Social Hierarchy/Social Rank on Health
The consequences are very clear about Social Hierarchy/Social Rank on health. Below is an article that has relevance for all the Healthy Mendocino Project Priority Areas:
http://thelancet.com/journals/lancet/article/PIIS0140-6736(17)30191-5/fulltext
Here are the recommendations of evidence-based strategies to minimize the impact of social hierarchy on health:
Invest in children
- Early childhood development enrichment programs
- Intensive parent support (home visiting) programs
- Enrollment of all children in early childhood education
Get the welfare mix right
- Regulate markets as necessary
- Implement income transfer policies that redistribute resources (ie, progressive tax and benefit regimes)
- Optimize balance between targeted and universal social protection policies through benefit design that minimizes both undercoverage and leakage
- Eliminate child poverty through monetary and non-monetary support for families with dependent children
Provide a safety net
- Provide income support or tax credits
- Provide social housing
- Subsidize childcare
- Provide free access to health care (especially preventive services)
Implement active labor market policies
- Provide job enrichment programs
- Democratize the workplace (involve employees in decision making)
- Provide career development and on-the-job training
- Provide fair financial compensation and intrinsic rewards
- Promote job security
- Discourage casualization of the workforce
Strengthen local communities
- Foster regional economic development
- Promote community development and empowerment
- Encourage civic participation
- Create mixed communities with health-enhancing facilities
Provide wrap-around services for the multiply disadvantaged
- Coordinate services across government and NGOs
- Provide intensive case management when necessary
- Foster engagement of the targeted families and individuals
Promote healthy lifestyles
- Strengthen tobacco control and addiction services
- Improve the diet of poor families (eg, through subsidizing fruit and vegetables, community gardens, purchasing co-ops, school meals)
- Provide green space and subsidized sport and recreation facilities
Ensure universal access to high quality primary health care
- Subsidize practices serving high need populations
- Provide additional nursing and social worker support for practices in disadvantaged areas
- Assist patients with clinic transport and childcare
- Provide services free at point of use
- Provide conditional cash transfers (to increase demand for clinical preventive services)