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What determines the health of an Individual…??

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HEALTH” & “DISEASE” lie along a continuum and there is no clear cut-off line. It is thus obvious that health fluctuates within a range of optimum well-being to various levels of dysfunction. Man is said to be a social animal, which is in continuous interaction with the internal and the external environment.

These interactions among the internal and the external environment may be health-promoting or deleterious depending on the circumstances.

Introduction

There are so many factors that affect the health of individuals and communities together. Whether people are healthy or not, is determined by the circumstances and environment. Factors like our habitats, environments, income, education and social relationships have impacts on health.

Underlying these broad factors is a much deeper level of structural causes, which are more difficult to change. These can be summarised as the distribution of money, power, and resources at global, national and local levels.

The Determinants of Health can broadly be divided under :

  1. Biology and Genetics
  2. Individual Lifestyle and Behaviour
  3. Social factors
  4. Physical Environment
  5. Political influence and policymaking
  6. Health Care System etc.

Biology and Genetics

The metaphor of car health may help establish this scheme. The life of a car depends on 4 elements: design, accidents, maintenance & aging. If the car is involved in many accidents or is poorly maintained, it will not have the chance to grow old. These same 4 categories apply to humans but are more appropriately designated as Genes, External Agency, Internal Agency, and Aging. Hypothetically, if the first 3 of these 4 factors could be eliminated through a perfect design or gene set, no accidents or external disruptions, and ideal maintenance or balanced internal dynamics, then the car or body would have the opportunity to die of “Natural causes”- Aging, which rarely ever occurs.


Individual Lifestyle and Behaviour

Most policies and strategies now a day, to better the health of the community, aims at Individual Lifestyle and Behaviour. The main issues usually addressed include Diet, Physical Activity, Addictions, Sexual Activities and Hygiene; although at various times, other issues have also fallen within these rubrics, for example, exposure to the sun and use of seat belts. It could be well argued that if individuals ate a little and exercised more, then they would be less likely to become obese. Similarly, if they smoked less, drank less alcohol, engaged in safe sex, etc., they would lead a comparatively healthy life. So it can be well said that maintaining a healthy lifestyle could well be a simple matter of self-control.


Social Factors

Social factors are important determinants of health because they create inequitable differences in health outcomes. WHO has identified 10 social determinants of health: the social gradient, stress, early life, social exclusion, work, unemployment, social support, addictions, food & transport. Of these 10, the single strongest predictor of our health and well being is our position on the social gradient (or the “social ladder”). Whether measured by income, education, place of residence or occupation, those people at the top of the ladder have the most power and resources, and on average live longer and healthier lives. Those people at the bottom have the least power and usually run at least twice the risk of serious illness and premature death as those near the top.


Physical environment

The physical environment has a big effect not only on someone’s health but also on his mental state, social wellbeing, activities he/she participate in and even how well he/she does at work. A good physical environment includes- safe water, clean air, healthy workplace, safe houses, communities & roads, employment, working conditions, etc.

The physical environment can broadly be divided into:
  • The natural environment includes open green spaces, parks, trees, weathers, climate, etc.
  • The man-made environment includes buildings, transportations, etc.
  • Other environmental factors can also be considered which include: worksites, schools, exposure to toxic wastes, good lightning, etc.

Poor health outcomes are often made worse by the interaction between individuals and their social and physical environment. E.g.: In places where ozone pollution is high, there is often a higher prevalence of asthma in both adults and children compared with national averages.


Political Influence and Policymaking

The political system plays an important part in the health care structure of any country. Policies at local, state and federal levels affect individual and population health. Increasing taxes on tobacco sales, for example, can improve population health by reducing the number of people using tobacco products. Some policies affect the entire population over an extended period of time while simultaneously helping to change individual behavior. For example, Mandatory wearing of the helmet for people riding two-wheelers. This leads to an increase in safety standards of two-wheeler riders, which in turn reduced rates of injuries and deaths from two-wheeler accidents.

Political factors influencing health include:

  • Government type and stability
  • Freedom of press
  • Levels of bureaucracy and corruption
  • Regulating and de-regulating trends
  • Tax policies and trade and tariff controls
  • Environmental and consumer protection legislation
  • Likely changes in the political environment

Health Care System

Access to health services and health service qualities have a great impact on the health of an individual. But there are some barriers that cause difficulties to access a healthy life such as:

  • Lack of availability of medical care
  • High cost
  • Lack of insurance coverage
  • Limited language access.

Due to these barriers, the health needs of an individual are not met properly which leads to delay or inability to get preventive services and hospitalization which could have been prevented.


Why emphasize on Determinants of Health?????

  1. It has a direct impact on health.
  2. Predict the greatest proportion of health status variance.
  3. To structure the health system.
  4. To interact with each other to produce health.
  5. Health promotion is fundamentally concerned with action and advocacy to address the full range of potentially modifiable determinants of health.
  6. They are the root of the problems so it gives us what strategies should be used in Health policies to promote health or prevention of diseases.


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