KP 231 - Lecture 3 - Determinants of Health

Chronic Disease

• last one year or longer

• require ongoing medical attention

• limits activities of daily living

• termed as non-communicable diseases

• chronic diseases surpasses infectious disease

Chronic Disease Examples

Heart Disease, Cancer, Diabetes

Determinants of Health

• factor or event that is capable of bringing change in the health status of an individual or population

• Biological, social, cultural, economic, physical

Risk Factor

An exposure that is associated with a disease, morbidity, mortality, or adverse health outcome

Determinant Modifiability

1) Modifiable Determinants

2) Non-modifiable Determinants

Modifiable Determinants

can be changed to alter health outcomes

Modifiable Determinants Example

Behaviour, lifestyle, some social and environmental

Non-modifiable Determinants

Cannot be changed to alter health outcomes

Non-modifiable Determinants Example

Genetics, age, sex, ethnicity

Why does Modifiability Matter?

• targets health promotion programs to modifiable factors

• earlier we catch diseases the more treatable (ex. cancer screening)

Key Determinants of Health

1. Income and Social Status

2. Social Support Networks

3. Education

4. Employment/Working Conditions

5. Social Environments

6. Physical Environments

7. Personal Health Practices and Coping Skills

8. Healthy Child Development

9. Biology and Genetic Endowment

10. Health Services

11. Gender

12. Culture

Canadians and Determinants of Health

• 50% of factors associated with health (gender, income)

• 25% health care (access/wait time)

• 15% biology (genetics)

• 10% environment (air quality)

Social Determinants of Health (SDH) / Primary Factors

that shape the health of Canadians are not medical treatments but rather the living conditions they experience

Social Determinants of Health

1) Income and Social Status (most important)

2) Social Support Networks

3) Education

4) Employment/Working Conditions

5) Social Environments

6) Physical Environments

7) Healthy Child Development

8) Culture

1) Income and Social Status

Health outcomes improve with each increase in income and social status

Income and Social Status With Health

• higher income =

  • better living conditions

  • access to nutritious food and health care

  • lower job stress

  • longer life expectancy

2) Social Support Networks

Strong support from family, friends, and communities improves health

Social Support Networks With Health

• buffering stress

• enhancing well-being

Sociap Support Networks with Health Example

social relationships having a greater impact on health than smoking or drinking

3) Education

health status improves with level of education and is closely tied to socioeconomic status

Education With Health

Effective education for children ad lifelong learning for adults are key contributors to health and prosperity for individuals and for the country

Education with Health Example

as we decrease our education the probability of health problems increases (regardless of sex, gender, ethnicity)

4) Employment / Working Conditions

Working conditions both physical and psychosocial, income, stress levels, and job control strongly influence health

Employment/Working Conditions with Health

with safer, lower-stress, and more supportive jobs linked to better physical and mental well-being and longer life

Employment/Working Conditions With Health Example

• desk job / stress increases chances of chronic diseases

• different jobs cover different levels of health insurance

• higher paid jobs = greater access to health care

5) Social Environments

Societal values and social environments shape individual behaviors and relationships, which together influence health and well-being.

Dimensions of Social Environments for a Healthy Lifestyle

1) individuals

2) individuals within their social environments (family)

3) the relation between individuals and their social environment

Social Environments

social environments/relationships can add resources to an indiviudals list of strategies to foster health and cope

6) Physical Environments

Environmental exposures and community design, including air and water quality, housing, and local surroundings, significantly influence physical and psychological health

Physical Environments Example

The more tobacco shops around your school the more susceptible you are to begin smoking

7) Healthy Child Development

Early childhood experiences, especially from conception to age six, strongly shape brain development, lifelong health, trust, emotional control and positive relationships in the future

Healthy Child Development with Health

• positive environments lead to improved learning, behaviour and health into adulthood

• Infants and children who are neglected or abused are at higher risk for injuries, a number of behavioural, social and cognitive problems later in life and death

Healthy Child Development Examples

• Canadas government child tax has gotten many kids out of poverty

• Ontario's lunch/snack programs

8) Culture

Cultural participation strengthens social cohesion, supports mental and physical health, and improves resilience and well-being, while exclusion and marginalization increase health risks for some groups

Non Modifiable Determinants

• cannot be changed to alter health outcomes

• associated with the development of risk factors and disease

  • ex. age, sex, ethnicity, genetics

Age With Health

• linked to disease risk

• ex. immunity, development, age related lifestyle

Sex with Health

• differences in disease frequency exists between sexes

• biological

  • reproductive system

  • hormonal effects

  • genetic predisposition

• non-biological reasons

  • differences in social roles and health related behaviours