Social Determinants of Health and Swimming Upstream

Social determinants of health are those parts of our lives that we sometimes do not think of as creating much of an effect on our overall health, but they do in fact play a large role in how healthy one is. The home, the school, the work environment, and or neighborhood we are surrounded by on a daily basis, all have an impact on who we are and how we function as human beings. In terms of the physical environments of these places, are they safe? Or do they contain toxins such as mold or contaminated water that could be putting undue stress on our physical and psychological systems. Is the space closed off and cluttered and crowded? Is there enough light coming in? Is there enough adequate space for the amount of people occupied in the space? Social determinants of health can also relate to the type of people you are around. Are the relationships you have with the people you interact with on a daily basis causing you physical or psychological harm. In essence are the people you interact with on a daily basis toxic to your whole self, your whole being? We tend to be aware of the fact that mold or lead poisoning can cause serious health side effects causing parts of the body and nervous system to malfunction but undue over mental stress can also have an unfavorable impact on our nervous system. The HPA Axis, which is the hypothalamus, pituitary gland, and the adrenal glands, in simple terms helps to regulate the stress response within our body. If continually put in a state of high stress the system will constantly relay messages to the adrenal glands to keep releasing cortisol. Cortisol is one of the main stress hormones in our body and is good for when we need to act in a fight or flight type of manner. However constant release of cortisol can have a negative effect causing both physical and mental problems. One such side effect is the shutdown of the prefrontal cortex, the area of the brain that helps with executive functioning and decision making. It is one of the last areas of the brain to fully develop so it is unfortunate that prolonged stress will cause it to stop working.

In listening to the TedTalk by Rishi Manchanda, “What Makes Us Get Sick? Look Upstream”. I love how Rishi brings attention to the need for more healthcare workers, in any aspect of the system, to be agents for better change by swimming or looking upstream for the root cause(s) of potential health problems. I feel that our service/professional development hours in a way is preparing us to do just that, be upstream swimmers in the field of occupational therapy in order to be positive change agents for promoting health in the world. Is that not what prevention is all about? In volunteering and furthering our knowledge with different professional development opportunities we are gathering tools to put in our toolbox that we can later call upon when we are practicing in the field. You never know when one small moment while volunteering might just be the seed for an idea that helps someone else, thus continuing the chain of events in a positive way. We all have slightly different interests, which is great, because that means we are all investigating and learning through various volunteer and professional development avenues which in return will help us as occupational therapists to reach many people, groups, and populations along our swim upstream.