Transformative Education
for Health Professionals

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Mental Health; Analysis of exposure over the life-course to social determinants


Analysis of exposure over the life-course to social determinants shows that exposure to negative and positive determinants processes and accumulate over time, influencing epigenetical, psychosocial, physiological, and behavioural attributes among individuals as well as social conditions in families, communities, and social groups including gender.






Prenatal period and early childhood: Strong evidence shows that many mental and physical health conditions emerge in later life but originate in early life. Stressors experienced in sensitive development periods during early childhood affect biological stress regulatory systems, neural mechanisms by which stress responses are regulated in the brain, and the expression of genes related to stress responses.

Childhood: The negative effects of stressors are buffered by social support provided by loving, responsive and stable relationships with a caring adult. Such relationships build secure attachment between child and caregiver, which is essential for healthy social and emotional development. Secure attachment to the primary caregiver in the early years is of fundamental importance for the individual in buffering against anxiety and coping with stressors. Cumulative exposure to stressors over time causes alterations in stress responses that have physiological effects on the immune system, cardiovascular function, respiratory system, and other systems, including the brain, that affect physical functioning in ways that are damaging to health.

Adolescence: As children grow into adolescents, they become more interested in risky behaviours, including harmful substance use.  It is important to ensure that adolescents have the knowledge to make informed decisions, and that they have protective factors including social and emotional support and positive interactions with peers, family, and the wider community.   Depressive symptoms among adolescents are associated with their history of adverse childhood experiences as well as their current experiences.

Adulthood: Unemployment and poor quality employment are particularly strong risk factors for mental disorders. In addition adult mental health can be profoundly affected during family building and it partly relates to socioeconomic factors. 

Older adulthood: Social isolation among older people is particularly significant (especially for women) in raising the risk of mental disorders. A review of literature shows links between loneliness in older people and depressive symptoms, poor mental health and cognition, alcoholism, suicidal ideation, and mortality.


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