Determinan Sosial

Kesehatan : Tingkat
Masyarakat

Disampaikan oleh:
Yayi Suryo Prabandari

BAGIAN ILMU KESEHATAN MASYARAKAT

FAKULTAS KEDOKTERAN
UNIVERSITAS GADJAH MADA
Apa yang akan kita
diskusikan?
Rasional diperlukannya pemahaman
tentang Determinan sosial kesehatan
Apakah yang dimaksud dengan determinan

sosial kesehatan?
LATAR BELAKANG PERLUNYA PEMAHAMAN
TENTANG:
SOCIAL DETERMINANTS
OF HEALTH
WHOs Commission on Social
Determinants of Health (2008)
established the following overarching
recommendations:
improve the conditions of daily life - the
circumstances in which people are born, grow,
live work and age memperbaiki kondisi
kehidupan sehari-hari

tackle the inequitable distribution of power,

money and resources - the structural drivers
of those conditions of daily life globally,
nationally and locally; mengendalikan
distribusi kekuatan, uang dan sumber yang
tidak seimbang
WHOs Commission on Social
Determinants of Health (2008)
established the following overarching
recommendations:
measure the problem,
evaluate action,
expand the knowledge base,
develop a workforce , that is trained
in the social determinants of health,
and
raise public awareness about the
social determinants of health.
In may 2009 the sixty-second World Health
Assembly, after having considered the report of
the WHO Commission, recommended to all
Member States:

to tackle the health inequities within and across

countries through political commitment on the
main principles of 'closing the gap in a generation
as a national concern, as is appropriate, and

to coordinate and manage inter-sectoral action for

health in order to mainstream health equity in all
policies, where appropriate, by using health and
health equity impact assessment tools;
In may 2009 the sixty-second World Health Assembly,
after having considered the report of the WHO
Commission, recommended to all Member States:

to develop and implement goals and strategies to

improve public health with a focus on health
inequities;

to take into account health equity in all national

policies that address social determinants of health,
and to consider developing and strengthening
universal comprehensive social protection policies,
including health promotion, disease prevention and
health care, and promoting availability of and access
to goods and services essential to health and well-
being;
More recently, In may 2009 the sixty-second
World Health Assembly, after having
considered the report of the WHO
Commission, recommended to all Member
States:

to ensure dialogue and cooperation among

relevant sectors with the aim of integrating
consideration of health into relevant public
policies and enhancing inter-sectoral action;

to increase awareness among public and private

health providers on how to take account of social
determinants when delivering care to their
patients;
In may 2009 the sixty-second World
Health Assembly, after having
considered the report of the WHO
Commission, recommended to all
Member States:
to contribute to the improvement of the daily
living conditions contributing to health and social
well-being across the lifespan by involving all
relevant partners, including civil society and the
private sector;

to contribute to he empowerment of individuals

and groups, especially those who are
marginalized, and take steps to improve the
societal conditions that affect their health;
In may 2009 the sixty-second World Health
Assembly, after having considered the report
of the WHO Commission, recommended to all
Member States:
to generate new, or make use of
existing, methods and evidence,
tailored to national contexts in
order to address the social
determinants and social gradients
of health and health inequities;
In may 2009 the sixty-second World Health
Assembly, after having considered the report
of the WHO Commission, recommended to all
Member States:

to develop, make use of, and if

necessary, improve health information
systems and research capacity in order
to monitor and measure the health of
national populations, with
disaggregated data such as age, gender,
ethnicity, race, caste, occupation,
education, income and employment
where national law and context permits
so that health inequities can be detected
and the impact of policies on health
equity measured
Determinan Sosial
Kesehatan
WHO Commission on Social
Determinants of Health (2008)

Thedeterminants of health include the

social, physical and economic
environments, as well as individual
characteristics and behaviors.

The context of peoples lives determines

their health, not less than their genetic
inheritance and their personal choices and
way of life thus, health is inappropriate
These determinants include factors
such as:

Income and social status higher income and

social status are linked to better health. The
greater the gap between the richest and
poorest people, the greater the differences in
health;

education - low education levels are linked

with poor health, more stress and lower self
confidence;

physical environment - safe water and clean

These determinants include factors
such as:

employment and working conditions - people

in employment are healthier, particularly
those who have more control over their
working conditions;

social support networks - greater support

from families, friends and communities is
linked to better health;

culture - customs and traditions, and the

beliefs of the family and community all affect
These determinants include factors such
as:

genetics - inheritance plays a part in determining

lifespan, healthiness and the likelihood of
developing certain illnesses;

personal behavior and coping skills - balanced

eating, keeping active, smoking, drinking and how
we deal with life's stresses and challenges all affect
health;

health services - access and use of services that

prevent and treat disease influence

gender - men and women suffer from different types

Fakta
Penyebab Kematian Terbanyak
Negara berkembang Negara Maju
Berat badan kurang Penyakit yang berhubungan dengan penggunaan
tembakau
HIV/AIDS Penyakit jantung iskemik
Infeksi saluran pernafasan bawah Depresi unipolar dan penyakit serebrovaskular
Kondisi perinatal dan penyakit diare Gangguan akibat konsumsi alcohol
Malaria Kehilangan pendengaran onset dewasa
Kondisi maternal PPOK
Depresi unipolar Kecelakaan lalu lintas
Penyakit jantung iskemik Kanker paru/tracheal dan bronchial
Campak Alzheimer dan demensia lainnya
TBC Cidera yang disebabkan diri sendiri
18
 Gaya Hidup dan
Kesehatan
Evolusi
Budaya: perubahan adaptif
budaya untuk menghadapi tekanan
lingkungan

Gaya Hidup: perilaku seseorang,

cara hidup seseorang

Adanya evolusi budaya menyebabkan

perubahan gaya hidup

19
THE
HEALTH
HIRARCHY
HIRARKI
KESEHATAN
HIRARKI
KESEHATAN DAN
SAKIT PADA
MANUSIA
KAITAN ILMU
SOSIAL DAN
MASALAH
KESEHATAN
SEBUAH CONTOH:
PENYEBAB
KEMATIAN ANAK
Diskusikanlah
Adanya kepercayaan bahwa:
Ibu hamil tidak boleh makan ikan
Anak yang diare merupakan tanda anak tersebut
tumbuh besar
Remaja putri di Jawa Tengah tidak diperbolehkan
makan rempela, brutu, usus serta pisang dan
nanas
Partus lama ibunya banyak dosa
Perspective
Emic: Etic:
Outsider view of the
Insider view of the world
world
Community view
Researcher view
Individual view Health care worker

view
Perspektif
Illness/Sakit:
Menunjuk pengalaman
rasa sakit/distress
Menggambarkan efek
pada yg menderita dan
Disease/Penyakit: bgmn hal tsb
Deskripsi profesional mempengaruhi yg lain
Fokus pada:
sebuah penyakit Apa yg penyebabnya &
Perspektif biomedis siapa yang terpengaruh
Apa yg dilakukan setelah itu
Fokus pada kontrol
Apa yg terjadi pada saat
dan pengobatan Anda menderita karena sakit
Renungkan
Tingginya angka kematian ibu
Mengapa jumlah perokok di Indonesia

begitu tinggi?
Mengapa seseorang yang telah mengetahui

manfaat olah raga tidak melakukan olah

raga secara teratur dan terukur?
Terima kasih atas perhatian
Ibu/Bp/saudara