Wednesday, September 15, 2010

The most important heath factors are social

In sickness and in wealth
Unmasking the social determinants of health

Ryan Meili, Briarpatch: In one of the first lectures of medical school, students are asked what factors will have the greatest impact on a person's health. Lifestyle choices are a common response. Others will talk about access to health services, while others guess genetics or culture. After the student weigh in, they are shown the Canadian Institute for Heath Information's list of health determinants, in order of impact.

The Determinants of Health
  1. Income status
  2. Education
  3. Social support networks
  4. Employment and working conditions
  5. Early childhood development
  6. Physical environment
  7. Personal health practices and coping skills
  8. Biological and genetic factors
  9. Health services
  10. Gender
  11. Culture
  12. Mass media technology (i.e., television viewing and physical inactivity)
Invariably this list is met with surprise. As aspiring doctors the students think they are in the business of making people healthy. But they discover that the services offered by the health professionals barely crack the top 10 factors that influence people's health. The lesson to be drawn from the list of determinants, and the one that is stressed to students, is that the most important factors that determine people's health are social, and the most effective solutions are political.
Image source here.