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Determents of Health
Dr. C. SENTHILKUMAR
Assistant Professor,
Dept of Sociology and Social Work
Arsi University, Ethiopia

Chapter - III
Social and Cultural aspects of
Human Health & Medicine

• Determinants of Health
• The range of personal, social, economic, and
environmental factors that influence health
status are known as 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 a long, healthy life?
• Developing objectives that address the
relationship between health status and biology,
individual behavior, health services, social
factors, and policies.

Determenents of Health Chapter - III.ppt

• Income and Social Status
• Higher income and social status are linked to
improved health status. These two factors
may be the most important determinants of
health. The greater the gap between the
richest and the poorest people in an area, the
greater the disparities in their health.

• Social Support Network
• Greater support from families, friends, and
communities is linked to better health for
individuals. Social support is a source of
emotional reassurance and provides a safe
place for a person to discuss their problems,
which can help them to cope with adversity.
Social networks provide information and
practical support, such as knowing someone
who can assist in a time of need.

• Education and Literacy
• Health status improves with a person’s level of
education. Education both contributes to and
is a result of social position. Education
contributes to health and prosperity by
equipping people with knowledge and skills
for problem-solving, and helps provide a sense
of control and mastery over life
circumstances. It also improves people's
ability to access and understand information
to help keep them healthy.

• Employment/Working Conditions
• Unemployment, underemployment, stressful
or unsafe work is associated with poorer
health. People who have more control over
their work circumstances and fewer stress-
related demands on the job are healthier and
often live longer than those engaged in more
stressful or riskier work and activities.

• Social Environment
• The importance of social support also extends
to the broader community. Social or
community responses can add resources to an
individuals’ repertoire of strategies to cope
with changes and foster good health. The
array of values and norms of a society
influence in varying ways the health and well-
being of both individuals and populations.

• Examples of social determinants include:
• Availability of resources to meet daily needs, such
as educational and job opportunities, living
wages, or healthful foods
• Social norms and attitudes, such as discrimination
• Exposure to crime, violence, and social disorder,
such as the presence of trash
• Social support and social interactions
• Socioeconomic conditions, such as concentrated
poverty
• Quality schools, Transportation options, Public
safety, Residential segregation

• Physical Environment
• Factors related to housing, air quality, water
quality, safe houses, and transportation
systems all contribute to health.
Environmental influences on health can be
positive or negative, and range from global, to
national and/or regional issues, to the local
built environment, to the social environment.

• Examples of physical determinants include:
• Natural environment, such as plants, weather,
or climate change
• 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

• Personal Health Practices and Coping Skills
• Individuals can prevent diseases, promote
self-care and make choices that enhance
health. Lifestyle includes not only individual
choices, but also the influence of social,
economic, and environmental factors on the
decisions people make about their health.
Personal life “choices” are influenced by the
socioeconomic environments in which people
live, learn, work and play.

• Examples of individual behavior
determinants of health include:
• Diet
• Physical activity
• Alcohol, cigarette, and other drug use
• Hand washing

• Healthy Child Development
• Early childhood development is a determinant
of health later in life. Other determinants of
health in turn also affect the development of
children. Determining the inclusion or
exclusion, content, and frequency of a wide
variety of preventive health interventions that
is particularly useful during childhood

• Biology and Genetic Endowment
• The basic biology and organic makeup of the
human body is a fundamental determinant of
health. Genetic inheritance provides pre-
disposition to a wide range of individual
responses that can affect health status
throughout the lifespan.

• Health Services
• Access and use of services that promote
health and prevent disease influence health.
Simple measures, such as protecting water
supplies, often have the greatest impact on
overall health. Examining high-use
populations in terms of health care utilization
can be an effective way to target interventions
tailored to specific groups such as those with
multiple co-morbidities.

• Barriers to accessing health services include:
• Lack of availability
• High cost
• Lack of insurance coverage
• Limited language access

• Gender
• Gender refers to the societal characteristics
that society ascribes to the two sexes.
Gendered norms influence the health system's
practices and priorities. Gender inequities do
not only result from income disparities;
gender is also linked to differential access to
health services, to unequal obligations to
provide unpaid family care duties, and to
disparities in nutrition.

• Culture
• The customs, traditions, and the beliefs of the
family and community all affect health. A
person’s cultural background has an influence
on their beliefs, behaviours, perceptions,
emotions, language, diet, body image, and
attitudes to illness, pain, and misfortune. All
of these factors can influence health and the
use of healthcare services.

• What is culture?
• Culture is the patterns of ideas, customs and
behaviours shared by a particular people or
society. These patterns identify members as
part of a group and distinguish members from
other groups. Culture may include all or a
subset of the following characteristics:

• Ethnicity
• Language
• Religion and spiritual beliefs
• Gender
• Socio-economic class
• Age
• Sexual orientation
• Geographic origin
• Group history
• Education
• Upbringing
• Life experience

Impact of culture on health
• How patients and health care providers view
health and illness.
• What patients and health care providers believe
about the causes of disease.
• What types of health promotion activities are
practiced, recommended or insured.
• How illness and pain are experienced and
expressed.
• Where patients seek help, how they ask for help
and, perhaps, when they make their first
approach.

Cont..
• Patient interaction with health care providers.
• The degree of understanding and compliance
with treatment options recommended by
health care providers
• How patients and providers perceive chronic
disease and various treatment options.

What health professionals can do
• Consider how your own cultural beliefs, values
and behaviours may affect interactions with
patients.
• Respect, understand and work with differing
cultural perceptions of effective or
appropriate treatment.
• Where needed, arrange for an appropriate
interpreter.
• Listen carefully to your patients and confirm
that you have understood their messages.

Cont..
• Make sure you understand how the patient
understands his or her own health or illness.
• Recognize that families may use
complementary and alternative therapies.
• Negotiate a treatment plan based on shared
understanding and agreement.

• Ethno Medicine
• Western medicine. Modern medicine.
Traditional medicine. Eastern medicine.
Complementary medicine. Alternative
medicine. Holistic medicine. There are so
many types of medicine! Aah!! Well, here's
another one to add to that list: ethno
medicine.

• Definition
• Ethnomedicine is a term that refers to a wide
range of healthcare systems/structures,
practices, beliefs, and therapeutic techniques
that arise from indigenous cultural
development.

• Ethno medical systems tend to see the mind
and body as one entity and they focus on
preventative techniques, such as the use of
massage therapy, exercise, spices, herbs, and
food to heal a diseased or ill individual.

Ethno medicine isn't limited to the obvious
things, like using indigenous plants and
ingredients to treat the sick. It also involves
studying or utilizing:
• How a disease/illness arises, according to the
native cultural point of view.
• Indigenous beliefs about what a person's signs
and symptoms really mean.
• The way by which a disease/illness progresses.
• The best ways by which a disorder should be
managed and who should manage it and how.

• Complementary and Alternative Medicine
• Complementary and alternative medicine
includes practices such as massage,
acupuncture, tai chi, and drinking green tea.

• Types of Complementary and Alternative
Medicine
• Scientists learn about CAM therapies every
day, but there is still more to learn. Some of
the therapies listed below still need more
research to prove that they can be helpful.

• Meditation: Focused breathing or repetition
of words or phrases to quiet the mind.
• Hypnosis: A state of relaxed and focused
attention in which a person concentrates on a
certain feeling, idea, or suggestion to aid in
healing.
• Reflexology: Using pressure points in the
hands or feet to affect other parts of the body.

• Yoga: Systems of stretches and poses, with
special attention given to breathing.
• Tai Chi: Involves slow, gentle movements with
a focus on the breath and concentration.
• Imagery: Imagining scenes, pictures, or
experiences to help the body heal.
• Creative outlets: Interests such as art, music,
or dance.

• Talk with Your Doctor Before You Use CAM
• What types of CAM therapies might help me:
• Reduce my stress and anxiety?
• Feel less tired?
• Deal with symptoms and side effects, such as
pain or nausea?

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Determenents of Health Chapter - III.ppt

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