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KEY
DETERMINANTS |
UNDERLYING PREMISES |
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Income and
Social Status |
Health status improves at each
step up the income and social hierarchy. High income determines
living conditions such as safe housing and ability to buy sufficient
good food. The healthiest populations are those in societies which
are prosperous and have an equitable distribution of wealth. |
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Social
Support Networks |
Support from families,
friends and communities is associated with better health. The
importance of effective responses to stress and having the support
of family and friends provides a caring and supportive relationship
that seems to act as a buffer against health problems. |
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Education
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Health
status improves with level of education. Education increases
opportunities for income and job security, and equips people with
a sense of control over life circumstances - key factors that influence
health. |
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Employment/
Working Conditions |
Unemployment,
underemployment and stressful work are associated with poorer health.
People who have more control over their work circumstances and fewer
stress related demands of the job are healthier and often live longer
than those in more stressful or riskier work and activities. . |
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Social
Environments |
The array of values and norms of a society influence in varying
ways the health and well-being of individuals and populations. In
addition, social stability, recognition of diversity, safety, good
working relationships, and cohesive communities provide a supportive
society that reduces or avoids many potential risks to good health.
Studies have shown that low availability of emotional support and
low social participation have a negative impact on health and well-being.
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Physical
Environments |
Physical
factors in the natural environment (e.g., air, water quality) are
key influences on health. Factors in the human-built environment
such as housing, workplace safety, community and road design are
also important influences. |
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Personal
Health Practices and Coping Skills |
Social
environments that enable and support healthy choices and lifestyles,
as well as people's knowledge, intentions, behaviours and coping
skills for dealing with life in healthy ways, are key influences
on health. Through research in areas such as heart disease and
disadvantaged childhood, there is more evidence that powerful biochemical
and physiological pathways link the individual socio-economic experience
to vascular conditions and other adverse health events. |
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Healthy Child
Development |
The
effect of prenatal and early childhood experiences on subsequent
health, well-being, coping skills and competence is very powerful.
Children born in low-income families are more likely than those
born to high-income families to have low birth weights, to eat less
nutritious food and to have more difficulty in school. |
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Biology and
Genetic Endowment |
The
basic biology and organic make-up of the human body are a fundamental
determinant of health. Genetic endowment provides an inherited
predisposition to a wide range of individual responses that affect
health status. Although socio-economic and environmental factors
are important determinants of overall health, in some circumstances
genetic endowment appears to predispose certain individuals to particular
diseases or health problems. |
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Health Services |
Health
services, particularly those designed to maintain and promote health,
to prevent disease, and to restore health and function contribute
to population health. |
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Gender |
Gender
refers to the array of society-determined roles, personality traits,
attitudes, behaviours, values, relative power and influence that
society ascribes to the two sexes on a differential basis. "Gendered"
norms influence the health system's practices and priorities. Many
health issues are a function of gender-based social status or roles.
Women, for example, are more vulnerable to gender-based sexual or
physical violence, low income, lone parenthood, gender-based causes
of exposure to health risks and threats (e.g., accidents, STDs,
suicide, smoking, substance abuse, prescription drugs, physical
inactivity). Measures to address gender inequality and gender bias
within and beyond the health system will improve population health.
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Culture |
Some
persons or groups may face additional health risks due to a socio-economic
environment, which is largely determined by dominant cultural values
that contribute to the perpetuation of conditions such as marginalization,
stigmatization, loss or devaluation of language and culture and
lack of access to culturally appropriate health care and services.
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