Determinants of Health
Health is multifactorial. The factors which influence health lie both within the
individual and externally in the society in which he or she lives. It is a truism to
say that what man is and to what diseases he may fall victim depends on a
combination of two sets of factors - his genetic factors and the environmental
factors to which he is exposed. The following can be considered as determining
factors of health:
1. Heredity
2. Environment
3. Life-style
4. Socio-economic condition
5. Health and family welfare services
6. Other factors
Heredity
The physical and mental traits of every human being are to some extent determined
by the nature of his genes at the moment of conception. The genetic make-up is
unique in that it cannot be altered after conception. A number of diseases are now
known to be of genetic origin, e.g., chromosomal anomalies, errors of metabolism
mental retardation, some types of diabetes, etc. The state of health therefore
depends partly on the genetic constitution of man.
Environment
The environment aspect of health determinants is classified as “internal” and
“external”. The internal environment of man pertains to “each and every
component part, every tissue, organ and organ-system and their harmonious
functioning within the system”. Internal environment is the domain of internal
medicine. The external or macro-environment consists of those things to which
man is exposed after conception. It is defined as “all that which is external to the
individual human host”. It can be divided into physical, biological and
psychosocial components, any or all of which can affect the health of man and his
susceptibility to illness. The environmental components (physical, biological and
psychological) are not water-tight compartments but are inextricably linked with
one another.
Lifestyle
The term “lifestyle” is rather a diffuse concept often used to denote “the way
people live “, reflecting a whole range of social values, attitudes and activities. It is
composed of cultural and behavioral patterns and lifelong personal habits (e.g.
smoking and alcoholism) that have developed through processes of socialization.
Lifestyles are learnt through social interaction with parents, peer groups, friends
and siblings and through school and mass media.
Health requires the promotion of healthy lifestyle. In the last 20 years, a
considerable body of evidence has accumulated which indicates that there is an
association between health and lifestyle of individuals. Many current-day health
problems (e.g., coronary heart disease, obesity, lung cancer, drug addiction) are
associated with lifestyle changes.
Socio-economic conditions
Socioeconomic conditions have long been known to influence human health. For
the majority of the world’s people, health status is determined primarily by their
level of socioeconomic development, e.g., per capita GNP, education, nutrition,
employment, housing, the political system of the country, etc.
Health and Family Welfare services
The term health and family welfare services cover a wide spectrum of personal and
community services for treatment of disease, prevention of illness and promotion
of health. The purpose of health services is to improve the health status of
population. For example, immunization of children, provision of safe water, care of
pregnant women and children would contribute to better health and well being. To
be effective, the health services must reach the social periphery, equitably
distributed, accessible at a cost the country and community can afford and socially
acceptable. All these are ingredients of is now termed “primary health care”, which
is seen as the way to better health.
Other factors
Other contributions to the health of populations derive from systems outside the
formal health care system, i.e., health related systems (e.g. food and agriculture,
education, industry, social welfare, rural development) as well as adoption policies
in the economic and social fields that would assist in raising the standards of
living. This would include employment opportunities, increased wages, prepaid
medical programmes and family support systems.
In short, medicine is not the sole contributor to the health and wellbeing of
populations. The potential of inter-sectoral contributions to the health of
communities is increasingly recognized
Physical Activity and Health Benefits
Although research interest on physical activity and health dates back to the 1950s,
the breakthrough in the scientific evidence on health benefits of physical activity
largely took place during the 1980s and 1990s. There is an overwhelming amount
of scientific evidence on the positive effects of sport and physical activity as part
of a healthy lifestyle. The positive, direct effects of engaging in regular physical
activity are particularly apparent in the prevention of several chronic diseases,
including: cardiovascular disease, diabetes, cancer, hypertension, obesity,
depression and osteoporosis.
The Report from the United Nations Inter-Agency Task Force on Sport for
Development and Peace states that young people can benefit from physical activity
as it contributes to developing healthy bones, efficient heart and lung function as
well as improved motor skills and cognitive function. Physical activity can help to
prevent hip fractures among women and reduce the effects of osteoporosis.
Remaining physically active can enhance functional capacity among older people,
and can help to maintain quality of life and independence.
Physical and psychosocial health
The WHO has estimated that “one in four patients visiting a health service has at
least one mental, neurological or behavioral disorder, but most of these disorders
are neither diagnosed nor treated”. A number of studies have shown that exercise
may play a therapeutic role in addressing a number of psychological disorders.
Studies also show that exercise has a positive influence on depression. Physical
self-worth and physical self-perception, including body image, has been linked to
improved self-esteem. The evidence relating to health benefits of physical activity
predominantly focuses on intra-personal factors such as physiological, cognitive
and affective benefits, however, that does not exclude the social and inter-personal
benefits of sport and physical activity which can also produce positive health
effects in individuals and communities.
The health benefits of physical activity can be summarized as follows:
Control of body weight
Reduce the risk of cardiovascular disease
Lowers blood pressure and cholesterol
Reduces the risk for type 2 diabetes and metabolic syndrome
Reduce the risk of some cancers
Strengthen bones and muscles
Improve mental health and mood
Improve ability to do daily activities
Increase chances of living longer
