There are many aspects that make up the social determinants of health. Some examples of social determinants are access to health care, economic stability, education, neighborhood and environment, and social inclusion/exclusion. (Wilkinson and Marmot, 2003) All of these factors play a role in an individual’s overall health. This is essentially saying all the different people that make up a specific society have different levels of health based on the social determinants they have. In this blog post I will be fixated on the issues that the LGBT community faces when looking for appropriate health care in Ireland, and how social inclusion and exclusion can affect the LGBT community’s health.
“If the major determinants of health are social, so must be the remedies.” (Marmot 2005) It is obvious that the major determinant of health, that is being a part of the LGBT community, is a social issue. The leading religion in Ireland is Catholicism. This is important because according to this religion it is not natural to be homosexual. This is a belief that courses through the country of Ireland. This would lead someone who identifies as a part of the LGBT community to feel some social exclusion among their society. “Reducing these social inequalities in health, and thus meeting human needs, is an issue of social justice.” (Marmot 2005)
One issue that people in the LGBT community in Ireland face is “Only one in three participants believed that healthcare professionals have sufficient knowledge of LGBT issues,” (Sharek et. al. 2014) This is a serious issue because if the health care professionals have no knowledge on an issue how are they going to successfully treat a patient. This is another piece that connects to the social determinant of social exclusion. The fact that there are LGBT issues that heterosexual people do not face, health care professionals have little knowledge on how to help. Another part of the problem is that, “Lesbian, gay and bisexual people may be reluctant to discuss their sexuality with healthcare providers because of fears of possible negative consequences, including breaches of confidentiality and overt homophobia” (Mayock, Bryan, Carr, and Kitching 2009) There is a fear that once their community finds out that they are homosexual or identify with as something other that heterosexual there will be the negative consequences of social exclusion.
This is not to say that all health care professionals are trying to bring negative consequences upon people in the LGBT community. However, there is the issue that most people in Ireland follow the rules of Catholicism and that directly impacts how the politics are used. There are inequalities that the LGBT community face in Ireland and if public health professionals want to help the situation they may have to have better understanding of the politics of Ireland. “For public health professionals to use the political arena effectively… to tackle health inequalities, they must not only have a basic understanding of how politics works, but also know what the impact of politics on population health.” (Mackenbach 2014)
Mackenbach, Johan P. “Political Determinants of Health.” Department of Public Health, 2014, anthropology.msu.edu/anp270-us18/files/2015/05/Political-Determs-of-Hlth-Mackenbach-2014.pdf
Mayock, P., Bryan, A., Carr, N., & Kitching, K. (2009). Supporting LGBT Lives: A study of Mental Health and Well-Being of Lesbian, Gay, Bisexual and Transgender People. the Gay and Lesbian Equality Network (GLEN) and BeLonG To Youth Service, 2(4), 7-103. Retrieved from http://doras.dcu.ie/21638/1/SupportingLGBTLives.PDF
Sharek D.B., McCann E., Sheerin F., Glacken M. & Higgins A. (2015) Older LGBT people’s experiences and concerns with healthcare professionals and services in Ireland. International Journal of Older People Nursing 10, 230–240. doi: 10.1111/opn.12078
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.