Determinants of Health PATH216 Mohamed M. B. Alnoor.
-
Upload
dana-gregory -
Category
Documents
-
view
217 -
download
1
Transcript of Determinants of Health PATH216 Mohamed M. B. Alnoor.
“Absence of disease”
“The condition of being sound in body, mind or spirit, especially freedom from physical disease or pain” Webster English Dictionary
Definition of Health
“Soundness of body or mind, that condition in which its functions are duly and efficiently discharged” Oxford English Dictionary
Definition of Health
WHO Definition:
“ Health is a state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity
”1948
Definition of Health
Physical Dimension of Health
-Implies perfect functioning of organs, at optimum capacity , and in harmony.
-Involves the ability to carry out daily tasks, and achieve
fitness . -A normal person :
- no evident disease,- growth is comparable peers.
Dimensions of health
Not merely the absence of mental illness, but also the
ability to respond to the various experiences
of life with flexibility and a sense
of purpose.
Mental Dimension of Health
Dimensions of health
Mental health is a state of balance or harmony
between the individual and others
as well as between the individual and
the environment
Mental Dimension of Health
Dimensions of health
The following characteristics are attributes of a mentally healthy person:
a) he is free from internal conflicts ,b) he accepts criticism, c) he searches for identity, d) he has a strong sense of self-esteem ,e) he knows himself, f) he has a good self-control,
g) he faces problems and tries to solve them .
Mental Dimension of Health
Dimensions of health
Ability to interact successfully with people within the
environment, maintaining intimacy with
others, showing respect and
tolerance for those with different
opinions and beliefs.
Social Dimension of Health
Dimensions of health
Health practices and beliefs are strongly influenced by
the person’s : economic level life style family culture
Social Dimension of Health
Dimensions of health
Low-income groups are less likely to seek health care to
prevent or treat illness ;
High-income groups are more prone to stress-related habits and illness
Social Dimension of Health
Dimensions of health
Other Dimensions
Spiritual dimension It includes :
- principles and ethics- the purpose in life
- religious beliefs and values
all are important components of the way the person behaves in
health and illness .
Dimensions of health
Vocational dimension When work is fully adapted
to human goals, work often plays a role in promoting both physical and mental health .
The importance of this dimension is clear when individuals suddenly lose their jobs or retire .
Other Dimensions
Dimensions of health
-Behavioral -Environmental
-Health services
-Gender- Other factors
Determinants of Health
-Physical environment-Biological environment-Psychosocial environment
1 -Behavioral:
Determinants of Health
-Nutrition/ food-Personal hygiene
-Habits
&customs-Smoking ( passive
smoking )-Alcohol & substance abuse
-Exercise - Sleep
- Violence/ abuse- Recreation
- Compliance to treatment
- Reaction to stress
Determinants of Health
1 -Behavioral:
2 -Environmental :A- Physical environment:
- Air - Water (quantity and quality)
- Waste disposal- Housing- Climate
-temp.- humidity and rainfall
Determinants of Health
Determinants of Health 2- Environmental: A- Physical environment:
- Geography - Heat- Light- Noise
- Vibration- Radiation
B- Biological environment: -Man(age, sex, genetic)
-Microbes -Insects-Rodents-Animals-Plants
Determinants of Health 2- Environmental :
C- Psychosocial environment:
-Habits-Customs-Ethnicity-Cultural values
Determinants of Health 2- Environmental :
Ethnicity
languageculture
religion common origin
( ancestry )shared history
Identification with a social group on grounds of :
Determinants of Health2- Environmental: C- Psychosocial environment:
Culture
Knowledge,Beliefs,Goals ,Values ,
Attitudes andPractices
Complex social phenomenon of shared :
Determinants of Health2- Environmental: C- Psychosocial environment:
- Religion/Morals- Education/health
awareness -Employment
- Community life- Housing
Determinants of Health2- Environmental: C- Psychosocial environment:
How EDUCATION influences health
High level of education can lead to:• Employment:
secure well paid
health benefits• Good health: by developing favorable
knowledge attitudes behaviors
Determinants of Health2- Environmental: C- Psychosocial environment:
- Political organization: %-GNP on health
- Resource allocation- Services:
-Availability- Accessibility
- Commitment to development ( social NOT economic )
for all
people
Determinants of Health2- Environmental: C- Psychosocial environment:
-SES is associated with health outcomes:
Mortality Morbidity Disability
Well-beingpeople of higher SES have better health than people of lower SES:
Determinants of Health2- Environmental: C- Psychosocial environment:
SES: Socio-economic statusEducation• Illiterate
• Elementary
• Intermediate
• Secondary• University• Postgraduate
8
1
7
5
4
3
SCORE
SES: Socio-economic statusOccupation• Unemployed
• Laborer• -------------• -------------• -------------• Professional
1
6
5
4
3
8
SCORE
SES: Socio-economic statusIncome(per month)• < 1000• 1 000- 4 000
• 5 000-14 000
• -------------• -------------• > 50 000
1
6
5
4
3
SCORE
2
SES: Socio-economic statusHousing
• -----------• -----------• -----------• -----------• -----------
2
1
5
43
NeighborhoodSCORE
SES: Socio-economic status
Housing
Ow
nersh
ip Neig
hborh
ood
Typ
e
Occu
patio
n Educa
tion
MinimumMaximum
T o
t a
l
Sco
re
88 6 8 511 111 4
29
Avera
ge
17
Inco
me
81
Lower ClassMiddle ClassUpper Class
11 - 22
4 - 10
23 - 29
< 11
>23
11 - 22
SES: Socio-economic status
RANGE
-SES is associated with health outcomes:
Mortality Morbidity Disability
Well-beingpeople of higher SES have better health than people of lower SES:
Determinants of Health2- Environmental: C- Psychosocial environment:
3 -Health Services related determinants :
- H. E.- MCH
- Control of communicable disease- Control of non-communicable
disease
Determinants of Health
4- Gender related determinants:
1993 Global Commission on Women’s Health
- Reproductive health- Nutrition
- Employment/occupation- Domestic violence
Determinants of Health
5 -Other Factors: .Transition related
determinants: Industrial age information age
Information & Communication Revolutioneasy access to health
information medical professionals and the
public
Determinants of Health
Intersectoral related determinants : Food & agriculture
Education Industry
Social welfare
Determinants of Health5 -Other Factors:
Rural development Raising standard of living Employment opportunities Increased wages
Determinants of Health5 -Other Factors:
Life Expectancy:
Children have dramatically different life expectancies depending on where they
were born :Japan or Sweden: > 80 years ;Brazil: . . . . . . . . . .. . . .72 years ;India: . . . . . . . . . . . . . . . 63 years ;African countries: < 50 years.
Health inequities between countries
the infant mortality rate (the risk of a baby dying between birth and one year of age) is:
2 per 1000 live births in Iceland.
>120 per 1000 live births in Mozambique ;
Risk of maternal death during or shortly after pregnancy is
only 1 in 17 400 in Sweden but it is 1 in 8 in Afghanistan .
Health inequities between countries
Health inequities within countriesWorldwide between:
rich and poor, men and women ,
dominant and marginalized ethnic groups
all lead to differences in health and longevity.
:by gender
Indian Subcontinent(UN 1987-9):
girls :
death rate nearly twice as boys: due to family behavior .
1/6 death: neglect and discrimination .
less than boys: immunization and nutritional status.
Health inequities within countries
New philosophy of Health
*Fundamental right*Intersectoral
*Integral part of Development*Central to Quality of Life
*Involves Individuals, Families, Communities Local, National and International responsibilities
*Social Investment*World wide Social Goal