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Determinants of Health
Dr.Abhay B Mane
Professor,
Dept. of Community Medicine
COMPETENCY CM 1.2
Define health; describe the concept of holistic
health including concept of spiritual health and
the relativeness & determinants of health
What is health?
What is determinants?
Determinants of health?
Biological determinants
 Our genetic make up at conception
E.g. chromosomal abnormalities
Metabolic disorder
Mental retardation
 Impact of modern medicine-
genetic counseling
Gene therapy
Biological determinants
 Health Defn- state of health based on absence of
genetic constitution of genes that correspond serious
defect, presence of genetic constitution of genes that
correspond normal characterization, normal karyotype.
 Positive health (WHO)- Implies that person should able
to express potentialities of genetic heritage
Behavioural & sociocultural conditions
 Lifestyle-the way people live
 Social values
 Attitude
 Activities
 Learnt from-?
 Parents, peer group, friends, sibling, school, media
 Association of lifestyle & health
 Developing countries- Developed countries
 lack of sanitation, poor nutrition NCD
 Poor personal hygiene, habits
 Customs, cultural practices
Environmental factors
 Hippocrates first relate disease to env.
 Classification
 Internal
Tissue, organ, system
Their functioning in system
 External/macro env.
All that is external to human
Divided into Physical, biological, psychological
 Direct impact on physical, mental, social well being of person
 Full use of physical & mental capabilities in favourable env.
Socio-economic conditions
 Per capita GNP
 Education
 Nutrition
 Employment
 Housing
 Political system
Socio-economic conditions cont…
1.Economic status
reduce morbidity
Increase life expectancy
Improve quality of life
Determines
purchasing power
Standard of living
Family size
Pattern of disease- higher rates of NCD
Behaviour in community
Socio-economic conditions cont..
2.Education
Illiteracy (mainly females)
Poverty
Malnutrition- underweight-Kerala-19.7% Bihar-41%
- stunting- Kerala- 23.4%, Bihar- 42.9%
Ill health
High IMR, Child MR
E.g. Kerala- IMR-4.4 & Female literacy-98.3% (NFHS-5)
E.g. Bihar- IMR-46.8 & Female literacy- 57.8% (NFHS-5)
Socio-economic conditions cont..
3.Occupation
Unemployment- higher ill health & death
Loss of work- loss of income, status
Psychological & social damage
Socio-economic conditions cont..
4.Political system
 Technocrat, Beaurocrat,
 % of GNP on health care (target 5% of GNP by WHO)
 Decision of resource allocation
 Manpower policy
 Choice of technology
 Who will get benefit (accessible & available to them)
Health services
 For prevention of illness, health promotion, treatment of
disease
 Immunization of children influence incidence/prevalence of
particular disease
 Provision of safe water reduce mortality, morbidity from water
borne diseases
 MCH services reduce mortality, morbidity
 Should be equitably distributed, accessible at cost country &
community can afford, socially acceptable-Primary Health
Care
Aging of population
 Rapid population aging- increased prevalence of
chronic diseases & disabilities
Gender
 Over yrs due to increased emphasis on women
health, it becomes priority in all developmental
plans
Other factors
 Mass medias
 Food & agriculture education
 Industrial development
 Social welfare
 Rural development
 Insurance policies
 Employment opportunities
 Increased wages

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CM 1.2 Determinants of health in PSM.pptx

  • 1. Determinants of Health Dr.Abhay B Mane Professor, Dept. of Community Medicine
  • 2. COMPETENCY CM 1.2 Define health; describe the concept of holistic health including concept of spiritual health and the relativeness & determinants of health
  • 6. Biological determinants  Our genetic make up at conception E.g. chromosomal abnormalities Metabolic disorder Mental retardation  Impact of modern medicine- genetic counseling Gene therapy
  • 7. Biological determinants  Health Defn- state of health based on absence of genetic constitution of genes that correspond serious defect, presence of genetic constitution of genes that correspond normal characterization, normal karyotype.  Positive health (WHO)- Implies that person should able to express potentialities of genetic heritage
  • 8. Behavioural & sociocultural conditions  Lifestyle-the way people live  Social values  Attitude  Activities  Learnt from-?  Parents, peer group, friends, sibling, school, media  Association of lifestyle & health  Developing countries- Developed countries  lack of sanitation, poor nutrition NCD  Poor personal hygiene, habits  Customs, cultural practices
  • 9. Environmental factors  Hippocrates first relate disease to env.  Classification  Internal Tissue, organ, system Their functioning in system  External/macro env. All that is external to human Divided into Physical, biological, psychological  Direct impact on physical, mental, social well being of person  Full use of physical & mental capabilities in favourable env.
  • 10. Socio-economic conditions  Per capita GNP  Education  Nutrition  Employment  Housing  Political system
  • 11. Socio-economic conditions cont… 1.Economic status reduce morbidity Increase life expectancy Improve quality of life Determines purchasing power Standard of living Family size Pattern of disease- higher rates of NCD Behaviour in community
  • 12. Socio-economic conditions cont.. 2.Education Illiteracy (mainly females) Poverty Malnutrition- underweight-Kerala-19.7% Bihar-41% - stunting- Kerala- 23.4%, Bihar- 42.9% Ill health High IMR, Child MR E.g. Kerala- IMR-4.4 & Female literacy-98.3% (NFHS-5) E.g. Bihar- IMR-46.8 & Female literacy- 57.8% (NFHS-5)
  • 13. Socio-economic conditions cont.. 3.Occupation Unemployment- higher ill health & death Loss of work- loss of income, status Psychological & social damage
  • 14. Socio-economic conditions cont.. 4.Political system  Technocrat, Beaurocrat,  % of GNP on health care (target 5% of GNP by WHO)  Decision of resource allocation  Manpower policy  Choice of technology  Who will get benefit (accessible & available to them)
  • 15. Health services  For prevention of illness, health promotion, treatment of disease  Immunization of children influence incidence/prevalence of particular disease  Provision of safe water reduce mortality, morbidity from water borne diseases  MCH services reduce mortality, morbidity  Should be equitably distributed, accessible at cost country & community can afford, socially acceptable-Primary Health Care
  • 16. Aging of population  Rapid population aging- increased prevalence of chronic diseases & disabilities
  • 17. Gender  Over yrs due to increased emphasis on women health, it becomes priority in all developmental plans
  • 18. Other factors  Mass medias  Food & agriculture education  Industrial development  Social welfare  Rural development  Insurance policies  Employment opportunities  Increased wages

Editor's Notes

  1. Micro env./ domestic environment- personal way of living, eating habits, smoking, drinking, use of drugs
  2. India spend only 2% of GNP on health care