There are many social determinants in a country that all come into play and affect the health of its citizens. The World Health Organization sees some factors that come into play in terms of social determinants of health are stress, social exclusion, social support and unemployment, to name a few (WHO 2003). For my topic on PTSD prevalence in Peruvian women, I would like to focus on the factor of social support.
According to the World Health Organization, those that lack social and emotional support from others are more likely to experience a lesser well-being feeling, along with higher rates of depression (WHO 2003). The WHO also mentions that it’s suggested that good social relations can reduce the physiological response to stress (WHO 2003). In Peru, women in the Andean region are the most physically abused women in the world, with women in Lima, Peru, not too far behind. This abuse is widely tolerated by both men and sometimes even women (Rondon 2009). They don’t have any kind of social support from their peers or spouses to stop the violence, which plays a huge role in the amounts of PTSD diagnoses the country sees. Not only do they not have the social support from the community to seek help for the abuse, there isn’t any support from counselors or mental health care facilities, because there isn’t any mental healthcare at the primary level. The health care treatment that is available to women in Peru are in psychiatric hospitals, that are often very very far from their homes, so it really keeps people from seeking the help that they want. According to the article by Bonnefoy et al., the unequal distribution of the social determinants of health produce inequalities in health (Bonnefoy et al. 2007). I think that the lack of access of mental health clinics is definitely an unequal distribution of social determinants of health, since we see that social and emotional support is a determinant of health. If they can’t turn to their peers or government because they condone the behavior that they are experiencing, then they should at least be able to have the access to talk to someone who is able to give them the social and emotional support they need.The unavailability and inaccessibility of mental healthcare is the most important human rights and public health issue in Peru, Rondon (2009) argues. The women in Peru don’t even have the government to turn to for support, because while it’s illegal, getting abused by your husband as seen as a common part of marriage, and that everyone has to go through it. These people don’t have social or emotional support available to them in any form, and I believe that’s a huge reason why so many people develop PTSD. I could also argue that social exclusion plays a role in their determinants of health. Women are so socially excluded from education and employment opportunities compared to men. The community would rather give an educational opportunity to a male than a female, and women aren’t really allowed a social life, since they mostly sit at home and take care of the children, clean the house, and prepare meals. They aren’t often aware of the resources outside of their house, and even if they were, they would be offered to a male before it was offered to them. I feel as if all these factors really play a role in these women’s health.
Bonnefoy, Josiane, et al. “Constructing the Evidence Base on the Social Determinants of Health: A Guide.” National Institute for Health and Clinical Excellence, Nov. 2007.
Rondon, Marta B. “Peru: Mental Health in a Complex Country.” International Psychiatry , vol. 6, no. 1, Jan. 2009
Wilkinson, Richard, and Michael Marmot. “Social Determinants of Health: The Solid Facts.” Anthropology MSU, World Health Organization, 2003, anthropology.msu.edu/anp270-us18/files/2015/05/Soc-Determs-of-Hlth-the-solid-facts-WHO-2003.pdf.