Social Determinants of Health for HIV Among Hispanic Women.

Abstract

Population health outcomes are influenced by complex, integrated, and overlapping social structures and economic systems. From the time people are born, they are placed at a particular level of social status. These concepts are included in what the World Health Organization (WHO; 2014) defines as the Social Determinants of Health (SDH): “Conditions, in which people are born, live, grow, work and age” (para. 1). In other words, health is determined in part by the social, economic, political, cultural, and environmental contexts in which people live. Oftentimes, individuals are not able to directly control their SDH (WHO, 2014). The SDH are defined or shaped by money, power, and other resources at multiple levels, from local to global, affecting a wide range of individuals (Mumtaz & Salway, 2009; WHO, 2014). The WHO has recognized that dealing with these social determinants is a fundamental priority in order to improve the health of people and to decrease inequalities (WHO, 2010a). For instance, while HIV prevention for Hispanic women has been a challenge for health care workers and policymakers, the conceptualization of SDH helps recognize HIV among Hispanic women in the context of sociocultural and economic inequalities (e.g., level of education, financial constraints, immigration, culture, substance abuse, and access to health care; Raphael, 2004; WHO, 2010a). A particular concern for both health care workers and policymakers is that relative to other races/ethnicities, Hispanic women are disproportionately affected by HIV (Centers for Disease Control and Prevention [CDC], 2014). Disparities have persisted in the rate of new HIV infections among Hispanic women for some time; in 2010, for example, the rate of new HIV infections for Hispanic women was 4.2 times that for White women (CDC, 2013a). According to a study by the Kaiser Family Foundation (2009), women of color fare worse on a variety of measures of health and health care access than do their White counterparts. Specifically, being HIV positive is one of the indicators associated with greater disparity (Kaiser Family Foundation, 2009). While Hispanics represent diverse nationalities and demographics, they share SDH, which present challenges for HIV prevention, contributing to the rise of HIV infection among Hispanic women across nationalities (CDC, 2009a, 2009b).