Determinants of health.pptx

A detailed PowerPoint presentation on the determinants of health

1. SPECTRUM AND DETERMINANTS OF HEALTH Dr. Sharon Baisil 1

2. OVERVIEW Introduction Concept of positive Health Spectrum of Health Determinants of Health Definition Types 2

3. Introduction Industrial revolution of 18 th century sparked numerous health problems due creation of slums, over-crowding, accumulation of filth in cities and towns leading to high burden of sickness and death among women and children. Edwin Chadwick’s report “THE SANITARY CONDITION OF THE LABOURING POPULATION IN GREAT BRITAIN” a land mark in the history of public health created tremendous awareness among the people about the importance of health. 3

4. Many factors like where we live, what we eat, how much we earn, state of our environment, our genetic composition, our relationship with friends and family have a significant impact on our health. THE CONTEXT OF PEOPLE’S LIVES DETERMINE THEIR HEALTH , and so blaming individuals for having poor health or crediting them for good health is in-appropriate. 4

5. Definition of Health According to WHO, “Health is a state of complete physical , mental and social well-being and not merely an absence of disease or infirmity and hence an ability to lead a socially and economically productive life.” 5

6. CONCEPT OF POSITIVE HEALTH Biological-Every cell and organ is functioning at optimum capacity and in perfect harmony with rest of the body. Psychological-Individual feels a sense of well-being and of mastery over his environment. Social-Individual’s capacity for participation in social system is optimal . 6

7. SPECTRUM OF HEALTH It emphasizes that health of an individual is a dynamic phenomenon. A process of continuous change subjected to frequent subtle variations. A state , not to be attained once for all but renewed for ever . 7

8. contd Health fluctuates within a range of optimal well being to various levels of dysfunction, including the state of total dysfunction namely death. The transition from optimum health to ill-health is often gradual and where one state ends other state begins. 8

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10. DETERMINANTS OF HEALTH Health is a multi-factorial state. It depends on multiple interactions and these interactions may be Health-promoting or deleterious. Definition Factors that contribute to a person’s current state of health. These factors may be biological, socio- economic, psychosocial, behavioral etc. 10

11. IMPORTANCE OF HEALTH DETERMINANTS “ Common diseases have roots in lifestyle, social factors and environment and successful health promotion depends upon a population based strategy of prevention .” 11

12. A comprehensive health determinants frame work should achieve the following Identify the determinants of health and the determinants of inequities in health. Show how major determinants relate to each other. Clarify the mechanisms by which social determinants generate health inequities . 4. Provide criteria for evaluating which determinants are the most important to address. 12

13. societies family community individuals 13

14. DIFFERENT HEALTH DETERMINANTS Biological It includes genetic composition of an individual. The genetic make-up is unique for every individual and cannot be altered after conception. Any defect or derangement in the genetic constitution may result in serious disorders. Example-Downs syndrome, in born errors of metabolism 14

15. 2 . Environmental Hippocrates- first person to relate disease to environment. Has a direct impact on physical, mental and social well-being. Broadly classified into INTERNAL and EXTERNAL. Internal- every component, tissue, organ and organ system and their harmonious functioning within the system 15

16. External: Physical: components like clean air, clean water, good houses, good roads and safe work environment promote health. The changing climatic condition is also a matter of major concern for health of the people. Biological: Infectious agents causing diseases like bacteria, fungi, viruses, parasites etc. Psychosocial: Negative life-events, high debt burden, lack of social support. 16

17. Environmental components are not water-tight compartments. If the environment is favourable, Individual can make full use of his physical and mental capabilities. A person should maintain a healthy relationship with environment because- “ Environment can transform genotypic potentialities into phenotypic realities ”. 17

18. 3. Behavioral It includes the PERSONAL LIFESTYLE . Life long personal habits that one develops through the process of SOCIALISATION . eg- smoking, alcohol consumption, use of drugs, unhealthy food habits, sedentary lifestyle. Changing pattern of diseases can be mainly attributed to behavioral determinants. 18

19. High prevalence of chronic non-communicable diseases are attributed to LIFESTYLE 19

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21. 3. Social Determinants Broadly classified into 2 types 1. Socio-cultural determinants. 2. Socio-economic determinants. The various social determinants are Poverty. Over-crowding. Poor housing condition. Malnutrition. 21

22. 5. Social inequity. 6. Illiteracy. 7. Un-employment. 8. Political system of country. 9.Customs and traditions. 10. Lack of social support. 11. Health services. 22

23. FRAMEWORK OF SOCIAL DETERMINANTS OF HEALTH 23

24. POVERTY Wields a destructive influence from birth to grave. Main cause for low birth weight babies, un-vaccinated children, high maternal mortality, mental illness, family disintegration and substance abuse. Leads to lack of access to health care, education, resources and means to improve lives. 24

25. Economic status determines the purchasing power, standard of living, the family size and the pattern of disease. Economic progress is the major factor in reducing morbidity, improving life expectancy and quality of life 25

26. Education : Critical in determining people’s social and economic position and thus their health. Children who do well in education more likely to make healthier choices in adult life. Illiteracy leads to poverty, malnutrition, ill-health, high infant and child mortality rates. 26

27. Occupation Main factor determining adequate income is participation in productive employment. It enhances the social status, improves self-esteem, provides social contact and a way of participation in community life. Un-employment is detrimental to both physical and mental health Few occupations will have a negative impact on health Eg- people working in asbestos industry prone to develop lung cancer. 27

28. Political system and Health services Political system is important in decisions concerning Resource Allocation Manpower policy Choice of technology 4. Degree to which health services are made available and accessible to different segments of the society. 28

29. Health care services are the one performed by health care professionals or by others under their directions for promoting, maintaining or restoring health. To be effective the health services should reach social periphery, equitably distributed, accessible at a cost the country and community can afford and socially acceptable. These are the ingredients of primary health care which is a way to better health. 29

30. Public health specialists play an important role in planning and managing health services. Social inequity is also a social health determinant of major concern. The Alma-ata declaration(1978) on primary health care stressed upon the special health needs of poor and vulnerable populations and hence health equity as a policy goal emerged strongly in international debates. 30

31. The declaration of Alma-ata Education about prevailing health problems and methods to prevent them Promotion of food supply and nutrition Supply of safe water and basic sanitation Maternal and child health care Immunization against infectious diseases Prevention and control of endemic diseases Appropriate treatment of common diseases and injuries; and Provision of essential drugs. 31

32. ECOLOGY OF HEALTH Science of mutual relationship between living organisms and environment. Dubos stated that, “health implies the relative absence of pain and discomfort and a continuous adoptation and adjustment to the environment to ensure optimal function.” Disease is a mal-adjustment of the human organism to environment. 32

33. The Ecological concept of Health is based on 3 biological laws. Disease results from an imbalance between disease agents and host. The nature and extent of the imbalance depends on the nature and characteristics of the host and the agent. The characteristics of the agent and the host and their interactions are directly related to and depend largely on the nature of physical, social and biologic environment . 33

34. The dynamic concept of ecology of health can be best illustrated by the familiar principle of LEVER AND FULCRUM. 34

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36. 36 DISEASE AGENTS Parasitic, nutrient ,chemical, physical or Mechanical These affect equilibrium through Their basic nature and character Resistance and liability Reservoirs and sources Conditions of dissemination. These determine the balance of health and preventive attack HUMAN HOST Interaction with agents Individual habits and group custom Age, sex and race characteristics Defense mechanisms Constitution and heredity Psychological characteristics Changes upset balance At Equilibrium Environment The aggregate of all external conditions and influences affecting the life and development of organism. Human behavior or society Variable fulcrum position Variable fulcrum position

37. Man’s intrusion into ecological system has given raise to many health problems. Urbanization , deforestation, industrialization, construction of irrigation canals and artificial lakes have a devastating effect on the natural environment. 37

38. Environmental factors and ecological considerations must be built into total planning process to prevent degradation of ecosystems. Prevention of disease through Ecological or Environmental manipulations or interventions is much safer, cheaper and a more effective rational approach than all other means of control. 38

39. RIGHT TO HEALTH Human Rights in the year 1948 stated that “Everyone has the right to a standard of living adequate for the health and well-being of himself and his family.” The preamble of WHO constitution also states that “It is the fundamental rights of every human being to enjoy the highest attainable standard of health.” 39

40. THANK YOU 40