Community health nursing –I

Determinants of Health

Presented By:
Randhir Singh Dhaka
DETERMINANTS OF HEALTH
Determinants means an influencing element or factor.

It is defined as influence of various factors which

interact with each other and determine the health
status of any individual, family and community at
large at any given point of time.
CATEGORY OF FACTORS
There are two types of
factors,
1) Intrinsic
2) Extrinsic
 The intrinsic factors
The intrinsic factors are from within
the individual, family and community.

e.g. Biological aspects and lifestyle.

 The Extrinsic Factors
The extrinsic factors are from outside
the individual, family and community.

e.g. environmental factors resources .

 Sp
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H SO a l H
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h M M
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D ea ta ND
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Well
Being
Health &
 Evidence base of health determinants

Transport Urbanization
Food and Water
Agriculture Radiation
Housing Nutrition and
Waste health
Energy Unemployment
Industry Addiction
 1) Human Biology
There are 4 types :
A) Genetic
Inheritance
B) Age
C) Racial Factors
D) Self Concept
A) Genetic Inheritance
Physica
l
charact
eristics

Genetic
Inheritance

Intelle
ctual
potent
ials
 Physical Characteristics
 Sexuality
Colour
Facial
Structure
Height
Body Posture
Intelligence
etc.
 Intellectual Potentials
It receives Positive Interactions and Re-
Enforcements From People Around Him Which
promote his/her Self Concept, Self Esteem, Self
Confidence & Promote His/her Mental & Social
Health.
There are number of diseases which are of genetic
origin such as mental retardation.
B) Age
Age influences illness
susceptibility as well as
behaviour. The young children
& the elderly are more
susceptible because of weak
body resistance.
Limited responses
Declining physical activity
and sensory perception
So prone to get ill health
C) Racial Factors
Racial Factors affect
health because of
different culture, values
& attitudes etc.
Susceptibility to illness
also varies with race.
e.g. sickle cell anaemia is
more common in
Africans and
Mediterranean people
D) Self Concept
It varies with each individual either positive or
negative.
Influencing factors:
Self expectations
Value
Attitudes

Habits and

beliefs
 2) Environment
Environment is one of the extrinsic factors which
influence health and wellness of human beings. It
includes,
A) Physical
B) Biological
C) Social Environment
Some time it may be referred as Micro
Environment & Macro Environment.
Micro Environment refers to
immediate, environment or personal
environment like
occupational environment,
social cultural environment.

Macro environment refers to

external environment, which is outside
the home.
B) The Biological Environment
 plant and animal kingdom
which helps in maintaining
the ecosystem and thereby
health of people.
Most of the plants and
animals are useful to human
beings and promote health.
But there are some disease
producing arthropods,
insects, micro organisms and
domestic and wilds animals.
C) The Social Environment
 people and social
institutions, socio cultural
events, religious beliefs,
moral and ethical values and
social rules and regulations
pertaining to living in the
society, socio economic
support system.
The individuals develop
positive and negative health.
 3) Life Style
Life style refers to people’s ways of living
which is reflective of their knowledge,
attitude and practices.

 It is composite of daily living activities, and

behavioural and cultural practices including
customs and tradition
We can change the
life style by
informal education
and formal
education. Good
life style promotes
positive attitudes &
practices.
Many health problems associated with
various unsound aspect of life styles.
Some behavioural practices such as
alcoholism, smoking, etc.
Maternal morbidity and mortality
associated with harmful traditional
practices during antenatal, natal, &
postnatal period.
4) health and health allied
resources

Socio
Health
economical
service
conditions

Health
Political
related
system
services
A) Health services
Health service are directly
concern with improvement of
health status of people. If the
health service are available and
utilized and by people then it
will have definite impact on
health status.
In that government provide a
primary health care services,
secondary and tertiary level
health care services
B)socio economics conditions
In developed countries there has been significant
reduction in the morbidity and increase in longevity at
birth because of socio economic condition
developments.
Socio economic condition include
a. Economic
b. Education
c. Occupation and living standard
a. Economic status
Money is power full
resources for developing
new project and
programmes related to
health.
But sometimes too much
money may result in harmful
life style and contribute to
various illnesses like cardio
vascular disease, nervous
disease, cancer etc.
b. education
Education is very
important aspect to
maintain good
heath.
More emphasis for
female education
C. Occupation and living standard
Occupation is another aspect of socio
economy condition which contribute to
health promotion.
Occupation is a source of income and
status.
Its keeps the individual busy and less
chances are there to get way laid and
unhealthy lifestyle.
C) Political system
The political
system has a very
strong role in
health promotion
of people.
The health care
delivery system is
determine by the
political system.
Decisions pertaining to health policy,
allocation of funds, programmes, manpower
development, infrastructure, health,
technology and delivery of health services are
made by the ruling party within the
parliament system.

Only 3% of the total GNP is spent on health

and family welfare whereas WHO
recommends for 5% of GNP.
D) Health related services
The health related
services include food and
agriculture, industry, rural
and urban development,
social welfare and
manpower development,
communication and
broadcasting &
transportation etc.
All these services have balance on
total socio economic and cultural
development of people this is
effective when there is
comprehensive approach in
approach in planning and
intersectoral co-ordination and also
collaboration wherever necessary.