127175856-Determinants-of-health-ppt.ppt

127175856-Determinants-of-health-ppt.ppt

1. Determinants of health
MARGARET Hannah

2. •Health is multi-factorial
•These factors are both with in individual and
externally in the society.
•What man is and the diseases he has fallen victim is
to due to genetics and the environment.
•These factors interact; interactions may be health
promoting or not.
Determinants of health

3. •There are as many determinants but these are
the most important;
–Heredity
–Environment
–Life style
–Socio-economic conditions
–Health and family welfare services
–Others
Determinants of health

4. •The physical and mental traits of every human; to some
extent is determined by genes.
•Genetic make up is unique and cannot be altered after
conception.
•A number of diseases are genetic in nature
List all the genetic diseases
Heredity

5. Hippocrateswere the 1
st
to relate disease and
environment.
There are two types of environment;
1.Internal
◦Pertains to the each and every component part, every
tissue, organ, system and their harmonious
functioning. (the domain of internal medicine).
2.External or the macro environment
◦Include all the those things man is exposed to.
◦May be divided into physical, biological and
psychosocial components.
Environment i

6. •It is established that environment has a direct
impact on the physical, mental and social wellbeing
of those living in it.
•The environmental factors include;
1.Housing
2.Water supply
3.Waste management
4.Psychosocial stress
5.Family structure
6.Economic support systems
Environment ii

7. It is composed of cultural and behavioral patterns and
life long habits.
Life style are learnt through social interaction with
parents, peer groups, friends, siblings and mass media.
Life style some times is health promoting or health
inhibiting
Give examples of life styles that are health inhibiting.
Give examples of life styles that are health promoting.
Life styles

8. •Health status is determined by their level of their development
per capita GNP, education, nutrition, employment, housing,
political system, e.t.c
1.Economic status
I.GNP is the mostly used measure of economic performance.
II.Economic progress; a major factor In reducing morbidity,
mortality, increasing life expectancy and improving the
quality of life.
III.It determines the purchasing power, standard of living,
quality of life, family size, pattern of diseases and deviant
behaviour in the community.
IV.Important factor in seeking health care.
Socio-economic conditions i

9. 2.Education
Is a factor influencing health; especially females.
The world map of illiteracy closely coincides the maps of
poverty, malnutrition, ill health, high infant, child and maternal
mortality rates.
Education compensates the effects of poverty on health
irrespective of the availability of health facilities (study in
India).
In the state of Kerala where Fe literacy 86.9%, IMR=12
compared to Fe literacy 39.4%; and IMR = 71%;
Socio-economic conditions ii

10. 3.Occupation
•State of being employed in productive work
promotes health.
•The unemployed show higher incidence of ill
health and death.
•For many loss of work may mean loss of income,
status and may cause psychosocial and social
damage.
Socio-economic conditions

11. 4.Political system
Health is always related to the political system.
Often obstacles to implementation of health
technologies are not technical but rather political.
Decisions concerning resource allocation, man power
policy, choice of technology and the degree to which
health services are made available and accessible to
different segment of society are examples of a political
system.
Socio-economic conditions iii

12. Health and family welfare cover a wide spectrum of
personal and community services for treatment of
diseases, prevention of illness and promotion of health.
The purpose of health services is to improve the health
status of populations.
The services include and are not limited to;
immunization, ANC, provision of safe water etc
To be effective the services must reach the peripheral,
equitably, distributed, accessible at an affordable cost by
the country and community ……PHC.
Health services

13. •Derived from systems outside formal health
care systems;
–Food,
–Agriculture
–Development
–Social welfare
–Industry
Other factors

14. Concepts of disease causation
Margaret Hannah

15. •There are many concepts of disease causation;
1.Germ theory (single cause idea or one to one)
relationship between causal agent and disease.
2.Agent man disease
3.Epidemiologic or disease triad
4.Ice berg concept.
5.Herd immunity concept.
Concepts of disease causation

16. 5.Multi-factorial causation; realization that single
cause was over an oversimplication; there are
other factors in the cause of disease which are
equally important.
•Some diseases have multiple causes e.g. TB is
merely due to the tubercle bacilli; poverty, poor
housing, over population, overcrowding, other
infections, malnutrition.
•Coronary heart disease and cancer.
6.Web of causation
Concepts of disease causation

17. Different disease are common in different places
and at different times.
To understand this we need to consider the;
1.The living organism of disease (Agent; toxic/infectious)
2.The people they infect (Host)
3.The surrounding where they live (Environment)
The agents need a suitable environment in which
the grow, multiply, able to spread.
If they don’t succeed in doing this they die out
Epidemiologic or disease triad

18. The disease traid
Disease
Environment
Agent Host

19. •Disease is a result of complex interactions (imbalance) between the
agent, host and environment.
•The components of this interaction differ depending upon
circumstances of each group of affected populations.
•Recognizing the different components of this triad is important
because they are the source of opportunities to reduce disease at
multiple points in the transmission cycle.
•A common mistake is to focus on only one aspect of the triad for
disease control or prevention and to overlook the others.
The disease triad

20. The disease triad

21. The hosts are affected by their environment; for
example they may live in hot and wet climate but
people can change the environment by draining
swamps, changing the vegetation and adding
competing hosts.
Similarly, the environment can affect the agent, e.g
the altitude and temperature.
When the balance between the 3 is constant, there
will be a fairly steady number of people falling sick
all the time. When this happens the disease is said to
be endemic.
Illustration of the triad

22. •If the balance is shifted in favour of the organism,
e.g. Many non immune, there will be large number
of cases in a short time and this is said to be an
epidemic.
•When all the non immune have been diseased, the
number of the new cases will decline.
•If the balance is shifted against the agent the disease
will be controlled and the number of cases will go
down.
Illustration of the triad

23. •While many people may be exposed, a few of them are likely to
be infected.
•Human diseases are not randomly distributed in populations but
rather, their distribution is influenced by a number of factors.
•Examples include but are not limited to;
1.Innate resistance (e.g. gastric barrier, mucocilliary
transport mechanism)
2.Previous exposure
3.Passive immune status (neonates)
The host factors

24. 4.Age
5.Sex Gender
6.Behavior (e.g. mutual grooming, dominance, )
7.Production status (e.g., lactating vs. non-lactating)
8.Reproductive status (e.g., pregnant vs. non-pregnant,
sterile vs. intact)
9.Genetics
Host factors

25. •Age is a very important because the risk of many
diseases change widely over a persons life time.
•Neonates are very susceptible to many enteric and
respiratory infections but resistance increases as
the person grows.
•As immunity decreases in advanced age
susceptibility increases.
Host factors

26. 1.Dose (infective dose, concentration of organism in
the infectious material).
2.Environmental hardiness (the ability of agent to
survive in the environment).
3.Virulence (microbial): ability to cause disease
4.Infectivity (microbial): ability to establish infection
5.Toxicity (poisons): ability to cause toxicity.
The agent factors

27. 1.Population density
2.Peron movement between population.
3.Housing (e.g. ventilation, sanitation)
4.Animal stocking density
5.Environmental conditions (e.g. temperature, humidity, wind velocity,
precipitation)
6.Nutrition (protein, energy and macro and micro mineral adequacy)
7.Animal movement between groups
The environmental factors

28. •Many infectious agents are susceptible to the
ultraviolet (UV) in direct sunlight and desiccation.
Others survive for longer periods.
•These factors interact in complex ways that are
often under control of man.
•Example : increased population may lead to increased
microbial load in the environment, a roof –prevent exposure of
microbes from UV, poor ventilation-increase humidity-increased
survival of organisms-increase exposure and infects more people.
The environmental factors

29. •Based on the epidemiologic triad of disease
causation, briefly explain why malaria is a
common infection in South Sudan.
Assignment