chapter 2 Determinants of Lifelong Health, Wellness, and Fitness (Notes)

Concept Overview

• Determinants of health, wellness, and fitness are multifactorial; some factors are within personal control, others are not, and some are in between. The material emphasizes a comprehensive lifestyle approach to lifelong health and fitness.

• Major categories of determinants:

  • Biological determinants: factors over which we have little control

  • Social determinants: factors related to the social environment and systems

  • Lifestyle determinants: factors we can influence through choices and behaviors

• Figure references indicate how determinants interact to influence health, wellness, and fitness (Figure 1; Figure 2).

Biological Determinants

• Definition: Factors over which we have little control that influence health outcomes.

• Key factors:

  • Heredity — accounts for about $16\%$ of all health problems

  • Sex

  • Age

  • Disabilities/health conditions

• Implication: While biology sets certain baseline risks, the degree to which these risks manifest can be moderated by other determinants (e.g., lifestyle, environment).

Social Determinants

• Definition: Factors within social structures and contexts that affect health, wellness, and fitness.

• Social determinants of health (SDH) contribute to social, racial, and cultural disparities and inequities in public health.

• Key components of SDH:

  • Economic stability

  • Education

  • Built environment

  • Community context

  • Health care access and quality

• Impact: These determinants influence opportunities for healthy living and can shape health outcomes across populations.

Lifestyle Determinants

• Definition: Factors over which individuals typically have greater personal control, though life circumstances can shape behaviors.

• The five categories of lifestyle behaviors (lifestyle determinants) are:

  • Engaging in regular physical activity

  • Establishing healthy eating habits

  • Managing stress

  • Avoiding destructive habits

  • Adopting prevention safety habits

• Note: While individuals can exercise more control, life circumstances can constrain choices and behaviors.

Healthy Habits

• Healthy habits are critical to wellness and encompass a broad set of practices beyond the core lifestyle determinants:

  • Regular physical activity

  • Nutrition habits

  • Managing stress

  • Safety habits

  • Adopting good personal health habits

  • Seeking and complying with medical advice

  • Being an informed consumer

• These habits support both personal health and public health through consistent, sustainable behaviors.

Table 1: Major Causes of Death in the United States

• Current Rank vs Current Cause:

  • $1$ — Heart disease

  • $2$ — Cancer

  • $3$ — COVID-19****

  • $4$ — Unintentional injuries

  • $5$ — Respiratory diseases

  • $6$ — Stroke

  • $7$ — Alzheimer disease

  • $8$ — Diabetes

  • $9$ — Influenza/pneumonia*

  • $10$ — Kidney disease

• 1900 Rank vs 1900 Cause:

  • $1$ — Pneumonia*

  • $2$ — Tuberculosis*

  • $3$ — Diarrhea/enteritis*

  • $4$ — Heart disease

  • $5$ — Liver disease

  • $6$ — Injuries

  • $7$ — Injuries

  • $8$ — Cancer

  • $9$ — Senility

  • $10$ — Diphtheria*

• Footnotes:

  • *Infectious diseases

  • ****Reporting issues and pre-existing conditions possibly present

• Implications: Shifts in leading causes reflect changes in public health, medical advances, and reporting nuances over time.

Table 2: Habits for Optimal Health

• Types of Habits and their focus:

  • Physical Activity Habits: Finding ways to get regular physical activity

  • Nutrition Habits: Making healthy food choices

  • Stress Management Habits: Coping with stressful situations

  • Destructive Habits: Avoiding tobacco, drugs, and excessive alcohol

  • Safety Habits: Adopting safe practices and making safe decisions

  • Social Habits: Seeking out positive influences and social support

  • Prevention Habits: Following recommended health practices

  • Medical Habits: Adhering to screening guidelines/Following medical advice

  • Consumer Habits: Making informed choices about health, wellness, and fitness

  • Environmental Habits: Supporting conservation and healthy environments

• Purpose: Provides a framework for practical, everyday actions that contribute to long-term health outcomes.

Priority Lifestyles for Good Health

• Core priorities:
  1) Regular physical activity
  2) Healthy eating
  3) Managing stress

• These lifestyles are especially critical because:

  • They affect the lives of all people

  • Improvements can be made at individual and community levels

  • Small changes can have a major impact on both individual and public health

Physical Activity

• Definition: A behavior that involves human movement and results in physiological changes, including increased energy expenditure and improved physical fitness.

• Health benefits:

  • Can help improve immune function

  • Helps reduce the risk of chronic disease

• Note: Activity types can vary; the key is consistency and progression to meaningful energy expenditure.

Healthy Eating

• Relationship to activity: Being physically active and eating well are two complementary healthy lifestyle practices that can improve well-being and add years of quality living.

• Social support: Research shows that support from others can help individuals eat healthfully.

Managing Stress

• Importance: Managing stress promotes positive immune function and a balanced life.

• Skill development: Time management is one skill that can help manage lifestyle and stress levels.

Determinant Interactions

• Determinants interact to influence health, wellness, and fitness.

• Cognitive and emotional factors influence the choices one makes (cognitions and emotions influence behavior).

• Personal actions and interactions directly influence health, wellness, and fitness (feedback loops among determinants).

Self-Management Skills

• Core idea: Personal actions and interactions can be managed to overcome barriers to healthy living.

• Practical strategies include:

  • Finding convenient, safe spaces to be physically active; e.g., walking inside when weather is bad or advocating for safe and healthy environments

  • Using self-management tools to adopt and sustain a healthy lifestyle

• Specific self-management tools:

  • Using time effectively

  • Obtaining help and social support from friends and family

  • Building knowledge

• Takeaway: Self-management empowers individuals to translate knowledge into sustained healthy behaviors, even in the face of barriers.

Figure References (Note)

• Figure 1: Determinants of health, wellness, and fitness (conceptual) – demonstrates broad categories and their interactions.

• Figure 2: Influence of personal actions and interactions on health, wellness, and fitness – underscores how daily decisions shape outcomes.

• Text notes highlight the availability of text alternatives for slide images where provided.