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Understanding Health Inequities Through Personal and Systemic Lenses: A Reflection on My Journey in Kitwe, Zambia by Victor Mushimbami

 





Introduction


Reflecting on my childhood in Kitwe, Zambia, I clearly remember the significant healthcare disparities in my community, family, and neighborhood. The painful memories of my sisters' premature deaths due to inadequate healthcare still resonate in my mind. These experiences profoundly shaped my understanding of healthcare inequities and fueled my passion to pursue health studies, in addition to my theological training.


Health Inequities in My Community

The Mushimbami family, including myself, faced significant barriers in accessing quality healthcare, nutritious food, and other essential resources. Our socioeconomic status relegated us to a lower rung in the social ladder, making us vulnerable to health disparities. We often had to rely on traditional remedies and makeshift healthcare facilities, which were inadequate and sometimes harmful. The nearest government hospital was understaffed, underfunded, and often prioritized patients who could afford private care. This perpetuated the cycle of poverty and poor health, making it seem like a never-ending curse.


Personal Experiences with Health Inequities

One of the most poignant experiences was witnessing my two sisters fall ill and ultimately succumb to their illnesses due to lack of access to proper healthcare. The pain and helplessness I felt as I watched them suffer are still etched in my memory. The nearest government hospital was ill-equipped to handle their conditions, and we could not afford private care. Doctors would sometimes redirect patients to their private clinics, exacerbating the existing health inequities. This experience made me realize that health inequities are not just statistics but have real-life consequences that affect families and communities.


Understanding Social Determinants of Health

The video “What makes us Healthy? Understanding the Social Determinants of Health” (Let’s Learn Public Health, 2027) highlighted how social determinants like socioeconomic status, access to healthcare, and environmental conditions significantly impact health outcomes. This video helped me understand that health inequities are not solely the result of individual failures but are perpetuated by systemic issues. It emphasized the need to address these underlying factors to reduce health inequities.


Impact of Social Determinants on Health

The video “Social Determinants of Health: what are they and how do they impact the health of populations?” (Clinical Scholars, 2021) explained how social determinants like education, housing, and employment opportunities shape health outcomes. In our community, limited access to quality education, decent housing, and stable employment perpetuated the cycle of poverty and poor health. This video reinforced my understanding of the need to address social determinants to improve health outcomes.


Healthcare and Social Determinants

Fulton-Scott’s video “How social Determinants impact Health Care” (2021) emphasized the need for healthcare providers to consider patients’ social determinants when providing care. However, in our experience, this was often overlooked, leading to inadequate care and perpetuating health inequities. This video highlighted the need for healthcare providers to be aware of the social determinants that affect their patients’ health outcomes.


Systemic Nature of Health Inequities

The National Institute of Health’s video “Social Inequalities in Health” (2014) highlighted how social and economic policies perpetuate health disparities, reinforcing the need for policy changes to address these issues. This video helped me understand that health inequities are not just individual problems but are perpetuated by systemic issues that need to be addressed through policy changes.


Conceptual Models of Social Determinants of Health

Lucyk and McLaren’s scoping review “Taking stock of the social determinants of health: A scoping review” (2024) and Morteza et al.’s narrative review “Conceptual Models of Social Determinants of Health: A Narrative Review” (Morteza et al., 2017) provided a comprehensive overview of the various conceptual models and frameworks used to understand social determinants of health. These reviews highlighted the complexity of social determinants and the need for a multifaceted approach to address them.


Conclusion

In conclusion, my experiences and the referenced materials have dispelled any preconceived notions I had about health inequities being solely the result of individual failures. Instead, I have come to understand that systemic issues like socioeconomic status, access to healthcare, education, and environmental conditions perpetuate these inequities. To improve these issues, I believe we need policy changes that address the root causes of health disparities, increased investment in public healthcare and education, and community-based initiatives that prioritize the needs of marginalized populations. By acknowledging and addressing these social determinants, we can work towards reducing health inequities and promoting health justice.


References

Let’s Learn Public Health. ( June 25, 2027). What makes us Health? Understanding the Social Determinants of Health. YouTube [Video]. Retrieved from https://youtu.be/8PH4JYfF4Ns?si=Opo_X8wDARIQuLVv


Clinical Scholars. ( 2021, Mar 11). Social Determinants of Health: what are they and how do they impact the health of populations ? YouTube [ Video]. Retrieved from https://youtu.be/oC_MPCXs0Sw?si=q4pYuhCUExew2hl4


Fulton-Scott, V. ( 2021, September 14). How social Determinants impact Health Care. YouTube [Video]. Retrieved from https://youtu.be/xAlxtog_4ns?si=l-hztXdcz93hrTnJ


National Institute of Health. ( 2014, November 5). Social Inequalities in Health. YouTube [ Video]. Retrieved from https://youtu.be/roAQHn5rEoQ?si=zNF72Ld0Amv8FFQ2


Lucyk, K and McLaren, L. ( 2024). Taking stock of the social determinants of health: A scoping review. PLOS ONE. Retrieved from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0177306

Morteza, S., SHOKOUH, H., ARAB, M., EMAMGHOLIPOUR, S., RASHIDIAN, A., MONTAZERI, A. and ZABOLI, R. ( 2017). Conceptual Models of Social Determinants of Health: A Narrative Review. National Library of Medicine. Retrieved. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439032/


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