If we accept the correlation between wealth and health, we begin to ask why? What is it about being ‘better off’ that leads to better health? Is it simply access to money that buys better food, a better home in a better neighborhood, and access to better schools? From this question about why, we begin to look at a wider assortment of factors that influence health. This simple diagram, based on the traditional epidemiological triangle (host, agent and environment) shows that in order to understand patterns of health and disease we must understand each category of factors From this simple model we have progressed to much more complex models and efforts to understand the determinants of health that include not just the physical and biological but also the social, psychological, emotional, and behavioural influences on health. The reason that we do this is because we devote a lot of time, attention and resources to maintain or improve health of individuals and populations. A large share of this has traditionally been channeled through the medical care system and the public health care system. *If we are to do our jobs properly we must have some understanding of what is now almost a vast lybrinthe of evidence of the determinants of health. From this we can endeavour to provide an appropriate mix of services, programs and policies to improve health.
There are a number important limitations to this conceptual model for measuring disparity. Philosophical differences exist as to whether any determinants of health should be considered unavoidable. Some also feel that all inequalities constitute inequities Practical limitations include our ability to identify relevant determinants for specific diseases, and how these may vary across populations. Empirical linkage between some determinants and health status has been made, but remains imprecise. Some determinants of health are categorical – such as gender. Others are probably continuous, such as culture and freely-chosen behavior, that are to a large extent unavoidable, but which may have an avoidable component. Finally, ethics are a subjective matter, and a judgement of what is inequitable will depend as much on who judges as how the judgement is made.
El triángulo epidemiológico causal de las enfermedades está formado por el medio ambiente , los agentes y el huésped . Un cambio en cualquiera de estos tres componentes alterará el equilibrio existente para aumentar o disminuir la frecuencia de la enfermedad, por lo tanto se pueden llamar factores causales o determinantes de la enfermedad
Like social environments, physical environments exert powerful influences on health. These can be related to…. There can also be important interactions between social and physical environments; for example industrial areas are not often located near high income neighbourhoods, ‘ agents of disease’ includes microbiological, toxicological, mechanical, kinetic, radiation, etc
Edad- padecer ciertasenfermedades esta en relacion directa con la edad. Sexo- Hay enfermedades propias de cada sexo Etnicidad- ciertas enfermedades se presentan en determinados grupos etnicos Ocupacion-existen riesgos ocupacioneales que predisponen a padecer ciertas enfermedades