Introduction
This note covers the determinants of health (the main factors causing most disease in a region) and health indicators, including the European Community Health Indicators (ECHI) and the Healthy Life Years indicator.
Health determinants
Health determinants are the main factors causing the majority of diseases in a given region; they are complex and combined.
- Health is determined by the complex influence of social, biological, physical, chemical and other elements of the environment together with political and economic factors: labour, lifestyle, communications, education, healthcare services etc.
- Health is multifactorial: it is influenced by natural and social factors. Natural factors act via social factors and lifestyle.
- Social medicine studies public health and its determinants. Public health is determined by 3 main groups of indices: demographic indices, disease incidence, and physical development and activity.
- Factors determining health include: the social and economic environment, the physical environment, and individual characteristics and behaviours.
Social determinants of health
- Lifestyle: composed of cultural and behavioural patterns and lifelong habits such as smoking. Habits are learned via family, friends, school and mass media.
- Social gradient: life expectancy is shorter and the prevalence of disease is higher further down the social ladder. Health policy must tackle the social and economic determinants of health.
- Stress: stressful circumstances make people worried, anxious and unable to cope, which damages health and can lead to premature death.
- Early life: a good start in life needs a good support system (parents); education lasts a lifetime.
- Social exclusion: life is commonly shorter when quality of life is poor; social exclusion, poverty and discrimination cost lives.
- Work: stress in the workplace increases the risk of disease; people with more control over their work have better health.
- Unemployment: job security is needed for top well-being and job satisfaction; higher rates of unemployment cause more illness and premature death.
- Social support: friendship, good social relations and strong supportive networks improve health at home, at work and in the community.
- Addiction: individuals turn to alcohol, drugs and tobacco and suffer from their use; use is influenced by the social setting.
- Food: because global market forces control the food supply, healthy food is a political issue.
- Transport: healthy transport means less driving and more walking and cycling, backed up by better public transport.