ISSUES

INFLUENCING
HEALTH
PATRICIA MATERU
LEARNING OBJECTIVES:

By the end of this session, students are expected to be able to:

Describe determinants of health
Describe the role of social issues in health
Describe the role of culture in the prevention of diseases.
 Describe the role of environment in the prevention of diseases.
Inter-relate the concepts of environment, health and development
HEALTH DEFINITION

• WHO definition: The world Health Organization (WHO)

described health in1948, in the preamble to its constitution,
as “A state of complete physical, mental, and social well-
being and not merely the absence of disease or infirmity”
• Lay definition: Persons are healthy when they are doing their
activities with no apparent symptoms of disease in them.
“the state of being free from illness or injury’.
HEALTH DEFINITION CONT…

• Health is multidimensional, (physical, mental, and social), some other

dimensions like spiritual, emotional may also be included.

• Physical health- is concerned with anatomical integrity and physiological

functioning of the body. It means the ability to perform routine tasks
without any physical restriction. E.g., Physical fitness is needed to walk
from place to place.
HEALTH DEFINITION CONT…

• Mental Health- is the ability to learn and think

clearly and coherently. E.g., a person who is not
mentally fit (retarded) could not learn something
new at a pace in which an ordinary normal person
learns.
HEALTH DEFINITION CONT…

• Social health- is the ability to make and maintain acceptable

interaction with other people. E.g. to celebrate during festivals; to
mourn when a close family member dies; to create and maintain
friendship and intimacy, etc. Emotional health - is the ability of
expressing emotions in the appropriate way, for example to fear,
to be happy, and to be angry. The response of the body should be
congruent with that of the stimuli.
HEALTH DEFINITION CONT..

• Emotional health is related to mental health and

includes feelings. It also means maintaining one’s own
integrity in the presence of stressful situation such as
tension, depression and anxiety.
HEALTH DEFINITION CONT..

• Spiritual Health - Some people relate health with

religion; for others it has to do with personal values,
beliefs, principles and ways of achieving mental
satisfaction, in which all are related to their spiritual
wellbeing.
DETERMINANTS OF HEALTH

• Health or ill health is the result of a

combination of different factors. There are
different perspectives in expressing the
determinants of health of an individual or a
community.
DETERMINANTS OF HEALTH CONT….

• There are two concepts which determine health

Human field concept
Ecological concept
DETERMINANTS OF HEALTH CONT….

 Human field concept: there are four major determinants

[Link] Biology Every Human being is made of

genes. In addition, there are factors, which are
genetically transmitted from parents to offspring. As a
result, there is a chance of transferring defective trait. .
Genetic Counseling
 DETERMINANTS OF HEALTH CONT….

2. Environment: is all that which is external to the individual human host.

Those are factors outside the human body. Environmental factors that could
influence health include:
• a. Life support, food, water, air etc
• b. Physical factors, climate, Rain fall
DETERMINANTS OF HEALTH CONT….

• c. Biological factors: microorganisms, toxins, Biological

waste,
• Psycho-social and economic e.g. Crowding, income level,
access to health care
• e. Chemical factors: industrial wastes, agricultural wastes, air
pollution, etc
DETERMINANTS OF HEALTH CONT….

3. Life style (Behavior): is an action that has a specific frequency,

duration, and purpose, whether conscious or unconscious. It is
associated with practice. It is what we do and how we act. Recently
life style by itself received an increased amount of attention as a
major determinant of health. Life style of individuals affects their
health directly or indirectly. For example: Cigarette smoking
Unsafe sexual practice Eating contaminated food
DETERMINANTS OF HEALTH CONT….

4. Health care organization: Health care organizations in terms of their resource in human
power, equipments, money and so on determine the health of people. It is concerned with a.
 Availability of health service People living in areas where there is no access to health
service are affected by health problems.
DETERMINANTS OF HEALTH CONT….

Acceptability of the service by the community

 Accessibility : in terms of physical distance, finance
etc
 Quality of care that mainly focuses on the
comprehensiveness, continuity and integration of the
health care
DETERMINANTS OF HEALTH CONT….

• Ecological issues:
1. Physical Determinants -The physical factors affecting the
health of a community include: the geography (e.g. high
land versus low land), the environment (e.g. manmade or
natural catastrophes) and the industrial development (e.g.
pollution occupational hazards)
DETERMINANTS OF HEALTH CONT….

[Link]- cultural factors : Include the beliefs,

traditions, and social customs in the community. it
also involves the economy, politics and religion in
the community
DETERMINANTS OF HEALTH CONT….

Community organization - Community organization include the

3.

community size, arrangement and distribution of resources

(“relations of productions’)
4. Behavioral determinants- The behavioral determinants affecting
health include individual behavior and life style affecting the health
of an individual and the community. E.g. smoking, alcoholism
SOCIAL ISSUES AND HEALTH

• The social and economic conditions in which people are born,

grow, live, work, and age, are called the social determinants of
health. Since the mid 1980s, the understanding that these
determinants of health are critical to the health and well-being of
populations has grown and the determinants of health are now
almost universally accepted by health systems across the world
SOCIAL ISSUES AND HEALTH

• Housing
• Poverty
• Safety
• Sense of belonging
• Transportation
Are among social factors which affect health
SOCIAL ISSUES AND HEALTH CONT..

• Housing: A safe and comfortable place to live is fundamental to our sense of wellbeing.
When housing is inadequate or unavailable, individual as well as community wellbeing
may suffer
• Poverty : has been recognized as a critical factor in the social determinants of health.
“Level of income shapes overall living conditions, affects psychological functioning, and
influences health-related behaviors such as quality of diet, extent of physical activity,
tobacco use, and excessive alcohol use.
SOCIAL ISSUES AND HEALTH CONT…

• Safety: perceptions of safety are important. A community’s

perception of safety contributes to a sense of wellbeing, allows
individuals freedom of movement, and reduces unintentional
injuries.
• Violence is a major contributor to premature death and
disability It is a force that damages the physical, mental and
spiritual health of individuals.
• Property offences are offences in which property was involved,
but no individuals are injured.
• Domestic offences are those offences that occur within a
domestic relationship
• Motor vehicle collisions (MVCs) are motor vehicle collisions
that are reported to the police.
SOCIAL ISSUES AND HEALTH CONT…

Sense of belonging: A feeling of belonging to a country, region, and local community can
influence people's sense of identity and the extent to which they participate in society.
Generally, a strong sense of belonging is positively associated with better self-reported
physical and mental health. A strong sense of belonging also contributes to individual and
community wellbeing (Human Resources and Skills Development)
• can be assessed by participation in political activities, participation in social activities,
charitable donations and volunteering.
SOCIAL ISSUES AND HEALTH CONT…

• Transportation: has long been an issue of concern for residents . As a rural community
with numerous several small towns and numerous hamlets and villages the ability to
travel between centres, as well as to access services in larger centres is important
• Without transportation, it becomes difficult for people in communities to access any
services – and from a health perspective - physicians, wellness clinics, early childhood
resource centres, fitness opportunities, socialization program and educational
opportunities.
CULTURE AND HEALTH

• Culture is that complex whole which includes knowledge, belief,

art, morale, law, customs and other capabilities and habits acquired
by man as a member of society.
• Culture refers to the sum total of the life- ways of a group of
people who share values, beliefs and practices that are passed on
form generation to generation and which change through time.
CULTURE AND HEALTH CONT…

The three suggested levels of culture include:

 Concrete - the most visible tangible artifacts such as clothes, music, art, food and games.
Festivals and celebration focus on these dimensions.
 Behavioral – practices reflect values and defined social and gender roles, languages
spoken, and approaches to non-verbal communication. Behavioral aspects of culture
include language, gender roles, family structure, political affiliation, and community
organization.
CULTURE AND HEALTH CONT…

• Symbolic – values and belief are often expressed in symbols and rituals. Although often
abstract, symbolic meaning is key to how people define themselves in relation to each
other, the world and the universe. Symbolic expression includes value systems, religion,
worldview, customs, spirituality, morals and ethics.
CULTURE AND HEALTH CONT…

• Culture is one of the determinants of health among the environmental factors.

• An individual’s culture influences his or her attitude toward various health issues,
including perceptions of what is and is not a health problem, methods of disease
prevention, treatment of illness, and use of health providers.
CULTURE AND HEALTH CONT…

• In every culture, the care of the sick person is clearly dictated not only as to what care
he/she is given, but also who will do it and how he/she should proceed. We learn from
our own cultural and ethnic backgrounds how to be healthy, how to recognize illness, and
how to be ill.
• Meanings attached to the notions of health and illnesses are related to basic, culture-
bound values by which we define a given experience and perceptions.
CULTURE AND HEALTH CONT…

 Health care professionals in primary care settings are often challenged by the cultural
differences between themselves and their patients that may inhibit effective and satisfactory
health care
 The concept of cultural difference is becoming more salient in primary health care and the
management of chronic illness, yet remains problematic for health care providers and patients
alike.
 Lifestyle, diet and stress are areas of human behavior clearly shaped by cultural differences.
 All play an important role in the management of chronic diseases such as diabetes and high
blood pressure
CULTURE AND HEALTH CONT…

 A range of medical domains have begun to address cultural diversity in health care,
including nursing, genetic counseling, health education , pediatrics , even dentistry
 Primary care providers often find themselves trying to (re)shape culturally-determined
lifestyles, behaviors and practices (e.g., as they strive to help patients manage their
chronic diseases).
 Health care that fails to accommodate cultural differences is associated with more severe
disease outcomes
QUIZ

List cultural practices from your locality and

discuss the influence of these cultural practices on
the health of your community.
ENVIRONMENT AND HEALTH

A man’s environment is all of the many things that surround him

everyday.
These include the home he sleeps ,works and eats; the water he
drinks and bathes in; the air he breathes; the latrine he uses etc.
Because each of these items has a direct influence on his health, it is
vital that their quality be the best possible under the circumstances.
COMPONENTS OF A HEALTHY
ENVIRONMENT
• Provision of basic necessities such as shelter, warmth, water, food,
light, ventilation, sanitary facilities and emergency medical care.
• Protection from biological threats such as molds, unsafe or
insufficient water, unsafe food, vector born diseases, venomous
animals, rodents and hazardous insects and other animals for
example dogs
COMPONENTS OF A HEALTHY
ENVIRONMENT CONT….
• Protection from physical threats such as traffic and
transport, violence and crime, injuries, extreme heat or cold
and radiation
• Protection from chemical threats such as air pollution,
water pollution, pesticides, hazardous wastes, hazardous
materials and finishes, asbestos, paints and cleaning agents
INTERRELATION OF THE CONCEPTS OF
ENVIRONMENT AND DEVELOPMENT

Health and development are closely related.

Development provides the means for health, while health is a key component for
development
It is well known that poor people suffer more from ill-health and disease than rich people,
and that they use the available health services less often.
The richer parts of the country also tend to have healthier people and better medical
services.
These two examples show that economic development and good health go together.
INTERRELATION OF THE CONCEPTS
OF ENVIRONMENT AND
DEVELOPMENT CONT…
If the hardships of economic recession are not shared
equally, the poor will suffer to a greater degree.
It is now realized that medical services, especially
curative services, do little on their own to improve the
health of the community
INTERRELATION OF THE CONCEPTS
OF ENVIRONMENT AND
DEVELOPMENT CONT…
Much more is achieved when everyone has sufficient food to eat and simple measures are
taken to improve the environment.
That is why good nutrition and god environmental health are such important elements of
primary health care
In addition, the development of a cash economy, improved agricultural methods, fair
sharing of land, better education - especially for women-high literacy standards and
improved infrastructure all lead to improved health.
INTERRELATION OF THE
CONCEPTS OF ENVIRONMENT AND
DEVELOPMENT CONT…
The environment is an important part of the overall picture of human life and behavior.
Biological, physical, social and economic environments have a bearing on how people
live and behave
The way people live and behave determines the diseases from which they suffer and how
effectively the health services work.
People are affected by their environment, and can change it if they want to.
KEY POINTS:

• The socio- cultural factors affecting the health of a community include the beliefs,
traditions, and social customs in the community
• Kirchstein ……… underscored that “research on social and cultural factors is a
vital part of efforts to understand health disparities, and critical to understanding
the etiology of health and illness in general.
• The environment can be changed to make it healthier

• Health and development are closely related.

THANK YOU.