Social Determinants of Health in the Lives of People with Disability

Abstract

Purpose: Health is socially produced through the acquisition of socioeconomic, cultural and environmental domains, known as Social Determinants of Health (SDH). It is noted that people with disability experience social inequalities in health, as they are denied rights involved in the production of health. Therefore, this study aimed to review the existing literature on the SDH of people with disability and to identify the gaps in knowledge and challenges in this field.

Method: An integrative review study was carried out in the Eric, PubMed and Science Direct databases. From 2013 to 2022, 1,252 articles were identified and 29 were selected for analysis. All the articles were in English and only one was based in Brazil. The studies were analyzed by categorization according to the layers of Dahlgren and Whitehead's SDH theoretical model.

Results: The results indicated a greater number of studies carried out with guardians of people with disabilities. People with disability tend to experience depression and engage in less physical activity. Their social participation is hampered, mainly by the lack of accessibility to transport and voting. Their friendships are limited due to negative disability stereotypes. Working contributed to a feeling of well-being and social belonging, although access to employment was negatively impacted by their disability. It was pointed out that access to education reinforces the possibilities of access to formal work.

Conclusion: People with disability face multiple and interrelated challenges to their health, which are influenced by the social determinants of health (SDH). Each sector involved in the provision of health services and social support has a role to play in addressing these challenges. Thus, public policies that promote the social and collective participation of people with disability, especially in the labour market, are essential.