B.Ameena Beebi Assistant Professor of Home Science

1. Nutrition
Public

2. The Determinants of Health 2
These include:
 The physical factors
 The chemical factors
 The social factors
 The person’s individual characteristics
and behaviours.

3. Examples of physical determinants are:
 Natural environment, such as plants, weather, or climate change
 Built environment, such as buildings or transportation
 Worksites, schools, and recreational settings
 Housing, homes, and neighborhoods
 Exposure to physical hazards
 Physical barriers, especially for people with disabilities
 Aesthetic elements, such as good lighting, trees, or benches
PHYSICAL FACTORS

4. Examples of physical determinants are:
 Exposures to contaminants in air, water, food and soil, are associated
with many chronic diseases and with emerging communicable
diseases.
 Climate change and the associated weather extremes will also affect
health: hyperthermia from extreme heat, injury from extreme wind
and rain.
 Changing distribution of vectors and infectious agents introducing
disease to previously unaffected regions.
PHYSICAL FACTORS

5.  Air pollutants can also cause climate change which will affect
communities differently.
 People in urban centres do not enjoy good air quality.
Indoor air may contain constituents such as asbestos, moulds, radon
gas, carbon monoxide and methane that affect health.
 E.g. in counties where ozone pollution is high, there is often a higher
prevalence of asthma in both adults and children compared with state
and national averages. Poor air quality can worsen asthma symptoms,
especially in children.
CHEMICAL FACTORS

6.  ‘The sick building syndrome’ describes a range of ailments related
to living or working in closed buildings with poor air quality.
 Another threat to healthy indoor air quality is tobacco smoke,
especially for children living in the homes of smokers. These
children experience more asthma and bronchitis; they are at a higher
risk for sudden infant death syndrome and have more lung and ear
infections than children living in homes without tobacco smoke.
CHEMICAL FACTORS

7. Examples of social factors include :
 Availability of resources to meet daily needs, such as educational and
job opportunities, living wages, or healthful foods.
 Social norms and attitudes, such as discrimination.
 Exposure to crime, violence, and social disorder
 Social support and social interactions.
 Exposure to mass media and emerging technologies, such as the
Internet or cell phones.
SOCIAL FACTORS

8. Examples of social factors include :
 Socioeconomic conditions, such as concentrated poverty
 Quality schools
 Transportation options
 Public safety
 Residential segregation
 Culture - customs and traditions
 Access to health services
SOCIAL FACTORS

9. Socioeconomic Status
 Higher income and social status are linked to
better health. The greater the gap between the
richest and poorest people, the greater the
differences in health.
 A person’s social status is defined by a
combination of their wealth, education,
occupation and lifestyle. Each of these, alone or
in combination, can exert positive or negative
influences on a person’s health.
 The association between social status and
health is now termed social inequalities in
health.

10.  Absolute poverty refers to having inadequate resources to meet
basic needs for shelter, nutritious food, clothing, and education.
People living in poverty lack the resources and opportunities to
make choices that promote good health.
 Being poor may also expose them to inferior physical environments
that place them at risk for health problems. Absolute poverty is the
leading health determinant in lowincome countries; infants and
children are particularly susceptible to its effects.
SOCIOECONOMIC STATUS

11.  Low education levels are linked with poor health, more stress and
lower self-confidence.
 Education also has a more direct influence on health in that it affects
a person’s ability to navigate the health care system, to interpret
health information and to communicate effectively with health
professionals.
 ‘Health literacy’ refers to the patient’s ability to understand health
information and to follow guidelines for their treatment.
SOCIAL FACTORS- EDUCATION

12.  Employed people are healthier, particularly those who have more
control over their working conditions.
 The WHO recognizes fair employment and decent work as a
cornerstone of health, and advocates for fair minimum wages, full
employment, and occupational health and safety standards.
 Work-related diseases, caused or exacerbated by the patient’s work,
are derived from the amount of a person’s perceived control over
demands at work, their work satisfaction, perceived levels of
physical risk, and job security.
SOCIAL FACTORS- EMPLOYMENT

13.  This refers to support from families, friends and communities.
 It is linked to better health.
 It is a source of emotional reassurance and provides a safe place for
a person to discuss his problems, which helps him to cope with
adversity.
 It provides information and practical support, such as knowing
someone who can assist in a time of need. It can also support people
in making healthier behaviour choices.
SOCIAL SUPPORT NETWORK

14.  Access and use of services that prevent and treat disease influences
health.
 Both access to health services and the quality of health services can
impact health.
 Lack of access, or limited access, to health services greatly impacts
an individual’s health status. For example, when individuals do not
have health insurance, they are less likely to participate in
preventive care and are more likely to delay medical treatment.
HEALTH SERVICES

15. Health Services
Barriers to accessing health services
include:
 Lack of availability
 High cost
 Lack of insurance coverage
 Limited language access
These barriers to accessing health
services lead to:
 Unmet health needs
 Delays in receiving appropriate care
 Inability to get preventive services
 Hospitalizations that could have
been prevented

16.  Individual behavior also plays a role in health outcomes. For
example, if an individual quits smoking, his or her risk of
developing heart disease is greatly reduced.
Examples of individual behavior determinants of health include :
 Diet.
 Physical activity.
 Alcohol, cigarette, and other drug use.
 Hand washing.
INDIVIDUAL CHARACTERISTICS AND BEHAVIOURS

17.  Inheritance plays a part in determining lifespan, healthiness and the
likelihood of developing certain illnesses, personal behaviour and
coping skills.
 Some biological and genetic factors affect specific populations more
than others. E.g., older adults are biologically prone to poorer health
than adolescents due to effects of aging.
 Sickle cell disease is a common example of a genetic determinant of
health.
INDIVIDUAL CHARACTERISTICS
BIOLOGICAL AND GENETIC MAKEUP

18.  Gender refers to "the array of socially constructed roles and
relationships, personality traits, attitudes, behaviours, values,
relative power and influence that society ascribes to the two sexes
on a differential basis.“
 Men and women suffer from different types of diseases at different
ages.
 Examples include the exploitation of women in the sex trade,
underage marriage, or the work conditions in sweat shops in the
garment industry. Single parents are almost always women, the
lower income of women also affects their children.
INDIVIDUAL CHARACTERISTICS – GENDER

19.  Early nutrition, physical development and fitness are important, as is
emotional development which, if positive, builds resiliency, and if
negative, enhances vulnerability.
 Timing of exposures and experiences can be critical.
 For example, traumatic experiences in early childhood shape personality
and have a lasting impact on how a person views his world, how he
relates to others, and how he interprets events.
 The impact of broken homes, chronic childhood stresses etc. have non-
specific effects, acting mainly to increase emotional vulnerability in adult
life.
INDIVIDUAL CHARACTERISTICS
EARLY CHILDHOOD DEVELOPMENT

20.  Advances in health care have conferred immense benefits on health
and longevity for developed and many developing countries.
 The invention of antibiotics, antisepsis, life-saving surgical
procedures, as well as advances in nursing process, have all
revolutionized the management of a wide range of diseases.
 Health interventions (sanitation, communicable disease control
measures, etc.) and disease prevention (immunization, tobacco
control measures, and screening) have made major contributions to
saving lives and improving health.
IMPLICATION FOR NURSING

21.  Relatively simple measures, such as protecting water supplies, often
have the greatest impact on overall health. Similar historical declines
occurred for polio, smallpox, and whooping cough, all of which
responded dramatically to improvements in hygiene long before
effective medical treatments were developed.
 Many public health and health care interventions focus on changing
individual behaviors such as substance abuse, diet, and physical
activity. Positive changes in individual behavior can reduce the rates
of chronic disease in this country.
IMPLICATION FOR NURSING

22. Thank
You