3.0 Introduction

Chapter Introduction

You may wonder why you are learning about the social determinants of health (SDoH) in a course about psychoactive substances and society. The reason is that SDoH impact various aspects of our daily lives, including how and why some people use psychoactive substances and/or develop problems associated with substance use. As you progress through the course material this semester, you will discover that using a health-oriented lens will aid you in developing a better understanding of, and critical engagement with, a variety of issues pertaining to drugs, drug use, and drug policy.

According to the World Health Organization (n.d., para. 1), “the social determinants of health…are the non-medical factors that influence health outcomes” (i.e., the conditions in which we live, grow, work and play, including social forces such as economic policies and political systems). These factors may lead to the implementation of social policies that harm our health (e.g., prohibitionist substance control policies). But they can also lead to the development of policies and programs that reduce health risks (e.g., access to reasonably priced healthy safe food and affordable housing), including reducing risks to people who use drugs/substances (PWUD/PWUS) (i.e., drug testing services, elimination of simple drug possession offences) and/or those experiencing substance use disorders (SUDs) (e.g., evidence-based drug education, safe consumption sites, safe drug supply). The purpose of this chapter is to facilitate an understand of the SDoH and how they can impact the health of individuals in both positive and negative ways, including the development of SUDs.

Chapter Objectives/Learning Outcomes 

After completing the chapter materials, you should have an understanding of:

  1. The social determinants of health (SDoH).
  2. What is meant by upstream and downstream interventions.
  3. How SDoH are tied to substance use and risks of developing SUDs.
  4. The relationship between SDoH and socially and/or structurally vulnerable populations.
  5. The meaning of primary and secondary prevention (including examples).
  6. Canadian examples of SDoH and primary and secondary prevention efforts.
  7. The next steps for helping people who use substances (PWUS) in Canada.

Questions to Think About When Completing Chapter Materials

  1. How do structural and intermediary determinants relate to substance use disorders and people who use drugs in our society?
  2. What are the benefits of upstream and downstream interventions? What is an example of each that may be used to address issues faced by people at risk of developing substance use disorders (SUDs)?
  3. Reflect on social determinants of health that vary across populations. How does this change the way you think about health and well-being, as well as people who experience SUD?
  4. What are some of the primary prevention models in your own community? How do they fit a social determinants of health framework?
  5. How did the COVID-19 pandemic impact the social determinants of health? How might this act as a risk factor for substance use and SUDs?

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Psychoactive Substances & Society (2nd Edition) Copyright © 2024 by Jacqueline Lewis & Jillian Holland-Penney is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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