Social justice considerations for occupational therapy: The role of addressing social determinants of health in unstably housed populations

Work ◽  
2020 ◽  
Vol 65 (2) ◽  
pp. 235-246
Author(s):  
Caitlin E. Synovec ◽  
Laura Aceituno
2021 ◽  
Vol 75 (6) ◽  
Author(s):  
Nuria Menéndez Álvarez ◽  
Emiliano Diez Villoria ◽  
Estíbaliz Jimenez Arberas ◽  
Ana María Castaño Pérez ◽  
Antonio León García Izquierdo

Importance: For the first time in recent history, people worldwide have faced severe restrictions in occupations because of the measures adopted by governments to contain the coronavirus disease 2019 (COVID-19) crisis. Objective: To determine the limitations on participation of occupational therapists and occupational therapy students during “lockdown” and their impact on social determinants of health. Design: A cross-sectional, descriptive study conducted via an online survey. Participants: A total of 488 occupational therapists and occupational therapy students in North America, South America, and Europe. Outcomes and Measures: A questionnaire consisting of the World Health Organization Disability Assessment Schedule 2.0 of the International Classification of Functioning, Disability and Health and items developed to assess the impact of lockdown on daily life was emailed to occupational therapy professional associations, organizations, and universities between April and June 2020. It was available in English, Spanish, and Portuguese and met all the parameters listed in the Declaration of Helsinki. Results: The roles and routines of people across the developed world have been affected by lockdown measures. The study shows marked differences between participants in the domains of getting along and life activities, as well as influence on the environment. Moreover, South American participants experienced these difficulties to a greater extent than European participants. Conclusions and Relevance: This study quantifies the limitations in the participation of occupational therapists and occupational therapy students and the relationship of occupation to social determinants of health. What This Article Adds: The results of this research corroborate the relationship between health and occupation and highlight elements, such as the environment and context, that are important in occupational therapy. Therapists’ ability to analyze occupation in relation to contextual and cultural factors will benefit clients.


Author(s):  
Bo Burström

This commentary refers to the article by Fisher et al on lessons from Australian primary healthcare (PHC), which highlights the role of PHC to reduce non-communicable diseases (NCDs) and promote health equity. This commentary discusses important elements and features when aiming for health equity, including going beyond the healthcare system and focusing on the social determinants of health in public health policies, in PHC and in the healthcare system as a whole, to reduce NCDs. A wider biopsychosocial view on health is needed, recognizing the importance of social determinants of health, and inequalities in health. Public funding and universal access to care are important prerequisites, but regulation is needed to ensure equitable access in practice. An example of a PHC reform in Sweden indicates that introducing market solutions in a publicly funded PHC system may not benefit those with greater needs and may reduce the impact of PHC on population health.


Author(s):  
Chris O’Leary ◽  
Chris Fox

This chapter argues that local authorities can and should use their purchasing power strategically to address the social determinants of health that affect their local area. It examines commissioning and procurement as local authority functions, defining these concepts and exploring the conceptual confusion between the two. The chapter then looks at the evidence of current practice of local authorities (with a particular focus on local authorities in the UK) in strategic use of their purchasing power. Core to the argument is the role of local voluntary organisations and small and medium-sized enterprises (SMEs), so there is a particular focus on the commissioning experience of these types of organisations. Finally, the chapter makes the case for the role that voluntary sector organisations can play in addressing social determinants of health, before drawing some broad conclusions about the way forward.


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