A state of
complete physical,
social and mental
well-being and not
merely the
absence of disease
or infirmity (WHO,
1946)
Determinants of
health
The Social (Economic) Determinants of Health
Refers to the social and environmental conditions in which
people live and grow- they can influence health
The social Gradient of
Health
Exists across society and involves the relationship between a populations health status and the populations social status.
Those with a poorer social status such as having no access to education and work will be more
likely to have shorter life expectancies and have a higher risk of developing serious illnesses.
Stress
Can be caused by a number of factors- work, study, relationships etc. Ongoing stress can impact
health by causing anxiety, low self-esteem, insecurity, lack of control and social isolation.
Early Life
A supportive and healthy early experience can increases better health outcomes. Early education and foetal
care influence health later in life
Work
Having a job is better than having no
job, although having control over ones
work leads to better health.
Unemployment puts health at risk as it
can lead to inability to purchase basic
neccessities
Transport
Transportation can influence heath by the amount of exercise one gets- cycling or walking can also decrease air pollution and
increase social interaction. Remote areas have limited access to close health services such as hospitals and food stores
Food
Food insecurity is a leading cause for malnutrition and poor health- A good diet and access to food is central to good health
however over eating can lead to overweight/obesity which is linked with a number of health problems and premature death.
Addiction
Contributes to worse health outcomes- smoking, alcohol, illicit drug addictions- increases risk
of chronic illness. Drug use is associated with social and economic disadvantages.
Social Exclusion
Poverty, deprivation and social exclusion have a major impact on health
Social Support
Social support is important for good health- social interaction provides people with the emotional and physical
support they- good social groups encourages healthy behaviour patterns.
SDOH For Indigenous Australians
Education and literaacy
Stress
Early life, healthy child development
Unemployment, working conditions
Social support
Social exclusion
Gender
Discrimination
Addiction
Food insecurity
The range of
behavioural,
biological,
socio-economic
and environmental
factors that
influence the
health status of an
individual and
population. (WHO,
1998)
Biological Determinants of Health
Genetics
Single-gene
E.g. Cystic fibrosis
Chromosomal
E.g.Down syndrome
Multifactorial
Biological Approach to Health-
Almost all diseases have a
genetic component however has
multiple determinants/factors
that interact with genes
Mitochondrial
DNA-linked
Body Structure
Height
Waist-hip ratio
weight
Bone density
Body Functioning
Blood pressure
Nutritional status
Biochemical status
Sensory function
Fitness
Movement and balance
Strength and function
Physiological, somatic (body),
cellular, molecular, organic
and genetic affects or
characteristics of the body
that directly and measurably
influence health.
Non-modifiable- genetically inherited
diseases but experience and access to
treatment is related to the DoH
Modifiable- Course of a disease with a
genetic profile can be altered through
environmental changes
Physical (environmental) Determinants of Health
Water Quality
Air Quality
Pollution
Climate and geography
Climate change is associated with heat-waves,
extreme weather and precipitation which can lead
to temperature and extreme weather related
deaths, air-pollution and nutritional health effects, and
water, food and vector-borne diseases.
Built environment
Poor Housing
lack of local shops supporting localisation
Food safety
Land and soil quality
Behavioural Determinants of Health
Behavioural DOH For Indigenous Australians
Tobacco
High body mass
physical inactivity
illicit drugs
alcohol
High BP and cholesterol
Partner violence and
child sexual abuse
Low fruit and
vege intake
Health Inequalities
Health equality aims to give all people the same things in order to enjoy a healthy life.
Health inequality is preventable and measurable. It is the unjust differences in health status
experienced by different populations
Health Inequities
Inequalities in health which are deemed to be unfair
or stemming from some form of injustice. Inequities
arise from a populations conditions and resources.
Health equity are the rights of people to have equitable
access to resources and services that give them the basic
needs to be able to live well. It aims to understand and
provide people with what they need in order to enjoy a
healthy life
Health (care) System
System which
involves all the
activities whose
primary purpose
is to promote,
restore or
maintain health.
Primary Health Care
Community-based, entry level
E.g. Midwifery
services, nurses,
dentists,
pharmacists,
Secondary Health Care
More serious, usually referred, requires more
specialists skills/tools
E.g. Hospitals or
specialists such as
psychiatrist, orthaepedics
Tertiary Health Care
Specialist services, highly
advanced facilities, fewer
in number
E.g. Larger Hospitals and
highly specialised
professionals and treatment
such as cancer treatment,
cardiac surgery, neurosurgery
Health System Blocks
Health System Blocks A
Service Delivery
Access to Essential Medicines
Health Workforce
Information Workforce
Financing
Governance
Health System Blocks B
Access
Coverage
Quality
Safety
Health System Blocks C-(aim)
Better Health
Responsive
Social and financial risk protection
Improved Efficiency
Health Promotion
Health promotion its the process of
enabling people to increase control over
their health and its determinants, and
thereby improve their health
(WHO,2005)
Ottawa Charter For Health Promotion
(WHO, 1986)
8 Key Determinants (Prerequisites)
Peace
Shekter
Education
Food
Income
Stable Eco-system
Sustainable Resources
Social Justice & equity
Strategies to
Promote Health
Enable
Working with
communities and
individuals to take
control over their health
and environment
through education and
empowerment
Advocate
Efforts by the individuals or
groups to gain political
commitment and social
acceptance in order to change
laws, policy that impact
populations health
Mediate
To work between conflicting
interests in society to change
external factors that
influence health and
wellbeing
Build
capacity
Is a set of processes
(or strategies) that
build
infrastructure,
program
sustainability and
problem solving
Health Promotion strategies work through settings
which are physical locations which health promotion
may be undertaken. E.g. schools, workplace or cities etc.
Actions (BCSDR- bad
cats smell dead rats)
Build Healthy Public Policy
Create supportive environments
Strengthen community Action
Develop personal Skills
Re-orient Health Services
Health Promotion Theories
Empowerment
theory
Inclusion & developing skills so people
have better control of their health
Socio-ecological theory
recognises environments
are influenced by multiple
factors- different actions
are needed
PLace-based Theory
Core concepts include integrated
planning, partnerships, targeting
struggling communities
Systems Thinking
Focuses on the big
picture- what is
occurring within the
systems and do the
subsystems affect
eachother
Marginalised Populations
Marginality
Occurs when particular population groups are affected
by multiple types of disadvantage
Intersectionality
Helps us understand how people or groups experience
aspects of marginalisation. Focuses on intersections
between socially constructed identities, power and
privialage/oppression
Stigma
Stigma is a label people get which is associated with
characteristics and associated with a negative association