Determinants of Health

This week’s lectures put forward the idea that medical care is only one of many determinants of health.  There is a vast amount of research literature that describes huge variations in medical and surgical practices from one geographical area to the next, with little or no apparent differences in the health status of the respective populations.  How can that be?

Many factors play a role in affecting the health of an individual or population. Medical and surgical practices are only a couple of the many determinants of health.

Other factors 1,2:

• Biology and genetics – some people are predisposed in developing certain illnesses because of genetics. Sex or gender also has an effect since men and women can suffer from different types of disease.

• Individual behavior or lifestyle choices - the use of alcohol, drugs, and smoking have an impact. Balanced diet and frequent exercise. Coping mechanisms for stress.

• Social Environment – family and support group, customs and traditions, community setting.

• Physical environment - access to safe and clean water and air, safe home, good working conditions

In examining these determinants more closely, one realizes that the complexity of health goes beyond medical care and the hospital.  Everything around us, who we are, where we live and what we do has some sort of an impact on our health, yet there is a misnomer that medical care and health are synonymous.  Perhaps if people realize that how they live their lives everyday constitutes their health then perhaps healthcare spending could be lowered.

The articles for this week’s required reading3,4 provide an insight on the number of factors that drive health care cost in the US. With a muriad list of health care drivers, some more administrative and bureaucratic in nature, there are some that can be addressed by us. The impact of lifestyle choices and personal choice is something that can be done. The high levels of obesity, 33.8% in 2009 according to the OECD health data 2011 shows that the US has the highest level amongst the select countries3. Granted that measuring and reporting in other countries may not be as well kept as in the US, the number in itself without a comparison is still startling.