sss

1. Unit 2: Determinants of health
and disease

2. Definition
• The World Health Organization (WHO) defines
the social determinants of health (SDOH) as
the conditions in which people are born, grow,
live, work and age
• These circumstances are shaped by the
distribution of money, power and resources at
global, national and local levels

3. Key Determinants of health
• Income and Social Status
• Social Support Networks
• Education and Literacy
• Employment/Working Conditions
• Social Environments
• Physical Environments
• Personal Health Practices and Coping Skills
• Healthy Child Development
• Biology and Genetic Endowment
• Health Services
• Gender
• Culture

4. What are social determinants of
Health?

5. Four categories of disease determinants
Social/Environmental
/ Political
Determinants
Behavioral/Individual
Determinants
Clinical/Physiological
Determinants
Health outcome
(Consequences)
physical
environment
social inequality
(poverty)
social exclusion
social support
Health systems
Other
Government and
NGOs structures
substance use
problems
Alcohol
violence
illicit drugs
motor vehicle
traffic
physical
inactivity
poor diet
tobacco
unsafe sex
Communicable
diseases,
NCDs: heart
disease
high blood
pressure
diabetes (type 2)
high cholesterol
overweight/obesity
asthma
HIV/AIDS
depression
malnutrition
Disability and
morbidity
ischemic heart
disease*
HIV/AIDS
lung cancer
stroke*
depression*
suicide
….

6. Why do we need to know it?
The web of causation of disease and injury is
complex, but each component part can be
mapped, its contribution to disease burden
can be estimated, and prevention strategies
can be informed by a systematic analysis of
what has been evaluated elsewhere
Interventions can (and need to be) applied at
every level

7. Why Emphasize Social Determinants?
Social determinants of health have a
direct impact on health
Social determinants predict the
greatest proportion of health status
variance
Social determinants of health
structure health behaviours
Social determinants of health interact
with each other to produce health

8. Context of social determinants in
Rwanda
QUESTION
Discuss each category of the social
determinants of health in Rwandan
context?