Determinants of Health: Social Determinants, Health, and Disease

Determinants of Health

Social Determinants and Health and Disease

Influencing Social Determinants

The way of life and the health, healthy life styles

Determinants of Health:

• Factors which, combined together, affect the health of individuals and communities → whether people are healthy or not, is determined by their circumstances and environment
• E.g. as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family
• Note: the more commonly considered factors such as access and use of health care services often have less of an impact

The determinants of health generally include:

• The social and economic environment
• The physical environment
• The person’s individual characteristics and behaviours

How factors affect the people’s lives?

• Particular factors may affect health either directly or indirectly
• Positive (biopositive effect) – promotion and protection of health; strengthen human health
• Negative (bionegative effect) – cause disease or defects in health; worsen human health

Health determinants can be divided into:

1. Internal (Individual) Factors

   • Endogenic – genetic, personal characteristics
   • Psychological
   • Behavioural – behaviour which is affected by subjective factors such as values, priorities, cultural level, ethic norms, religion, customs and teaching
   • Note: Man’s behaviour, while individual, is influenced by the social determinants

2. External (Environmental) Factors:

   • Social factors: further described below
   • Civilizational factors: further described below
   • Natural factors: water, soil, air, animals, plants ecosystem, geography, climate ...etc

Social Factors:

These are man-made determinants which influence the health of humans; they play the main role in affecting human health. They:

• Determine the natural environment in which people exist (living and working conditions)
• Influence the human psyche
• Dictate how scientific knowledge is applied to change and improve the environment

Further divided into:

• Socio-economic factors: higher income and social status are linked to better health
• Work – type of work, its environment, conditions and risks, associated occupational diseases, work injuries and preventative measures and places of work
• Education and cultural level: low education levels are linked with poor health, more stress and lower self-confidence
• Physical environment – safe water and clean air, healthy workplaces, safe houses, communities and roads
• Interpersonal relationships – family, job, social group, community, etc
• Health care system and access to it
• Demographic factors – population density, structure of population by age and motion of population
• Health services – access and use of services that prevent and treat disease influences health

Social Determinants:

• Economic situation of inhabitants – salary, income, social issues, insurance, etc
• Social funds – medical care, education, social care system, pensions, etc
• Education level
• Demographic events – natality, mortality, abortion, migration
• System of law, health and social policy

“Civilization” Factors

• Pollution (air, water and soil); Dangerous climate changes
• High noise levels
• Stereotyped, monotonous work
• Sedentarism, Stress, Smoking
• Increasing consumption of food – malnutrition/obesity (unbalanced diet)

Healthy life style:

A healthy life style should include at least 30 minutes of moderate physical activity at least 5 days per week as well as a balanced, healthy diet

Life-style related determinants:

• These are multi-dimensional
• Health problems linked to these determinants can be life-situation related (e.g. age related) or culture linked. In addition, socioeconomic factors are an important reason for variations in health
• Comprehensive health promotion in various settings (e.g. schools, workplaces, families and communities) has been proven to be efficient in addressing health determinants
• All these dimensions (determinants, health problems, life cycle, and settings) are linked to each other
• Depending on the situation, action focused to a specific disease or on a specific determinant can be justified
• Equally, specific actions which simultaneously address all relevant health determinants, can be the most efficient approach in many situations
• Life-style related determinants include:
  • The amount of physical exercise
  • Tobacco – smoking, the leading cause of death in the community
  • Nutrition – nutrition is one of the major health determinants
  • It is, together with smoking and physical inactivity, one of the main determinants for cardiovascular disease and cancer
  • Drugs and Substances – the majority of European citizens believe that the fight against drugs should be tackled at the EU level rather than at national level
  • Mental Health – there is no health without mental health due to of the linkage between health and the physical and psychosocial environment
  • Alcohol – in Europe, alcohol per capita consumption is the highest in the world, causing a high burden of disease and injury