Social determinants of health are important for policy maker, planners and officials of program implementation at all levels. The social characteristics are varied in every society. No program can be reached to the targeted population until they are not willing to accept and it must be accessible, available and affordable to them; moreover every health facilities, services and programs should be socially acceptable. India is a unique, diverse and multicultural country, its population is second largest in the world. More specifically, social determinants of health refer to the set of factors that contribute to the social patterning of health, disease, and illness. This presentation includes the gamut of aspects of social determinants of health and basic physiognomies of society and communities of India.

1. 4/12/2015 1
Impact of Social Inequality on Health:
An Indian Perspective
Presented by:
Yade Lal Tekhre
Former Director (Research)
National Human Rights Commission, India
&
Former Prof. of Sociology
National Institute of Health and Family Welfare
New Delhi, Government of India
4/12/2015

2. 4/12/2015
Socio-economic and cultural issues
Population and Demographic profile
Family and community based facts and
figures
Social problems and challenges
This presentation is based on
social determinants of health

3. • Second largest country in the world
• India lives in villages
• Social Stratification: caste & class
• Joint family system
• Economic disparity
• Poor health facilities
• Density of population
Basic features of India:
in relation to health
4/12/2015

4. Rate of Increase in Indian
Population
https://www.youtube.com
Per Year 1,55,31,000
Per Month 12,73,033
Per Day 42,434
Per Hour 1,768
Per Minute 29
4/12/2015

5. THE FAMILY AND COMMUNITY
• Unplanned pregnancy & unwanted child
• Early marriage and early pregnancy
• Socialization of the girl child
• Average age at marriage
• Gender inequality
• Child marriage
• Size of the family
• Son preference
4/12/2015

6. • Multiple pregnancies
• Low male participation in RCH
• Joint family system
• Gender discrimination
• Poor socialization of the girl child
• Stigma/Misconceptions about: food,
delivery of health care, disease etc
• Unsafe deliveries, poor ANC
registration/Institutional deliveries
• Dowry death; suicide rate
4/12/2015

7. Community & Society
• Basic occupation still agriculture
• Tribal, rural and scattered population difficult to
approach
• Alcoholism, crime rate, food habits,
• Poor health status: maternal and child health:
Anemia
• Illiteracy: poor enrolment, drop outs, quality of
education
4/12/2015

8. Violence and crime
• Violence against women (dowry deaths)
• Rape (a rape every 22 minutes) many unreported
• Religious complex
• Terrorism, naxalite caste related violence
• Female foeticide and infanticide
• Violation of human rights
• Child labour and slavery (bondage labour)
4/12/2015

9. • Human trafficking: women and children
women and girls are trafficked within the country for the
purposes of commercial sexual exploitation and forced
marriage especially in those areas where the sex ratio is
highly skewed in favour of men
• Violation of Human Rights
 Life, Liberty, Equality and Dignity
 Organ transplantation
 Primary health
 Lack of treatment of chronic/communicable disease
4/12/2015

11. Social stratifications
• Peculiar Class & Caste system
 inferiority complex
 cultural practices
 social status
 untouchability & discrimination
 social mobility
 endogamy
 restricted choice of occupation
4/12/2015

12. Economic status:
Poverty and unemployment
• Human Development Index Rank 136
• 0ut of 186 countries Low per capita income
$1570 in 2013, ranked at 120th out of 164 countries by the World Bank
• Pitiable sanitation conditions
• Corruption
• work culture, unequal wages, wider gap
between have and have not
(21% of the world’s global burden of disease, anemia
among children and women)
4/12/2015

13. Environmental issues
• Pollution: air, soil, water, thermal, radioactive
• Poor hygienic living conditions
• Hazardous workplace
• Occupational & waterborne disease
• Unsafe drinking water and poor sanitation
• Deforestation
• Natural calamities: drought, flood, stock,
earthquakes, cyclone, hot waves, cold waves
4/12/2015

14. Major Initiatives and Achievements to
Overcome Challenges & Inequalities
• Empowerment of women and children
• Partnership with stakeholders: Public Private Partnership, health sector reform
• Economic and educational attainments
• Socio-economic developments: drugs and technology, health
information system
• Strengthen of public health system and universal health
coverage: preventive, curative & promotive
• Policies and programs for overall development

15. THANK
YOU