Determinants of Health - Essay Example

?Determinants of Health The life and progress of every community is greatly dependent on the health of its individuals. There has been tremendous advancement in the field of medicine and health for mankind recognizes health of people as the most basic necessity of a moving society. More recently, this has also pushed scientific attention to probe what are the underlying determinants of health in modern societies in the first place? Interestingly, quite significant sensitivity has been noted of health to the environment and to what are referred to as the social determinants of health (Whitehead 1992). This paper recognizes and discusses some powerful determinants of health functioning as important subsystems in our community. These include lifestyle of the individual, his living and working conditions, and the effects of unemployment, good food, transportation and use of drugs etc (WHO). These factors can be broadly characterized into two classes: personal i.e., pertaining to the individual human being, and environmental i.e., those coming from the surroundings at large. In what follows, the paper discusses some of these factors and throws light on their interrelation to the entire community and relevance to health and well-being. Social living conditions come first and foremost in determining health. Life expectancy is shorter and most diseases are more common as you move down the social ladder in each society (Morris 2000). Economic and social conditions characterized by poverty affect health throughout life. The lower end of the social hierarchy runs twice the risk of serious diseases and early deaths as compared to the top end (Bartley 2002). This can be both because of physical and/or psychological factors, for example, raising a very large family, having poor housing or lack of private assets. In addition, the greater the length of time spent in such conditions, the more adverse the effects. The negative impacts of these factors keep on concentrating over the same people overtime and the constant psychological and physical suffering gradually becomes a permanent fact of their lives, silently taking away good health from their lives for good (Barker, Osmond, Simmonds 1992). Of the other notable health determinants, working conditions is one of the most crucial ones. Having a job is better for health than having no job, but the nature of job, stress at work, the style of management and relationships at workplace all play important roles in shaping health. At the workplace, health problems vary from class to class. Higher social class experiences more psychological problems than physical while the opposite is true for the lower class. For the higher social class, factors such as having the right job, opportunity to practice your skillset and having enough authority determine mental satisfaction levels (Bosma 1998). The health problems arising from these factors include backache, head ache and cardiac diseases. On the other hand, the lower class has more to do with the physical demands of the job. They are mostly exposed to physical injuries and muscular problems. Research has also found “job Control” to be a paramount determinant of health at workplaces (Schnall et al 2000). Having little control lessens satisfaction levels and increases risk of health problems significantly. Conversely, people having more control over their work enjoy better health. On the more macro level, in societies, factors such as the government health policy, the prevailing unemployment situation, pollution conditions and transportation systems of the cities have been frequently recognized as determinants of health in literature. Regarding government’s role and policies, a lot has been said and written. Providing health facilities and ensuring a healthy living for every person is essentially a state’s responsibility. Even in the most affluent of countries, there are significant issues regarding health that go up and are debated at the policy making level in the government. Moreover, the country wide movements organized under state control influence health of millions of the people that live in it. Examples of such movements can be the Canadian Population Health Initiative (CPIH) and the various Polio Eradication Movements organized every year in countries like Pakistan and India. Government policies are heavily scrutinized as well. On many occasions, Governments have been seen being criticized for their policies to be either impractical in the first place or else, not being implemented with full commitment (Glouberman and Miller 2003). This shows how important Government’s role is in health matters and how profound and far reaching it goes in determining health of the larger public. Transportation system is another macro level health determinant. It can give rise to better health in a number of ways by reducing reliance on cars and encouraging cycling, walking and public transport. With the more automated nature or jobs, physical exercise at work place has reduced drastically. Obesity, diabetes and cardiac diseases at work place have become commonplace. More cycling and walking not only means more exercise but also less fatal accidents and air pollution (Davies 1997). The transport policy should be formulated keeping in mind these factors as priority. Of the more recently observed relationships, a quite shocking one has been the one between unemployment rates and health (Beal, Nethercott 1997). Where and when unemployment has been widespread, illness and premature death rates have risen. The health problems associated with unemployment come from both, the financial problems it brings and psychological pressure it mounts. During the economic crashes of early and late 2000s, rates of heart diseases and mental illnesses due to chronic stress were reported to rise sharply. The economic conditions of a state and the resulting employment conditions hence directly affect health of its people. The identification and study of determinants of health is ultimately directed towards one purpose only – formulating more effective strategies by working bottom-up through the community layers for the improvement of public health. In this regard, the paper formulates and presents three strategies; firstly, a broad strategy to tackle health disadvantages caused by social inequity, secondly, policies for work places improvement, and lastly, a strategy regarding transportation system. The first strategy is primary about prioritization. It entails that welfare policies in societies should focus more towards the people who have been more disadvantaged in the past. Because health problems tend to accumulate and become severe as years of social disadvantage prolong, the people in this class are more likely to have health issues. Hence, the policies should first serve these people with safety nets to offset their earlier disadvantage and then come to the higher classes. For a strategy to improve workplace conditions, a number of steps can be proposed. The control factor, which was identified as a paramount job satisfaction factor earlier, should be fine-tuned. Employees should be given enough authority and involvement in decision-making to enable them to gel in the system and design their own work. Moreover, the top management should realize that there is no trade-off between health of the employees and their productivity, rather there is a continuous circle – improved health condition will give rise to a more efficient task force, which will bring more productivity and hence, even better health conditions and more efficient task force and so on and so forth. For the transportation system strategy, only a single step can bring significant value i.e., changing incentives in the overall policy. Road building should be discouraged by decreasing subsidies given to them and these funds should be invested in public transport systems. The policies should also include levying taxes on business use of cars and heavy fines on driving and parking violations. These strategies can help put the theory of determinants of health into practice towards a change for the better. References Barker, D. J., Osmond, C. and Simmonds, M. “Weight in infancy and death from ischemic heart disease” Lancet 2. (1989): 577–580. Bartley M, Plewis. “Accumulate labor market disadvantage and limiting long term illness”. International journal of epidemiology. (2002): 31:336-341. Beal N, Nethercott S. “Jobless and family morbidity: a study of a factor closure”. Journal of the royal college of general practitioners. (1997): 35:510-514. Bosma H et al. “Two alternative job stress models and risk of coronary heart disease”. American Journal of Public Health. (1998): 88:68-74. Davies A. “Road Transport and Health”. British Medical Association. (1997). Glouberman S, Miller J. “Evolution of the Determinants of Health, Health Policy, and Health Information Systems in Canada.” American Journal of Public Health. (2003). Morris JN et al. “A minimum income for healthy living”. Journal of Epidemiology and Community Health. (2005): 54:885-889. Schnall P et al. “Why the workplace and cardiovascular disease?” Occupational Medicine, State of the Art Reviews. (2000): 15:126. “Social Determinants of health, the solid facts, Second edition”. World Health Organization, Regional Office for Europe. (2003). Whitehead M. “The concepts and Principles of equity in Health” International Journal of Health and Service. (1992): 22:429-445 Read More