Unformatted text preview: 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… Disease Prevention and Healthy Lifestyles
Introduction to Personal Health Determinants of Health, Risk Factors, and
Prevention -… 1/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… Determinants of Health
What makes some people healthy and others unhealthy?
How can we create a society in which everyone has a chance to
live long healthy lives? LEARNING ACTIVITY
Watch this video about Determinants of Health[1]: Determinants of He…
He… This video demonstrates some of the factors that make some
people healthy and others unhealthy. Two examples in this
video serve to illustrate determinants of health, as well as
interventions which can change determinants of health and
lead to a speci c health outcome or outcomes. The video then
explains the four phases of the intervention life cycle. The range of personal, social, economic, and environmental factors that
in uence health status are known as determinants of health.
Determinants of health fall under several broad categories: -… 2/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… Social factors
Health services
Individual behavior
Biology and genetics
It is the interrelationships among these factors that determine individual
and population health. Because of this, interventions that target multiple
determinants of health are most likely to be e ective. Determinants of
health reach beyond the boundaries of traditional health care and public
health sectors; sectors such as education, housing, transportation,
agriculture, and environment can be important allies in improving
population health. Policymaking
Policies at the local, State, and Federal level a ect individual and
population health. Increasing taxes on tobacco sales, for example, can
improve population health by reducing the number of people using
tobacco products.
Some policies a ect entire populations over extended periods of time
while simultaneously helping to change individual behavior. For example,
the 1966 Highway Safety Act and the National Tra c and Motor Vehicle
Safety Act authorized the Federal Government to set and regulate
standards for motor vehicles and highways. This led to an increase in
safety standards for cars, including seat belts, which in turn, reduced
rates of injuries and deaths from motor vehicle accidents. Social
Social determinants of health re ect social factors and the physical
conditions in the environment in which people are born, live, learn, play,
work and age. Also known as social and physical determinants of health,
they impact a wide range of health, functioning and quality of life
outcomes.
Examples of social determinants include: -… 3/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… Availability of resources to meet daily needs, such as educational
and job opportunities, living wages, or healthful foods
Exposure to crime, violence, and social disorder, such as the presence of trash
Social support and social interactions
Exposure to mass media and emerging technologies, such as the
Internet or cell phones
Socioeconomic conditions, such as concentrated poverty
Quality schools
Transportation options
Public safety
Residential segregation
Examples of physical determinants include:
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 toxic substances and other physical hazards
Physical barriers, especially for people with disabilities
Aesthetic elements, such as good lighting, trees, or benches
Poor health outcomes are often made worse by the interaction between
individuals and their social and physical environment.
For example, millions of people in the United States live in places that
have unhealthy levels of ozone or other air pollutants. 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.[2] -… 4/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… Health Services
Both access to health services and the quality of health services can
impact health. Healthy People 2020 directly addresses access to health
services as a topic area and incorporates quality of health services
throughout a number of topic areas.
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.[3]
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 Individual Behavior
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.
Many public health and health care interventions focus on changing
individual behaviors such as substance abuse, diet, and physical activity. -… 5/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… Positive changes in individual behavior can reduce the rates of chronic
disease in this country.
Examples of individual behavior determinants of health include:
Diet
Physical activity
Alcohol, cigarette, and other drug use
Hand washing Biology and Genetics
Some biological and genetic factors a ect speci c populations more
than others. For example, older adults are biologically prone to being in
poorer health than adolescents due to the physical and cognitive e ects
of aging.
Sickle cell disease is a common example of a genetic determinant of
health. Sickle cell is a condition that people inherit when both parents
carry the gene for sickle cell. The gene is most common in people with
ancestors from West African countries, Mediterranean countries, South
or Central American countries, Caribbean islands, India, and Saudi
Arabia.
Examples of biological and genetic social determinants of health include:
Age
Sex
HIV status
Inherited conditions, such as sickle-cell anemia, hemophilia, and
cystic brosis
Carrying the BRCA1 or BRCA2 gene, which increases risk for breast
and ovarian cancer -… 6/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… Family history of heart disease Social Determinants of Health
Social determinants of health are economic and social conditions that
in uence the health of people and communities. These conditions are
shaped by the amount of money, power, and resources that people have,
all of which are in uenced by policy choices. Social determinants of
health a ect factors that are related to health outcomes. Factors related
to health outcomes include:
How a person develops during the rst few years of life (early childhood development)
How much education a persons obtains
Being able to get and keep a job
What kind of work a person does
Having food or being able to get food (food security)
Having access to health services and the quality of those services
Housing status
How much money a person earns
Discrimination and social support What are determinants of health and how are they related to
social determinants of health?
Determinants of health are factors that contribute to a person’s current
state of health. These factors may be biological, socioeconomic,
psychosocial, behavioral, or social in nature. Scientists generally
recognize ve determinants of health of a population:
Genes and biology: for example, sex and age
Health behaviors: for example, alcohol use, injection drug use (needles), unprotected sex, and smoking -… 7/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… Social environment or social characteristics: for example, discrimination, income, and gender
Physical environment or total ecology: for example, where a person
lives and crowding conditions
Health services or medical care: for example, access to quality
health care and having or not having insurance
Other factors that could be included are culture, social status, and
healthy child development. Scientists do not know the precise
contributions of each determinant at this time.
In theory, genes, biology, and health behaviors together account for
about 25% of population health. Social determinants of health represent
the remaining three categories of social environment, physical
environment/total ecology, and health services/medical care. These
social determinants of health also interact with and in uence individual
behaviors as well. More speci cally, social determinants of health refer to
the set of factors that contribute to the social patterning of health,
disease, and illness. Why is addressing the role of social determinants of health
important?
Addressing social determinants of health is a primary approach to
achieving health equity. Health equity is “when everyone has the
opportunity to ‘attain their full health potential’ and no one is
‘disadvantaged from achieving this potential because of their social
position or other socially determined circumstance.” Health equity has
also been de ned as “the absence of systematic disparities in health
between and within social groups that have di erent levels of underlying
social advantages or disadvantages—that is, di erent positions in a
social hierarchy.” Social determinants of health such as poverty, unequal
access to health care, lack of education, stigma, and racism are
underlying, contributing factors of health inequities. LEARNING ACTIVITY -… 8/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… Go to the Your Health Pro le webpage and answer the
questions.
What conditions do people with your health pro le most
frequently experience?
Are you under- or overweight? Risk Factors
What is a risk factor?
Risk factors are things in your life that increase your chances of
developing a condition or disease. They can include things like family
history, exposures to things in the environment, being a certain age or
sex, being from a certain ethnic group, or already having a health
condition. If you do have risk factors, your doctor or nurse will most likely
want you to be screened or immunized at a younger age or more often
than what is recommended. Check with your doctor or nurse to nd out if
you need to have speci c health screenings and how often you will need
them. Understanding Risk Factors
Part of learning how to take charge of your health requires
understanding your risk factors for di erent diseases. Risk factors are
things in your life that increase your chances of getting a certain disease.
Some risk factors are beyond your control. You may be born with them or
exposed to them through no fault of your own. Some risk factors that you
have little or no control over include your:
Family history of a disease
Sex/gender—male or female
Ancestry
Some risk factors you can control include -… 9/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… What you eat
How much physical activity you get
Whether you use tobacco
How much alcohol you drink
Whether you use illegal drugs
Whether you use your seat belt
In fact, it has been estimated that almost 35 percent of all U.S. early
deaths in 2000 could have been avoided by changing just three
behaviors:
Stopping smoking
Eating a healthy diet (for example, eating more fruits and vegetables and less red meat)
Getting more physical activity LEARNING ACTIVITY: FIND OUT ABOUT YOUR OWN
HEALTH RISKS Fill out the questionnaire at Keep Me Well to get the following
results:
Scorecard: An easy-to-read summary of your results that
will show you where to focus your e orts to best improve your health.
My Report: A more detailed report that provides feedback and links to trusted health information websites
that will help you take action to lower your risk for
chronic disease.
Local Community Supports and Programs: A list of resources in your area that can help you take action to improve your health. … 10/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… Having more than one risk factor
You can have one risk factor for a disease or you can have many. The
more risk factors you have, the more likely you are to get the disease.
For example, if you eat healthy, exercise on a regular basis, and control
your blood pressure, your chances of getting heart disease are less than
if you are diabetic, a smoker, and inactive. To lower your risks, take small
steps toward engaging in a healthy lifestyle, and you’ll see big rewards.
Inheriting risk—your family health history Rarely, you can inherit a mutated gene that alone causes you to get a
disease. Genes control chemical reactions in our bodies. If you inherit a
faulty gene, your body may not be able to carry out an important
chemical reaction. For instance, a faulty gene may make your blood
unable to clot. This problem is at the root of a rare bleeding disorder.
More often, you can inherit genes from one or both of your parents that
put you at higher risk of certain diseases. But having a gene for a certain
disease does not always mean you will get it. There are many unknown
factors that may raise or lower your chances of getting the disease.
People with a family health history of chronic disease may have the most
to gain from making lifestyle changes. You can’t change your genes, but
you can change behaviors that a ect your health, such as smoking,
inactivity, and poor eating habits. In many cases, making these changes
can reduce your risk of disease even if the disease runs in your family.
Another change you can make is to have screening tests, such as
mammograms and colorectal cancer screening. These screening tests
help detect disease early.
People who have a family health history of a chronic disease may bene t
the most from screening tests that look for risk factors or early signs of
disease. Finding disease early, before symptoms appear, can mean
better health in the long run. Your family’s health history could be
important for determining health risks for you and your children. Learn
more about how to document your family’s health history and share it
with your doctor. It is important to talk to your doctor or nurse about your
individual health risks, even if you have to bring it up yourself. And it’s
important for your doctor to know not just about your health, but your
family health history as well. Come to health care visits armed with … 11/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… information about you, your children, siblings, parents, grandparents,
aunts and uncles, and nieces and nephews, including
Major medical conditions and causes of death
Age of disease onset and age at death
Ethnic background
General lifestyle information like heavy drinking and smoking
Family Health History Family health history can help your doctor make a diagnosis if you or
your children shows signs of a disorder. It can reveal whether you or your
children have an increased risk for a disease; if so, the doctor might
suggest screening tests. Many genetic disorders rst become obvious in
childhood, and knowing about a family health history of a genetic
condition can help nd and treat the condition early.
Update your family health history information regularly and share new
information with your doctor. Remember that relatives can be newly
diagnosed with conditions between doctor’s visits.
The best way to learn about your family health history is to ask
questions. Talk at family gatherings and record your family’s health
information—it could make a di erence in your child’s life. LEARNING ACTIVITY: MY FAMILY HEALTH PORTRAIT Use the US Surgeon General’s online tool for collecting family
health histories, called My Family Health Portrait. (If you are
not able to do this activity with your own birth family, you can
do this activity for someone else who does know his/her family
health history.)
Enter your family health history. … 12/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… Record the names of your close relatives from both
sides of the family: parents, siblings, grandparents,
aunts, uncles, nieces, and nephews. Include conditions
each relative has or had and at what age the conditions
were rst diagnosed.
For relatives who are deceased, include the cause of
death and the age at death.
Print your family health history to share with family or
your health care worker.
Save your family health history so you can update it
over time.
Talk with your health care worker about your family
health history OPTIONAL LEARNING ACTIVITY: HEALTHIER YOU Complete a personal health risk assessment and family health
history. Determine what you can do to enhance your own
health and decrease your health risks.
Check out these resources to nd out more about Family
Health History
NIH Senior Health: Creating a Family Health History
Family Health History Examples of actions to take:
Bring your weight and BMI to normal levels
Stop smoking
Bring your cholesterol levels to a healthy level
Increase your aerobic, muscle-strengthening, and bonestrengthening activities
Reduce your consumption of alcohol … 13/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… Factors A ecting Human Health
Risk factors are those inherited, environmental and behavioral in uences
which are considered to increase the likelihood of physical or mental
health problems in the future. After studying this session you will be able
to describe health risk factors and explain their association with human
health.
Health and human behavior Behavior is an action that has a speci c frequency, duration and purpose
whether conscious or unconscious. It is what we do and how we act.
Health behaviors are those personal behavior patterns, actions and
habits that people perform in order to stay healthy, in order to restore
their health when they get sick and in order to improve their health
status.
Types of health behaviors In this section, you will learn about six di erent types of health behavior
that people may perform — from the initial stages of preventing diseases
up to their actions that may be associated with attempts to rehabilitate
themselves after a bout of illness.
Preventive health behaviors: These are actions that healthy people
undertake to keep themselves or others healthy and prevent disease or detect illness when there are no symptoms. Examples include handwashing with soap, using insecticide treated mosquito
nets and exclusive breastfeeding to age six months.
Illness behaviors: These include any activities undertaken by individuals who perceive themselves to be ill. This would include
recognition of early symptoms and prompt self referral for
treatment.
Sick-role behaviors: These include any activity undertaken by individuals who consider themselves to be ill, for the purpose of get- … 14/17 9/30/2019 Determinants of Health, Risk Factors, and Prevention | Disease Prevention and Healt… ting well. It includes receiving treatment from medical providers
and generally involves a whole range of potentially dependent behaviors. It may lead to some degree of exemption from one’s usual
responsibilities. For example a person who feels that he is ill might
visit the...
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