Determinants of Health

Determinants of Health

PATH216

Mohamed M. B. Alnoor

ContentDefinition of HealthDimensions of HealthDeterminants of HealthInequity in Health

Valued less than other desires

wealthpowerprestigeknowledge

H E A L T H?

“Absence of disease”

“The condition of being sound in body, mind or spirit, especially freedom from physical disease or pain” Webster English Dictionary

Definition of Health

“Soundness of body or mind, that condition in which its functions are duly and efficiently discharged” Oxford English Dictionary


WHO Definition:

“ Health is a state of complete physical, mental and social

well-being and not merely the absence of disease or infirmity

”1948


PhysicalMental

Social

a multi-dimensional process

Dimensions of health

Physical Dimension of Health

-Implies perfect functioning of organs, at optimum capacity , and in harmony.

-Involves the ability to carry out daily tasks, and achieve fitness .

-A normal person :- no evident disease,

- growth is comparable peers.


Not merely the absence of mental illness, but also the

ability to respond to the various experiences

of life with flexibility and a sense

of purpose.

Mental Dimension of HealthDimensions of health

Mental health is a state of balance or harmony

between the individual and others

as well as between the individual and

the environment


The following characteristics are attributes of a mentally healthy person:

a) he is free from internal conflicts ,b) he accepts criticism, c) he searches for identity, d) he has a strong sense of self-esteem ,e) he knows himself, f) he has a good self-control,

g) he faces problems and tries to solve them .


Ability to interact successfully with people within the

environment, maintaining intimacy with

others, showing respect and

tolerance for those with different

opinions and beliefs.

Social Dimension of HealthDimensions of health

Health practices and beliefs are strongly influenced by

the person’s : economic level life style family culture


Low-income groups are less likely to seek health care to

prevent or treat illness ;

High-income groups are more prone to stress-related habits and illness


Other Dimensions

Spiritual dimension It includes :

- principles and ethics- the purpose in life

- religious beliefs and values

all are important components of the way the person behaves in

health and illness .


Vocational dimension When work is fully adapted

to human goals, work often plays a role in promoting both physical and mental health .

The importance of this dimension is clear when individuals suddenly lose their jobs or retire .

Other Dimensions



-Behavioral -Environmental

-Health services

-Gender- Other factors


-Physical environment-Biological environment-Psychosocial environment

1 -Behavioral:Determinants of Health

-Nutrition/ food-Personal hygiene

-Habits

&customs-Smoking ( passive

smoking )-Alcohol & substance abuse

-Exercise - Sleep

- Violence/ abuse- Recreation

- Compliance to treatment

- Reaction to stress

Determinants of Health1 -Behavioral:

2 -Environmental :A- Physical environment:

- Air - Water (quantity and quality)

- Waste disposal- Housing- Climate

-temp.- humidity and rainfall


Determinants of Health 2- Environmental: A- Physical environment:

- Geography - Heat- Light- Noise

- Vibration- Radiation

B- Biological environment: -Man(age, sex, genetic)

-Microbes -Insects-Rodents-Animals-Plants

Determinants of Health 2- Environmental :

C- Psychosocial environment:

-Habits-Customs-Ethnicity-Cultural values

Determinants of Health 2- Environmental :

Ethnicity

languageculture

religion common origin

( ancestry )shared history

Identification with a social group on grounds of :

Determinants of Health2- Environmental: C- Psychosocial environment:

Culture

Knowledge,Beliefs,Goals ,Values ,

Attitudes andPractices

Complex social phenomenon of shared :


- Religion/Morals- Education/health

awareness -Employment

- Community life- Housing


How EDUCATION influences health

High level of education can lead to:• Employment:

secure well paid

health benefits• Good health: by developing favorable

knowledge attitudes behaviors


- Political organization: %-GNP on health

- Resource allocation- Services:

-Availability- Accessibility

- Commitment to development ( social NOT economic )

for all

people


-SES is associated with health outcomes:

Mortality Morbidity Disability

Well-beingpeople of higher SES have better health

than people of lower SES:


SES: Socio-economic statusEducationOccupationIncomeHousing

SES: Socio-economic statusEducation• Illiterate

• Elementary

• Intermediate

• Secondary• University• Postgraduate

8

1

7 543

SCORE

SES: Socio-economic statusOccupation• Unemployed

• Laborer• -------------• -------------• -------------• Professional

1

6 543

8

SCORE

SES: Socio-economic statusIncome(per month)• < 1000• 1 000- 4 000

• 5 000-14 000

• -------------• -------------• > 50 000

1

6 543

SCORE

2

SES: Socio-economic statusHousing

• Shack• Traditional house • Apartment

• Villa

1

6

3

8

TypeSCORE


• -----------• -----------• -----------• -----------• -----------

21

543

NeighborhoodSCORE


• Rented• Mortgaged

• Owned

8

15

OwnershipSCORE

SES: Socio-economic status

Housing Ownersh

ip Neighborhood Type

Occupation EducationMinimumMaximum

T o t a l

Score

88 6 8 511 111 4

29

Average

17

Income

81

Lower ClassMiddle ClassUpper Class

11 - 224 - 10

23 - 29

< 11

>2311 - 22

SES: Socio-economic status

RANGE

-SES is associated with health outcomes:

Mortality Morbidity Disability

Well-beingpeople of higher SES have better health

than people of lower SES:


3 -Health Services related determinants :

- H. E.- MCH

- Control of communicable disease- Control of non-communicable

disease


4- Gender related determinants:

1993 Global Commission on Women’s Health

- Reproductive health- Nutrition

- Employment/occupation- Domestic violence


5 -Other Factors: .Transition related

determinants: Industrial age information age

Information & Communication Revolutioneasy access to health

information medical professionals and the

public


Intersectoral related determinants : Food & agriculture

Education Industry

Social welfare

Determinants of Health5 -Other Factors:

Rural development Raising standard of living Employment opportunities Increased wages

Determinants of Health5 -Other Factors:

INEQUALITYINEQUITY

عدم الظلالمساواة

م

Health Inequities exist BETWEEN COUNTRIES and

WITHIN COUNTRIES

Life Expectancy:

Children have dramatically different life expectancies depending on where they

were born :Japan or Sweden: > 80 years ;Brazil: . . . . . . . . . .. . . .72 years ;India: . . . . . . . . . . . . . . . 63 years ;African countries: < 50 years.

Health inequities between countries

the infant mortality rate (the risk of a baby dying between birth and one year of age) is:

2 per 1000 live births in Iceland.

>120 per 1000 live births in Mozambique ;

Risk of maternal death during or shortly after pregnancy is

only 1 in 17 400 in Sweden but it is 1 in 8 in Afghanistan .

Health inequities between countries

Health inequities within countriesWorldwide between:

rich and poor, men and women ,

dominant and marginalized ethnic groups

all lead to differences in health and longevity.

:by gender

Indian Subcontinent(UN 1987-9): girls : death rate nearly twice as boys:

due to family behavior .

1/6 death: neglect and discrimination .

less than boys: immunization and nutritional status.

Health inequities within countries

New philosophy of Health*Fundamental right

*Intersectoral*Integral part of Development

*Central to Quality of Life*Involves Individuals, Families,

Communities Local, National and International responsibilities

*Social Investment*World wide Social Goal

H E A L T H

HEALTH

ealthducationgricultureaborreasuryousing

A. Mental DimensionB. Physical DimensionC. Social DimensionD. Spiritual Dimension

Choose one "Dimension of Health" from the list above (A – D) for each of the phrases below in (Questions : 1– 2 ) :

1. Freedom from internal conflicts : A. B. C. D.2. Economic level : A. B. C. D.

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Determinants of Health

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