What Influences the Health of Individuals?

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 • 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 • 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.