Determinants
of Health
Health is really multi-factorial. Synergy between many factors occurs to determine
how susceptible we are to disease or, by comparison, how healthy we are day to day. It can
be challenging to classify these determinants. We will discuss five categories of factors
that each have strong implications for our health. It is important to keep in mind the
fact that the categories are not discrete and certainly overlap. The impact of healthy
lifestyle behaviors, for example, are strongly influential on all of the other categories
of factors.
Lifestyle Factors
In the first half of this century people were too busy trying to survive to worry
about health as much we do today, much less about how we might practice healthier habits
in order to prevent disease. Progress that did occur was brought about through the
organization of unions in the workplace, legislatures, and public health ordinances.
Toward the end of the century, in 1999, the Healthy People 2000 report, made
a call to work towards a culture that actively promotes responsible behavior and the
"adoption of life-styles that are maximally conducive to good health” (USDHHS,
1990). Since that time, there is more and more concrete evidence indicating that
practicing healthy habits can significantly decrease our chances of developing chronic
disease. One of our favorite quotes is by Dr. Elliot Joslin, “Genes load the gun.
Lifestyle pulls the trigger”. Therefore, of all the health determinants that we have
discussed, lifestyle factors are among the most controllable and influential factors
influencing our health.
