Activity Post 6

“Social Determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks” (healthypeople.org). In Haiti poverty affects a wide range of health, functioning, and quality of life and outcomes and risks. This includes being sick and unable to see a doctor because of financial reasons. Not being able to attend school, and even not having a place to sleep at night. Poverty is essentially the cost of being poor in your everyday life. In Haiti, poverty and HIV go hand in hand in determining health. With an estimated HIV prevalence of 1.9% (CDC, 2017) and over 6 million Haitians below the poverty line of earning less than $2.41, and more than 2.5 million fall below the extreme poverty line of us $1.23 per day (World Bank). With poverty being so prevalent many Haitians, women specifically, turn to sex work to earn a wage which almost always comes with the unwanted guest HIV.

            Michael Marmot writes about the Social determinants of poverty saying, “It’s not difficult to understand how poverty in the form of material deprivation –dirty water, poor nutrition-allied to lack of quality medical care an amount for the tragically foreshortened lives of people…” (Social Determinants of Health Inequalities). He goes on detailing how relief is not always placed in the right spot, “…relief of such material deprivation is not simply a technical matter of providing clean water or better medical care. Who gets these resources is socially determined”. The idea is that government policies have created this type of inequality and while Haiti has combated some issues regarding HIV, like getting proper medicine to those infected, poverty is still an underlying problem that will always be throwing coal into the fire known as HIV.

            Like social determinants of health, politics play into shaping and molding the environment people exist in. Public policy molds the social environment of Haiti which molds health. “Laws are cultural values that are articulated and written down” (Lecture 6.2). That’s a good way to think about how policy comes to be laws. Politics has a lot of similarities to health. John Mackenbach writes, “Like health care, it has structures, processes, outputs and outcomes” (Political Determinants of Health). When policy ignores facts [inequalities], it’s setting up low standards for health. “Unemployment puts health at risk, and the risk is higher in regions where unemployment is widespread” (Social Determinants of Health the Solid Facts). Haiti has an unemployment rate of 13.5% (Statista), good for top 30 in the world. The Solid Facts continues saying that, unemployed people have an increased chance of a premature death of themselves or a family member. In Haiti, unemployed women look for work in an unsafe climate. Whether it’s violence against them, or running the risk of catching HIV women are in danger and increase their chance of a premature death. Political changes would kick start the shifting of social determinants of health to be more beneficial to the people.

            In 2014 the government of Haiti finally outlawed human trafficking (refworld). This is a clear example of how changing policy has improved determinants of health. Now that there are consequences the number of trafficking cases are going down. However, “Haiti’s weak judicial system and lack of awareness about trafficking among police, prosecutors, and judges hindered prosecution and conviction of traffickers” (2019 Trafficking in Persons Report: Haiti). There is still more work to do for Haiti – the social determinants of health are eager to keep Haitians life expectancy the same.

“Haiti – CDC Division of Global HIV & TB – Country Profile.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/globalhivtb/where-we-work/haiti/haiti.html.

“Haiti – Unemployment Rate 2008-2018.” Statista, www.statista.com/statistics/808531/unemployment-rate-in-haiti/.

“Haiti – United States Department of State.” U.S. Department of State, U.S. Department of State, www.state.gov/reports/2019-trafficking-in-persons-report-2/haiti/.

Mackenbach, J. P. “Political Determinants of Health.” The European Journal of Public Health, vol. 24, no. 1, 2014, doi:10.1093/eurpub/ckt183.

“Overview.” World Bank, www.worldbank.org/en/country/haiti/overview.

Siegrist, Johannes, and Michael Marmot. “Social Inequalities in Health.” 2006, doi:10.1093/acprof:oso/9780198568162.001.0001.

“Social Determinants of Health.” Social Determinants of Health | Healthy People 2020, www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health.

United Nations. “2014 Trafficking in Persons Report – Haiti.” Refworld, www.refworld.org/docid/53aab9f114.html.

Wilkinson, Richard G., and Michael Marmot. Social Determinants of Health: the Solid Facts. World Health Organization, Regional Office for Europe, 2003.

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