CDE Appendix 1 Literature Review - Central East Local Health ...

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The Culture, Diversity and Equity Project: Literature Review Figure 2.5 Dahlgren & Whitehead Model of the Determinants of Health Source: New Zealand Ministry of Health, 2002. Adapted from Dahlgren and Whitehead (1991). The integrative model accounts for a host of health determinants including: • Individual lifestyle factors – for example, whether we smoke, exercise, how much alcohol we drink • Social and community influences – for example, whether we belong to strong social networks, feel valued and empowered to participate in decisions that affect our health and wellbeing • Living and working conditions – for example, whether we live in safe housing and have decent working conditions • Culture, ethnicity and gender – for example, women, Maori and Pacific peoples are over-represented in lower paid jobs • General socioeconomic and environmental conditions – for example, our position in society, including income, education and employment, which affects our ability to participate (Ministry of Health, 2002, p.1-2). A more developed causal model of the determinants of health is elaborated in the body of the (2002) New Zealand Ministry of Health Strategy paper, as featured below (see Figure 2.6): 22
The Culture, Diversity and Equity Project: Literature Review Figure 2.6: New Zealand integrative model of the determinants of health Source: New Zealand Ministry of Health, 2002, p.16; Adapted from Howden-Chapman and Tobias, 2000. Most distinguishing of this top-down causality model is the way in which it envisions “the structure of society” as strongly conditioning individual health and health-related behaviour (p.16-17). New Zealand Intervention Framework The (2002) New Zealand Ministry of Health Strategy paper goes on to elaborate an intervention framework on the basis of the determinant of health models in Figure 2.5 and Figure 2.6. The intervention framework also draws on an intervention framework developed by Mackenbach (1998), which identifies four possible points of intervention to reduce socioeconomic inequalities in health (as shown in figure 2.7). 23
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REFERENCES ACAS [Advisory Conciliat
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