Determinants of Health

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

3. What is health?

4. What is determinants?

5. 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