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Determinants of Health

"Individuals and their health cannot be understood solely by looking inside their bodies and brains: one must also look inside their communities, their networks, their workplaces, their families and even the trajectories of their life" (Prof J Lomas, CEO, Canadian Health Services Research Foundation).

The best health care system in the world, alone, will not improve health and wellbeing. A person's health cannot be adequately explained by health behaviours and risk factors alone, but result from a combination of a multitude of factors.

A person's health and wellbeing is dependent on:

A GOOD START - Genes, food, water, shelter, air, housing, space, safety, transport, behaviour and lifestyle

A GOOD FUTURE - Education, skills, work, income, self esteem

GOOD CARE - Life skills, health care, community services, government policy

GOOD SUPPORT - Parents, family, friends, social connections

These influences are known as the determinants of health- the social, economic and environmental factors that determine whether or not we enjoy good health and well being. Health Inequity: A Review of the Literature. pdf ^{(2.55 Mb)}

Determinants of Health

The relationship between the determinants and actual level of health is complex. Because health determinants are inter-related and interdependent, outcomes of one determinant will influence and produce other outcomes.

For example, low income can result in lower levels of education, which influence where people live, their social contacts, their behaviours, lifestyle and overall health status.

Outcomes are also cumulative. Individuals or groups who experience low income, low educational attainment, lack of control, lack of social supports and inadequate coping skills have a poorer health status than those with fewer health risks.

The Perpetuating Cycle of Inequity Why is Jason in hospital? Because he has a bad infection in his leg. But why does he have an infection? Because he has a cut on his leg and it got infected. But why does he have a cut on his leg? Because he was playing in the local tip near his house and there was some sharp, jagged steel there and he fell on it. But why was he playing in the tip? Because he lives in a poor neighbourhood. A lot of kids play there because there is no where else to play and there is no one to supervise them. But why does he live in that neighbourhood? Because his parents cannot afford to live anywhere else. But why can't his parents afford a nicer place to live? Because his Dad is unemployed and his Mum is always sick. But why is his Dad unemployed? Because he doesn't have much education and he can't find a job. But why hasn't his Dad got much education? Because his family was poor and he dropped out of school. But why? Health Canada, Federal Provincial & Territorial Advisory Committee on Population Health for the Meeting of Ministers of Health. Toward a Healthy Future. Second Report on Health of Canadians. Ottawa: Health Canada, 1999.

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