not as vital to understanding the mental well-being in Jamaican women, both variables go hand and hand and could lead to health complications, (Hutchinson, Simeon, Bain, Wyatt, Tucker & Lefranc, 2004).
In my second article, “HIV/AIDS Prevention Practices Among Recent-Immigrant Jamaican Women,” the study was taken from another perspective. This study was on heterosexual Jamaican women who had recently came to the United States. The purpose of the study was to explain how prevention knowledge, health-beliefs, cultural factors as well as how SOCIAL factors influence the behaviors of these women while utilizing the Health Belief Model, (Gillespie-Johnson, 2008). It seems to always be clear that HIV/ AIDS is a serious matter; however, these Jamaican women that were interviewed did not actually consider themselves to be vulnerable to the condition. It was actually shown that women in these studies did not use condoms as most of them lacked social related negotiating skills from their partners as well as feared physical and psychological abuse from their partners, (Gillespie-Johnson, 2008). In other words, women in Jamaica tend to be treated poorly by men in Jamaica, and it is socially acceptable. Like most issues, once a problem becomes a social issue, it is hard to reverse it. Moreover, it is not socially acceptable for Jamaican women to talk about social issues. The social factors embedded in migration also play a role as well. Social variables derived from migration include language barriers, poverty and the use of welfare programs, (Gillespie-Johnson, 2008). Now, these social factors are by no means directly responsible to HIV/ AIDS in Jamaican women, but they help shape the pathway that lead to the reasons why these Jamaican women are vulnerable to the condition in the first place. For example, when the cost of healthcare is too high, then medical care/ examination is almost impossible. If illegal migration is a factor, then it is definitely a possibility that there is no health care to purchase. Overtime, Jamaican women have shown interest on one-on-one intervention as the optimal methodology for educating/ spreading awareness on HIV/AIDS , (Gillespie-Johnson, 2008). Group discussion has also been an intervention topic of interest. That being said, like anybody else, Jamaican women would prefer if these group discussions included variables that would make them more comfortable attending.
I think it is important to note that all attempts of intervention and mediation that take place on these Jamaican women should be strategically tailored to the root causes/ determinants of health themselves. Meaning that social determinants of health will be effectively mediated through social forms of intervention, (Marmot, 2005). This includes the methods spoken about above.
Gillespie-Johnson, M., PhD. (2008). HIV/AIDS PREVENTION PRACTICES AMONG RECENT-IMMIGRANT JAMAICAN WOMEN. Ethnicity & Disease,18(2), 2nd ser., S2-S175. Retrieved August 6, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2864647/.
Hutchinson, G., Simeon, D. T., Bain, B. C., Wyatt, G. E., Tucker, M. B., & Lefranc, E. (2004). Social and Health Determinants of Well Being and Life Satisfaction in Jamaica. International Journal of Social Psychiatry,50(1), 43-53. doi:10.1177/0020764004040952
Mackenbach, J. P. (2014). Political determinants of health. The European Journal of Public Health,24(1), 2-2. doi:10.1093/eurpub/ckt183
Marmot, M. (2005). Social determinants of health inequalities. The Lancet,365(9464), 1099-1104. doi:10.1016/s0140-6736(05)71146-6
Wilkinson, R. G., & Marmot, M. (2003). Social determinants of health: The solid facts (2nd ed.). Copenhagen: World health organization, Regional Office for Europe. Retrieved from http://anthropology.msu.edu/anp270-us18/files/2015/05/Soc-Determs-of-Hlth-the-solid-facts-WHO-2003.pdf