Health is an issue that affects all people, in all places, in different ways. Health refers to the level of functional and mental well-being of a person. Although health is related to age, it goes beyond merely having more birthdays. Healthy aging is associated with functional capacity (e. g. , being able to get up from a chair, walk, or climb stairs). Health also refers to the presence of diseases, disabilities, and death.
Health is influenced by individual attributes (i. e. genes), environmental factors (e. g. , air quality), economic factors (i. e. , poverty level), and social determinants (i. e. , social support, education). Health is determined by a combination of these different factors that interact with each other over time at different levels across the life span to influence health throughout the lifespan. The main purpose of public health programs around the world is to promote healthy aging among people via promoting healthy lifestyles (Mutch et al. , 2012).
Lifestyle choices are an important factor in producing good health or ill-health; examples include smoking cigarettes, overeating, drinking alcohol excessively, and not getting enough exercise. Health is the result of many factors including both personal choices about individual lifestyles (i. e. , chewing tobacco or not) and external features of the environment (i. e. , air quality).
Health is influenced by a person’s genes, environmental factors (e. g. , pollution), economic factors (i. e. poverty level), social determinants (i. e. , education), culture, community resources that are available within their geographical area/region/territory, socioeconomic status, physical work conditions, nutrition, access to healthcare services combined with other lifestyle choices each individual makes throughout his or her lifetime over time at different levels across the life span to influence health throughout the lifespan; these factors interact to produce health throughout the lifespan (National Health Service [NHS], 2016).
Health is commonly understood in terms of physical and mental well-being; this definition is often extended to include social and spiritual aspects which can impact overall wellness. Health influences lifestyles choices and motivations; including how we look after ourselves, choose to eat, drink, exert energy and relate with others. Analysis suggests that people in developed countries live up to ten years longer than people in developing countries.
Health can be measured through both subjective self-reports and objective measures such as biomarkers, based on parameters such as blood pressure or body mass index (PARIS21 Secretariat). Health determinants are defined by the World Health (WHO) as “the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels” (World Health Organization [WHO], 2011).
Health determinants can be categorized as either biological or social factors which influence health. Health is influenced by a combination of both personal choices about lifestyle and external environmental influences such as air quality and pollution levels (referred to as “non-modifiable” determinants) which then interact with individual attributes such as genes and behavior or “modifiable” determinants that include behaviors such as smoking cigarettes or exercising regularly (Samson et al. , 2013; WHO, 2008).
The concept of social determinants has been recognized for over 100 years, and gained particular prominence over the past 50 years. Health inequalities across different social groups are well known features of modern societies and there is now extensive evidence about how such differences in health emerge and persist over time. The concept of ‘social determinants’ emerged as a tool for explaining variations in population health outcomes which cannot be explained by variability in medical care or biology (World Health Organization [WHO], 2008).
The Health Development Agency defines social determinants of health as “the conditions in which people are born, grow, live, work and age” (HDA, 2003). Social factors have been seen to impact an individual’s life expectancy & overall wellness. Health inequities not only exist between or states but within communities that can exist based on gender, race/ethnicity, age, social class and sexual orientation (Parisi & Longo, 2009). Health inequities are seen to exist within geographic areas as well between different regions of countries.
Health disparities can also be seen in developing countries due to barriers with access to resources such as healthcare services or poverty levels which commonly occur across populations. Health outcomes around the world are influenced by multiple factors that contribute including geography/geographical location, family history & genetics, individual behaviors & life style choices and overall socioeconomic status which is associated with a variety of social variables such as education level/income earnings/ occupation status (National Health Service [NHS], 2016).
Efforts towards health equity can be achieved through efforts made at the individual, interpersonal and societal levels (WHO, 2008) Health is often monitored using a variety of indicators. Health outcomes can be measured using measures such as morbidity rates and mortality rates which track disease and death statistics; however these do not provide information about an individual’s quality of life (NHS, 2016). Health-related quality of life is used to describe how well or how effectively people are able to perform basic everyday tasks such as self care, job performance and social interactions.
Health inequalities may exist between different groups with low health-related quality of life as a result of differences in access to resources such as education & employment opportunities which collectively influence the opportunity for social mobility. Other factors that contribute to inequities in health status include race/ethnicity, geographic location and family income/parental education levels which are variables that are outside of the control of an individual (Samson et al. 2013).
Health inequities remain a global problem which can be addressed through policy changes aimed at reducing disparities. Monitoring health outcomes is one way to assess the impact of social determinants on health status. Health surveillance can be conducted using various tools such as Health Survey for England, Health Focus or public Health Intelligence Network which provide information about the general population’s health & wellbeing (NHS, 2016).
Health surveillance systems can then monitor trends in health over time based on specific subgroups. The Health Survey for England has monitoring programs that track new cases of diagnosis rates along with new cases of conditions such as diabetes. Health surveillance can also track mortality rates which provide valuable information based on specific data from a geographical area selection within a country or region.
Health profiles have been developed in the United States which monitor health indicators across different states and compare them to national averages which is an effective way of assessing social determinants of health even though the quality of data may vary by state (Samson et al. , 2013). Health disparities occur in many countries including developing nations where people have reduced access to resources that influence their overall wellbeing, however monitoring systems are limited in these settings due to challenges with tracking life expectancy rates & documenting chronic disease prevalence (WHO, 2008).
