Link and Phelan's (1995) Definition of Fundamental Causes of Disease
Link and Phelan define fundamental causes of disease as "the underlying social, economic, and political structures that create health inequalities." These causes are not directly related to individual behavior or healthcare access but rather to the broader structural conditions in which people live and work.
Social Conditions Fundamental to Triggering Diseases
Link and Phelan identified several social conditions that are fundamental to triggering diseases, including:
- Income inequality: Large disparities in income between the rich and the poor can lead to poor health outcomes for the poor, as they may have limited access to healthcare, housing, and other resources.
- Educational inequality: Lack of access to quality education can limit people's knowledge about health and healthy behaviors, increasing their risk of disease.
- Occupational inequality: Workers in low-paying, hazardous jobs may be exposed to harmful substances or working conditions that can lead to health problems.
- Racial discrimination: Racism and discrimination can lead to stress, poor access to healthcare, and other health disparities among marginalized groups.
- Gender inequality: Gender norms and stereotypes can limit women's access to healthcare, education, and employment, increasing their risk of certain diseases.
- Social exclusion: People who are socially isolated or excluded from mainstream society may have higher rates of mental health problems and other health issues.
- Institutional discrimination: Policies and practices that systematically disadvantage certain groups can create barriers to healthcare access and other social determinants of health.
How Social Conditions Trigger Diseases
Social conditions can trigger diseases in various ways:
- Physiological pathways: Poverty, discrimination, and other stressors can activate the body's stress response system, leading to inflammation, heart disease, and other health problems.
- Behavioral pathways: Social conditions can influence health behaviors, such as diet, smoking, and physical activity. For example, financial stress may make it difficult to afford healthy food or engage in regular exercise.
- Access to resources: Social inequalities can limit access to healthcare, safe housing, and other resources that are necessary for maintaining good health.