Determinants of Health

Professor Dr Gias U Ahsan, PhD

Ex Pro vice chancellor, Dean and
Founder Chairman, PH Dept
 Determinants of Health : What
Makes people Healthy or Unhealthy?
• "Why is Manirul in the hospital?
• Because he has a bad infection in his leg.
• But why does he have an infection?
• Because he has a cut on his leg and it got
infected.
• But why does he have a cut on his leg?
• Because he was playing in the junk yard next to
his apartment building and there was some
sharp, jagged steel there that he fell on
 Determinants of Health (cont)
• But why was he playing in a junk yard?
• Because his neighborhood is kind of run down. A
lot of kids play there and there is no one to
supervise them.
• But why does he live in that neighborhood?
• Because his parents can't afford a nicer place to
live.
• But why can't his parents afford a nicer place
to live?
• Because his Dad is unemployed and his Mom is
sick.
 Determinants of Health (cont)
• But why is his Dad unemployed?
• Because he doesn't have much education
and he can't find a job.
It considers the entire range of individual
and collective factors and conditions - and
their interactions - that have been shown
to be correlated with health status.
Commonly referred to as the
"determinants of health."
 12 determinants:
1. Income and Social Status
There is strong and growing evidence
that higher social and economic status is
associated with better health. In fact,
these two factors seem to be the most
important determinants of health.
 12 determinants
2. Social Support Networks
Support from families, friends and communities
is associated with better health. Such social
support networks could be very important in
helping people solve problems and deal with
adversity, as well as in maintaining a sense of
mastery and control over life circumstances.
The caring and respect that occurs in social
relationships, and the resulting sense of
satisfaction and well-being, seem to act as a
buffer against health problems.
 12 determinants
3.Education and Literacy
Health status improves with level of education.
Education is closely tied to socioeconomic status,
and effective education for children and lifelong
learning for adults are key contributors to health
and prosperity for individuals, and for the country.
Education contributes to health and prosperity by
equipping people with knowledge and skills for
problem solving, and helps provide a sense of
control and mastery over life circumstances. It
increases opportunities for job and income
security, and job satisfaction. And it improves
people's ability to access and understand
information to help keep them healthy.
 12 determinants
4. Employment / Working Conditions
Unemployment, underemployment,
stressful or unsafe work are associated
with poorer health.
People who have more control over their
work circumstances and fewer stress
related demands of the job are healthier
and often live longer than those in more
stressful or riskier work and activities.
 12 determinants
5. Social Environments
The importance of social support also
extends to the broader community. Civic
vitality refers to the strength of social
networks within a community, region,
province or country. It is reflected in the
institutions, organizations and informal
giving practices that people create to
share resources and build attachments
with others.
 12 determinants
6. Physical Environments
The physical environment is an important
determinant of health. At certain levels of
exposure, contaminants in our air, water,
food and soil can cause a variety of
adverse health effects, including cancer,
birth defects, respiratory illness and
gastrointestinal ailments.
 12 determinants

7. Personal Health Practices and Coping

Skills
Personal Health Practices and Coping
Skills refer to those actions by which
individuals can prevent diseases and
promote self-care, cope with challenges,
and develop self-reliance, solve problems
and make choices that enhance health.
 12 determinants
8. Healthy Child Development
New evidence on the effects of early experiences
on brain development, school readiness and health
in later life has sparked a growing consensus about
early child development as a powerful determinant
of health in its own right. At the same time, we have
been learning more about how all of the other
determinants of health affect the physical, social,
mental, emotional and spiritual development of
children and youth. For example, a young person's
development is greatly affected by his or her
housing and neighbourhood, family income and
level of parents' education, access to nutritious
foods and physical recreation, genetic makeup and
access to dental and medical care.
 12 determinants
9. Biology and Genetic Endowment
• The basic biology and organic make-up of the
human body are a fundamental determinant of
health.
• Genetic endowment provides an inherited
predisposition to a wide range of individual
responses that affect health status. Although
socio-economic and environmental factors are
important determinants of overall health, in
some circumstances genetic endowment
appears to predispose certain individuals to
particular diseases or health problems.
 12 determinants

10. Health Services

Health services, particularly those
designed to maintain and promote health,
to prevent disease, and to restore health
and function contribute to population
health. The health services continuum of
care includes treatment and secondary
prevention
 12 determinants

11. Gender
Gender refers to the array of society-determined
roles, personality traits, attitudes, behaviours,
values, relative power and influence that society
ascribes to the two sexes on a differential basis.
"Gendered" norms influence the health system's
practices and priorities. Many health issues are
a function of gender-based social status or roles.
 12 determinants

12. Culture
Some persons or groups may face additional
health risks due to a socio-economic
environment, which is largely determined by
dominant cultural values that contribute to the
perpetuation of conditions such as
marginalization, stigmatization, loss or
devaluation of language and culture and lack of
access to culturally appropriate health care and
services.
THANK YOU ALL