Health is no longer a simple concept of “no disease”. It is a concrete manifestation of people’s social function, which is a good adaptation state in the social context in which they live. In the development of modern society, having health is one of the basic rights that everyone enjoys, and it does not vary according to differences in race, creed, economic and social conditions. However, based on the current differences in society and politics and its development, and its impact on health, the phenomenon of unhealthy health has become a worldwide health problem.
‘When discussing the relative importance of social determinants and medical care for health outcomes, a critical distinction must be made between cross-sectional variation in health at a point in time and changes in health outcomes over time. In studies across states, cities, and other geographical regions, differences in the quantity of medical care are easily controlled for, and the frontier of medical science and technology is, for all practical purposes, similar everywhere.'(Fuchs, 2017) And today’s activity I will study on the neighborhood Social Determinants of Public Health in Shenzhen, China, focus on Prevalent Non-communicable Chronic Diseases. ‘During the accelerating urbanization process, an obvious transition from a widespread of infectious diseases to the prevalence of non-communicable diseases (NCDs) has occurred across the globe, which substantially increases the health burdens of the global population (Gong et al. 2012; Fano et al. 2013).'(Pi, 2018)
Shenzhen is the first special economic zone established after China’s reform and opening-up policies and has become a famous international city. Near to Hong Kong, it enjoys a unique context for development. In 2014, it has a high GDP which reaches 1450 billion yuan, ranking the fourth highest in China (Shenzhen Statistical Yearbook 2014). Even though it has experienced significant improvements in healthcare, socioeconomic disparities still exist in most areas. The total annual investment in health in 2014 was 8.3 billion yuan, only 3.85% of the total municipal fiscal expenditure (Shenzhen Health Statistical Yearbook 2014). With a huge number of migrants flowing into Shenzhen during the past decades, it has generated polarized demographic structure and residential patterns. The increased gap in the capital and social ties, as well as wealth between people, is the inevitable cause of polarization of health service provision and health outcomes in Shenzhen (Su et al. 2016a; 2016b; Wan and Su 2016; Weng et al. 2016). (Pi, 2018)
The main finding is that the incidence rates of three NCDs are significantly related to certain social determinants. Results of spatial binary regression do not show an association between the income variable with the prevalent NCDs. And the other four domains related to the incidence rates of diseases indicates that people with more disadvantages in socioeconomic status (e.g. no job, poor housing condition, etc.) are more likely to put their health at greater risks.
Results show that social determinants change with three noncommunicable diseases, and they have some similarities. Spatial binary regression identifies four principle social determinants of NCDs prevalence: employment, income, housing, and demographic structure. One essential social determinant (percentage of the floating population) is identified for all the three diseases by stepwise regression. The study highlights that the main social determinant related to the incidence rates of all NCDs is the indicator of demographic structure denoting the percentage of the floating population. Today’s study identifies and describes the understanding of the essential social determinants of NCDs in China.
Therefore, based on this, China can improve the importance of social determinants of health in light of China’s national conditions. Strengthen the leading role of the government and the functions of the health system, and strengthen cooperation and collaboration among various departments. Promote increased investment in relevant sectors affecting health, pay attention to the health needs of the poor, and prevent the emergence of poverty due to illness. To effectively address the health inequities caused by healthy social determinants.
Fuchs, Victor R. “Social Determinants of Health: Caveats and Nuances.” Jama, vol. 317, no. 1, 2017, pp. 25-26.
Pi, Jianhua, et al. “Neighborhood Social Determinants of Public Health: Analysis of Three Prevalent Non-Communicable Chronic Diseases in Shenzhen, China.” Social Indicators Research, vol. 135, no. 2, 2018, pp. 683-698.