Determinants of Health PDF

Determinants of Health Dr Jihene Maatoug Consultant Community and preventive medicine RP PHCC, Doha, Qatar 1 Definition of Health It is the state of complete Physical, mental and social well being, and not merely the absence of any disease or inf...

Determinants of Health Dr Jihene Maatoug Consultant Community and preventive medicine RP PHCC, Doha, Qatar 1 Definition of Health It is the state of complete Physical, mental and social well being, and not merely the absence of any disease or infirmity. (WHO) 2  Health cannot be isolated from its social context. The last few decades have shown that social and economic factors have as much influence on health as medical interventions The National Institute of Health (NIH). Available from: http://www.nih.gov/science/obssr.pdf 3  We also realize that it is just as important to understand how behavior and society affect health and can help fight disease. Combining information from both biomedical and, behavioral and social sciences will lead to the most effective interventions. The National Institute of Health (NIH). Available from: http://www.nih.gov/science/obssr.pdf 4  Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well- being 5 Determinants of health? 6 7 Age, sex, genetic…. 8 Social (education, socio-economic, culture...) Physical : (air pollution , water, sanitation, roads..) 9 Smoking, physical activity, drug use, nutrition… 10 Access, use service Cost, availability…. 11  Ecological Health Perspective: Levels of Influence Concept Definition 1- Intrapersonal level: Individual characteristics that influence behavior, such as (knowledge, attitudes, beliefs, and personality traits). 2- Interpersonal level: Interpersonal processes and primary groups (family, friends, and peers), that provide social identity, and support. 3- Population level: A- Institutional or organizational Rules, regulations, policies, and informal structures that may constrain or factors promote recommended behaviors. B- Social capital factors Social networks and norms or standards that may be formal or informal among (individuals, groups, or organizations). C- Public policy factors Local and national policies and laws that regulate or support healthy actions and practices for prevention, early detection, control, and management of disease. 12  13 Centers for Disease Control and Prevention. The Social-Ecological Model: a framework for prevention. 2015 Socio-ecological model of health 14 15  Determinants of Health : Community context (1) a- Environmental factors: ( 4 components (Biological, physical, Chemical, and Cultural), e.g. safe water supply, proper waste disposal, control of air pollution, and both culture and tradition affecting attitudes towards health. e.g. infection needs microorganisms, + insect vector, suitable climate, bad environmental sanitation, and bad health habits, so all these requirements will enable organisms to propagate. e.g. Accidents: Result from environmental factors e.g. road construction, and from individual faults. Domestic accidents in the old age are due to bad housing conditions, accidents in the work place are due to unsafe working environment. 16  Determinants of Health : Community context (2) b- Economic factors: related to the general economic status of the community (e.g. food availability, food price, transportation, education, etc. c- Health Services: Availability of health services in general, and for the special groups e.g. maternal and child healthcare, occupational, mental, geriatric, etc. 17 Determinants of Health : family Circumstances a- Environmental factors: Include housing quality, presence of safe water, and availability of sanitary facilities within the house. b- Economic factors: the household income, way of allocation of the income c- Relationship and care within the family: Familial relationships such as domestic violence, perception of needed care, ways of children raising, etc. 18 Determinants of Health: individual attributes (1) a- Genetic factors: it determines biological status of each individual and susceptibility to diseases. b- Behavioral factors: Related to the way of raising, it markedly affects the health status. c- Education: Important determinant shaped by schooling status and amount health related knowledge acquired. d- Occupation: Affect the income with its complex relation to health, it is also related to exposure to occupational hazards and injuries. 19 Determinants of Health: individual attributes (2) e- Self esteem, recognition and status. f- Life style and habits. g- Perception of health needs as priority in life. h- Dietary intake: Important factor that affects health from birth to death. Deficiencies affects growth, development and resistance. Overweight is related to a spectrum of diseases. 20 Basic health promotion responses to the broad determinants of health Knowledge and skills development Empowerment for healthy behaviour Mitigation of competing interests in society Creation of conditions that support healthy behaviour including re-orientation of health services Advocacy for health Mobilization of resources and social support for health services and development 21 Activity Use the ecological model of health to identify the determinants of : Breastfeeding 22 23