Question

Determinants of health reach beyond the boundaries of traditional health care and public health sectors. Sectors such as education, housing, transportation, agriculture, and environment can be important allies in improving population health. Provide a documented example in which this has been demonstrated, and provide supporting evidence.

Answer 1

Ans) Determinants of health are factors that contribute to a person’s current state of health. These factors may be biological, socioeconomic, psychosocial, behavioral, or social in nature. Scientists generally recognize five determinants of health of a population:

Genes and biology: for example, sex and age
Health behaviors: for example, alcohol use, injection drug use (needles), unprotected sex, and smoking
Social environment or social characteristics: for example, discrimination, income, and gender
Physical environment or total ecology: for example, where a person lives and crowding conditions
Health services or medical care: for example, access to quality health care and having or not having insurance
Other factors that could be included are culture, social status, and healthy child development. Scientists do not know the precise contributions of each determinant at this time.

- In theory, genes, biology, and health behaviors together account for about 25% of population health. Social determinants of health represent the remaining three categories of social environment, physical environment/total ecology, and health services/medical care. These social determinants of health also interact with and influence individual behaviors as well. More specifically, social determinants of health refer to the set of factors that contribute to the social patterning of health, disease, and illness.
- Addressing social determinants of health is a primary approach to achieving health equity. Health equity is “when everyone has the opportunity to ‘attain their full health potential’ and no one is ‘disadvantaged from achieving this potential because of their social position or other socially determined circumstance.” Health equity has also been defined as “the absence of systematic disparities in health between and within social groups that have different levels of underlying social advantages or disadvantages—that is, different positions in a social hierarchy.” Social determinants of health such as poverty, unequal access to health care, lack of education, stigma, and racism are underlying, contributing factors of health inequities.