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Determinants of Health
Determinants of Health
• Health is multi factorial.
• Some are inside the body-
genetic/intrinsic
• Some are - External factors
/environmental
• Interaction of them may be---
--health promoting
--deleterious.
Common Determinants of Health
• Genetic factors (biological)
• Environmental factors
• Life style
Behavioral & socio-cultural
• Gender & Age
• Socioeconomic conditions
Education, Occupation, Income
• Health services –utilization
Immunization, Family welfare
,nutritional…
Other determinants of health -
• Food & agriculture
• Education.
• Science & technology.
• Standard of living.
• Social justice, equity, human rights.
• Govt Polices to raise stand of living
• Inter sectoral contributions
• Dissemination of information (IEC)
Biological
determinants
• Genetic make-up (Heredity)
• It is permanent & can not be
altered.
• Transmitted by hereditarily.
• No treatment.
• Many be Prevented to some
extent.
Environmental
factors-
• Internal environment/Micro
• External environment/Macro
Physical-air, water, soil
Biological-
plants,animals,microbes
Social-culture,belifes,traditions-
Dynamic equilibrium is Health
Behavioral & socio-cultural
(Life style)
• Depends on economic status
(rich &
poor)
• Cultural values
vegetarianism-Non-vegetarianism
• Social values
Status of women
• Personal habits
Smoking…..
• Behavioralpattern
High risk behavior
Life style
• Learnt by observations by –parents, teachers,
peer groups, mass media…..
Includes cultural pattern, social value &
behavior…
• The way people thinks & live
- developedthrough process of socialization&
social interaction. (traditional lifestyles)
• So cultivate healthy lifestyles
like propernutrition &
sleep, exercise, avoid
drug abuse,
Life-style makes the
difference
• Malnutrition.
• Population explosion.
• Mental health
problems.
• RCH
• Cancer.
• Diabetes mellitus
• Cardiovascular
diseases
• AIDS & STDs.
• Environmental
Socioeconomic
conditions
• Determined by-Income (per
capita)
Literacy
Occupation
Purchasing
capacity
• Indirectly by-religion & caste
- Housing
- Political support
Economy &
literacy
• Determines quality of life (PQLI)
by
-Employment ,housing, nutrition.
- Productive workpromotes
health
-Finally determine health status
-
Socioeconomic
conditions---
• Per capita GNP
• GNP directed to wards health
care
• Political commitment
• Efficient leadership
Health services
• Availability & utilization of health
services
• Should include comprehensive
services
• Need based essential
• Must reach to social periphery
• Equitably distributed
• Accessible at affordable cost
• Socially acceptable
Health services
• Should promote health & prevent
illnesses. Eg:- Immunization of
children—
Provision of safe drinking
water— ANC-will reduce
MMR & IMR.
• Services must reach to all sections.
Family welfare services
• Covers spectrum of personal &
community services for treatment
,prevention & promotion of health
Like--- immunization, family planning,
MCH,ICDS, Nutritional….
Gender & Age
• Women’s affected by gender
difference
• Nutrition & development
• Violence
• Social status
• Economic independence
• During reproductive age
• Aging –leads Geriatrics problem
Other factors
• Better IEC system
• Rural development
• Employment opportunities
• Increased wages
• Family support systems
• Inter-sectoral coordination
between—
Depts. of education , agriculture, civil,
labor, environment, social welfare….
Indicators of health
• To measure health
status.
• To compare
• To assess the health
needs
• To plan & implement----
• To evaluate health care
Health is measured multi-
dimensionally &
indirectly
Health Indicators classified
as….
• Mortality indicator
• Morbidity indicators
• Disability indicators
• Nutritional status indicators
• Health care delivery indicators
• Utilization rates
Health Indicators also classified
as….
• Indicators of social & mental
health.
• Socio-economic indicators.
• Health policy indicators.
• Environmental indicators.
• Indicators of quality of health.
Mortality
Indicators
• Crude death rates
• Infant mortality rates
• Maternal mortality rates
• Child mortality rates.
• Proportional mortality
rates.
Morbidity
indicators
• Incidence rate
• Prevalence rate.
• Notification rate.
• Out patients attendance rate.
• Hospital admission rate
• Duration of stay in the
hospital.
Disability
rates
• Event type
No of days of restricted
activity. Bed disability days.
Sickness absenteeism.
• Person type
Limitation of mobility.
Limitation of daily
activity.
Nutritional status
indicators
• Incidence of LBW
• Incidence of LBW
• Anthropometric measurements of
< 5 mid arm circumference
height & weight with age
Health care delivery
indicators
• Doctor : Population.
• Nurse: Population
• Health worker:
Population
• Sub centers: Population
• P H C : Population
1:2500
1:5000
1:300
0
1:3000
1:30000
Indicators of social & mental
health
• Rates of crimes--- murder, theft,
suicides, Prostitution, gambling, drug
abuse….
• Rates of accidents.
• Rate ofdivorces, family violence
Socioeconomic
indicators
• Growth rate of population.
• Per capita income / GNP.
• Percentage of people below poverty
line.
• Level of unemployment.
• Dependency ratio.
• Literacy rate.
• Family size.
Health policy
indicators
• Proportion of the budget (NGP) spent
on… Health services—
RCH, RNTCP, ICDS, Pulse polio
Health related services—
Water
supply
Sanitation.
Nutritio
n
Housing
Environmental
indicators
• Indicators relating pollution of air,
water, noise, soil, radiation solid
waste…
• Percentage of houses having
.. safe water supply.
adequate sanitary facilities.
• Thus there is no single comprehensive
indicator to assess or to measure the
health status of country.
• Each indicator reflects one aspect of
health.
• Ideal indicator is yet to be developed.
Thus there is no single
comprehensive indicator to assess
or to measure the health status of
country.
Utilization
rates
• Proportion of infants “fully immunized”
• Proportion of mothers with adequate
ANC.
• Proportion of Deliveries conducted by
TBA.
• “Bed occupancy” rate in the hospital.
• Coverage with insecticidal spraying.

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determinants of health.pptx

  • 2. Determinants of Health • Health is multi factorial. • Some are inside the body- genetic/intrinsic • Some are - External factors /environmental • Interaction of them may be--- --health promoting --deleterious.
  • 3. Common Determinants of Health • Genetic factors (biological) • Environmental factors • Life style Behavioral & socio-cultural • Gender & Age • Socioeconomic conditions Education, Occupation, Income • Health services –utilization Immunization, Family welfare ,nutritional…
  • 4. Other determinants of health - • Food & agriculture • Education. • Science & technology. • Standard of living. • Social justice, equity, human rights. • Govt Polices to raise stand of living • Inter sectoral contributions • Dissemination of information (IEC)
  • 5. Biological determinants • Genetic make-up (Heredity) • It is permanent & can not be altered. • Transmitted by hereditarily. • No treatment. • Many be Prevented to some extent.
  • 6. Environmental factors- • Internal environment/Micro • External environment/Macro Physical-air, water, soil Biological- plants,animals,microbes Social-culture,belifes,traditions- Dynamic equilibrium is Health
  • 7. Behavioral & socio-cultural (Life style) • Depends on economic status (rich & poor) • Cultural values vegetarianism-Non-vegetarianism • Social values Status of women • Personal habits Smoking….. • Behavioralpattern High risk behavior
  • 8. Life style • Learnt by observations by –parents, teachers, peer groups, mass media….. Includes cultural pattern, social value & behavior… • The way people thinks & live - developedthrough process of socialization& social interaction. (traditional lifestyles) • So cultivate healthy lifestyles like propernutrition & sleep, exercise, avoid drug abuse,
  • 9. Life-style makes the difference • Malnutrition. • Population explosion. • Mental health problems. • RCH • Cancer. • Diabetes mellitus • Cardiovascular diseases • AIDS & STDs. • Environmental
  • 10. Socioeconomic conditions • Determined by-Income (per capita) Literacy Occupation Purchasing capacity • Indirectly by-religion & caste - Housing - Political support
  • 11. Economy & literacy • Determines quality of life (PQLI) by -Employment ,housing, nutrition. - Productive workpromotes health -Finally determine health status -
  • 12. Socioeconomic conditions--- • Per capita GNP • GNP directed to wards health care • Political commitment • Efficient leadership
  • 13. Health services • Availability & utilization of health services • Should include comprehensive services • Need based essential • Must reach to social periphery • Equitably distributed • Accessible at affordable cost • Socially acceptable
  • 14. Health services • Should promote health & prevent illnesses. Eg:- Immunization of children— Provision of safe drinking water— ANC-will reduce MMR & IMR. • Services must reach to all sections.
  • 15. Family welfare services • Covers spectrum of personal & community services for treatment ,prevention & promotion of health Like--- immunization, family planning, MCH,ICDS, Nutritional….
  • 16. Gender & Age • Women’s affected by gender difference • Nutrition & development • Violence • Social status • Economic independence • During reproductive age • Aging –leads Geriatrics problem
  • 17. Other factors • Better IEC system • Rural development • Employment opportunities • Increased wages • Family support systems • Inter-sectoral coordination between— Depts. of education , agriculture, civil, labor, environment, social welfare….
  • 18.
  • 19. Indicators of health • To measure health status. • To compare • To assess the health needs • To plan & implement---- • To evaluate health care
  • 20. Health is measured multi- dimensionally & indirectly Health Indicators classified as…. • Mortality indicator • Morbidity indicators • Disability indicators • Nutritional status indicators • Health care delivery indicators • Utilization rates
  • 21. Health Indicators also classified as…. • Indicators of social & mental health. • Socio-economic indicators. • Health policy indicators. • Environmental indicators. • Indicators of quality of health.
  • 22. Mortality Indicators • Crude death rates • Infant mortality rates • Maternal mortality rates • Child mortality rates. • Proportional mortality rates.
  • 23. Morbidity indicators • Incidence rate • Prevalence rate. • Notification rate. • Out patients attendance rate. • Hospital admission rate • Duration of stay in the hospital.
  • 24. Disability rates • Event type No of days of restricted activity. Bed disability days. Sickness absenteeism. • Person type Limitation of mobility. Limitation of daily activity.
  • 25. Nutritional status indicators • Incidence of LBW • Incidence of LBW • Anthropometric measurements of < 5 mid arm circumference height & weight with age
  • 26. Health care delivery indicators • Doctor : Population. • Nurse: Population • Health worker: Population • Sub centers: Population • P H C : Population 1:2500 1:5000 1:300 0 1:3000 1:30000
  • 27. Indicators of social & mental health • Rates of crimes--- murder, theft, suicides, Prostitution, gambling, drug abuse…. • Rates of accidents. • Rate ofdivorces, family violence
  • 28. Socioeconomic indicators • Growth rate of population. • Per capita income / GNP. • Percentage of people below poverty line. • Level of unemployment. • Dependency ratio. • Literacy rate. • Family size.
  • 29. Health policy indicators • Proportion of the budget (NGP) spent on… Health services— RCH, RNTCP, ICDS, Pulse polio Health related services— Water supply Sanitation. Nutritio n Housing
  • 30. Environmental indicators • Indicators relating pollution of air, water, noise, soil, radiation solid waste… • Percentage of houses having .. safe water supply. adequate sanitary facilities.
  • 31. • Thus there is no single comprehensive indicator to assess or to measure the health status of country. • Each indicator reflects one aspect of health. • Ideal indicator is yet to be developed.
  • 32. Thus there is no single comprehensive indicator to assess or to measure the health status of country.
  • 33. Utilization rates • Proportion of infants “fully immunized” • Proportion of mothers with adequate ANC. • Proportion of Deliveries conducted by TBA. • “Bed occupancy” rate in the hospital. • Coverage with insecticidal spraying.