1. What Influences the Health of Individuals?
Chapter 2

2. The Determinants of Health
Since 20th century, health standards have improved
decrease in infant mortality
increase in life expectancy
However, health gains not shared equally
rich vs poor
Dependent on life circumstances/determinants in order to achieve full health potential

3. Determinants of Health
Individual
Socio-cultural
Socio-economic
Environmental conditions
Determinants help explain and predict trends in health (i.e. provide reasons why some individuals & groups have better or worse health than others)
Conceptual Framework (Fig 2.1 Pg 33)

4. Many factors influence the health of individuals
These factors can either protect health or place it at risk
Risk factors: factors that increase the risk of ill-health (e.g. eating fatty foods)
Protective factors: factors that reduce the risk of ill-health (e.g. participating in PA)
These factors do not exist in isolation; they have a combined effect  determine health of individuals
Determinants can vary in the level of risk (e.g. high risk  smoking (lung cancer))

5. Individual Factors Knowledge, skills and attitudes
ability to acquire health knowledge & develop health-related skills is a powerful determinant of a person’s health
enables a person to recognise health problems and make informed decisions
Internet
Knowledge vs Application

6. Genetics certain diseases are known to be inherited
e.g. asthma, type-1 diabetes, heart disease and some cancers
heredity is a risk factor for these diseases

7. Socio-cultural Factors
Family
has a strong impact on the health and well-being of children and their parents (includes structure)
married vs unmarried
two-parent households vs lone-parent households
Peers
most individuals have a social need for acceptance seek championship, support, approval
peer pressure (positive or negative)

8. Media Religion plays a huge role in shaping how we see the world
influences our socialisation, values, development, opinions and knowledge
often contradictory information that is easy to become overwhelmed
important to be discerning when receiving information through the media
it can affect us when we are not fully aware that it is doing so
Religion
it has health-enhancing benefits (social support, a sense of meaning and purpose, a belief system and a clear moral code)
it can also be perceived as judgmental, alienating and exclusive (e.g. homosexual, pre-marital sex)
while religion may provide many health benefits, this may not be true in all circumstances

9. Culture
refers to accepted ways of behaving within a particular group in society
can vary across and within ethnic groups
it can be central to one’s health and well-being
definition of ethnic group
both positive and negative impacts
Low SES  social exclusion & isolation
Refugees  trauma (mental health problems)
Language difficulties & cultural beliefs and practices (alternative medicine, rituals, etc)  significant impact on health literacy
Health inequities (ethnic minority groups)

10. Aboriginality significant factor in determining health status
health is poor in comparison to non-Indigenous Australians
higher morbidity and infant mortality rates
shorter life expectancy
often face multiple social and cultural risk factors (e.g. unemployment, racism, geographic isolation, inadequate housing and water supply, and lower levels of education)
Changing sexual practices ( STIs & lower age childbearing)
Drug use (e.g. petrol and glue sniffing)
Alcohol-related problems (e.g. suicide, motor vehicle accidents, violence and abuse)  major health concerns
Poor nutrition (high sugar, fat, salt intake)
Poor hygiene and living conditions (anaemia, skin conditions, respiratory diseases, etc)
Mental illness (low self-esteem, unemployment, feelings of isolation or marginalisation)
Seek family advice rather than professional advice

11. Socio-economic factors
Employment
unemployment strongly related to health status
higher mortality and more illness and disability
no money to buy health-related goods and services
strong psychological and social impacts (alienation, poor self-esteem and stigma)
correlation between occupation and health (manual & low-skilled jobs vs managerial/professional jobs)

12. Education
higher levels of education  higher income  better employment prospects
better health literacy  gain better access to health services  achieve healthier lifestyle
Income
income is correlated to education and occupation
better health care, better housing and preventative measures (member of a fitness centre or buying nutritious foods)
People who are socially & economically disadvantaged tend to have worse health.
Illness and disability prevent one from securing and maintaining employment  result in  income
Poor health can also impair one’s ability to continue or succeed in education

13. Environmental factors
Geographic location
urban vs rural & remote areas
issues relating to confidentiality & privacy in closed-knit communities discouraged one from accessing to health services (e.g. teenage pregnancy, drug addiction, depression)
social pressures (engaging in risky behaviours)
Read Pg 38 for more examples

14. Access to health services
difficulty accessing, understanding or using information
Non-English speaking backgrounds
may retain traditional beliefs & use traditional health treatments rather than making full use of health services available
not as well informed about risky health behaviours
Access to technology
families in remote areas travel long distances to access essential health and social support services
costly and time consuming;
inaccessible to public transport
mental & counselling support services often do not exist in rural and remote areas
Lacking in early learning opportunities for children, family support and adult education opportunities, creating a great sense of social isolation
Internet access  NOT realistic ($$$)

15. Combination of Determinants
“Young people, dangerous driving and car culture”
by Hannah Graham and Rob White
Pg 40

16. The degree of control individuals can exert over their health
Modifiable and non-modifiable health determinants
people’s health behaviour is a major determinant of both their current and future health status
determinants may vary in how easy they are to modify
modifiable actions can be positive (e.g. PA) or negative (e.g. smoking)
limited control over individual factors (e.g. age, heredity, environmental)  non-modifiable

17. Factors that influence behaviour change can be divided into 3 general categories:
Predisposing factors
predisposed one towards certain behaviours to act in a particular way
e.g. our life experiences, knowledge culture & ethnicity, current beliefs & values, age, sex, income, family background, educational background and access to health care
Young people have little or no control over these factors

18. Enabling factors Reinforcing factors
e.g skills and abilities; physical, emotional and mental capabilities; community and government priorities and approaches to health; health resources and facilities
may be positive (encourage positive behaviour change) or negative (barriers and work against the intention to change unhealthy behaviours)
individuals have some control over enabling factors
identify positive/negative factors and make alternative plans for a positive behaviour change
Reinforcing factors
include the presence or absence of support and encouragement from important people or bodies in your life
e.g. employer actions & policies, health provider costs, community resources and access to health education

19. Changing influence of determinants through different life stages
less affluent families are disadvantaged and more likely to struggle (e.g. school, work, socio-economic, poor health, etc)

20. Health as a social construct
It varies from one society to another  different perspectives of health
A social view of health helps us to understand the range of health determinants influencing a person throughout the life stages

21. Recognises the interrelationship of determinants
Health is a dynamic quality that is affected by a complex interrelationship between the individuals and their physical, social, economic and political environments
There is a need for:
personal skills development
empowerment of communities to take action to promote health
the creation of social and physical environments that are supportive of health
an awareness of the impacts on health of public policies
health services that are orientated towards health promotion and the prevention of ill-health

22. Challenges the notion that health is solely an individual’s responsibility
Health risk cannot be attributed solely to individual risk behaviours
A person’s health and well-being are also associated with social institutions (e.g. families, communities, workplaces and the health care system)
These institutions can support or diminish the health of the individual

23. Design a case study
Design a case study about a hypothetical individual that describes how one-socio-cultural factor has an impact on the health status of the individual or on his or her level of participation in physical activity.
Swap your case study with another group and analyse the factors that impact on the person’s health or physical activity.
Propose ways to support the person in the case study to improve his or her health status or level of physical activity.