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The Determinants of Health

The World Health Organization defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Around the world, health status varies among people.

There is nothing more important than good health, it is our principal capital.

Factors That Determine Our health

Our predominant health status is determined by where we live, how we live, what we eat and a number of other factors. Some of these factors like diet and exercise are fairly within our control, while others like race and gender are unchangeable.

It helps to know these factors, understand how they impact our health. These factors do not have equal impact on health, some have more than others, the level of impact varies from place to place and from person to person – hence the greater need for more personalized medicine.

Some of The Main Determinants of Health;

•    Where you live/environment: is there clean and safe water and air? Is housing safe and not overcrowded? Is there good sanitation? What are levels of crime like? How safe are roads? Are there jobs with decent working conditions?

•     Genetics: have you inherited greater likelihood of certain illnesses? How do you cope with stress?

•     Income: unsurprisingly, higher income is linked to better health.

•     Nutrition: can you regularly eat enough healthy food?

•     Education: going to school can improve many other determinants of health.

•     Relationships with friends and family: better support networks are linked with better health.

•     Gender: men and women face different diseases at different ages. In many countries, women also face many extra challenges that affect their health.

•     Culture: customs, traditions, and beliefs can all affect health for better or worse.

•     Social status and social exclusion: people who are excluded, or on the margins of society have worse health chances.

•     Access to and use of health services: are services available nearby to prevent and treat poor health?

•     Personal behaviours: What do you eat? How much exercise do you do? Do you smoke or drink?

Some of these factors like genetic makeup and gender are largely unmodifiable, others can be modified with varying levels of ease.

Yet, there are a number of other factors that may not easily fit into the ones listed above that affect healthcare at both the individual and population level; access to primary healthcare, availability of effective transport systems, activity levels and exercise, elderly and dementia friendly environments, air quality and pollution, social habits like alcohol, smoking, drug use and sexual practices, chronic diseases like asthma, hypertension, diabetes, oral health practices, immunization coverage, land and water pollution, employment status, ability to communicate in English Language, Food security, gambling and other addictions, overcrowded households, mental health, noise pollution, obesity, availability of phone and internet services etc.

All these health determinants and factors interact to create a complex set of health dynamics. Reducing poverty, providing means of earning income, increasing access to education, promoting gender equality and promoting the general standard of living are key parts of the puzzle.

A look at these factors and determinants will bring to our understanding why living in certain countries like Nigeria could shave off a good eleven years from the global life expectancy average.

Health Seeking Behaviour

Good health is valuable and everyone everywhere should strive to attain it, maintain it and promote it.

The sum total of activities carried out by an individual in search of remedy for an illness or ways to promote and maintain good health for themselves or for another person is referred to as health-seeking behaviour.

Health seeking behavior varies among different people in different places and has been found to be affected by certain factors.

A study of rural dwellers in Ekiti state revealed that the most important factor affecting health seeking behavior was affordability. Others were proximity, staff attitude, quality of service, knowledge of staff owners and neatness of the facility. Also important to these rural dwellers were the availability of drugs and other required services such as laboratory services.

When asked to suggest how healthcare delivery could be improved, they suggested improvement of roads, provision of more health workers, equipping medical facilities, quick service delivery and tidy facility.

Another study of elderly Nigerians the same factors came into play, affordability, nature of the illness, quality of services provided, the attitude of health caregivers, waiting time, availability of service, proximity, level of education.

When There Is No Doctor

A study carried out in North Central Nigeria, where doctors are scarce, a study showed that self-diagnosis was the commonest form of diagnosis, for some this involved some form of self-prescribed laboratory tests, others sought opinion community health workers and family numbers. A small number admitted seeking a diagnosis from traditional healers.

After a diagnosis was made and care was to be sought, the medicine seller was the commonest point of call, followed by visits to the government hospitals, traditional medicine healers, private clinics and community health workers. Poor members of the community were more likely to seek care at home.

Half the World Lacks Access

Nigeria and other countries without Universal Health Coverage contribute to the 3.5 billion of the world’s population that cannot obtain essential health services, and the 100 million people pushed into extreme poverty each year due to out-of-pocket health expenses they must pay, according to a United Nations backed study.

Wide gaps exist in the availability of services in Sub-Saharan Africa and Southern Asia. In other regions, basic health care services such as family planning and infant immunization are becoming more available, but lack of financial protection makes it difficult for families to pay for these services.

Over 800 million people (almost 12 percent of the world’s population) spend at least 10 percent of their household budgets on health expenses for themselves, a sick child or other family members. They incur so-called “catastrophic expenditures”.

Incurring catastrophic expenses for health care is a global problem. In richer countries in Europe, Latin America and parts of Asia, which have achieved high levels of access to health services, increasing numbers of people are spending at least 10 percent of their household budgets on out-of-pocket health expenses.

Even in more affluent regions such as East Asia, Latin America, and Europe, a growing number of people are spending at least 10 percent of their household budgets on out-of-pocket health expenses.

In Conclusion

Inequalities in health services are seen not just between, but also within countries: national averages can mask low levels of health service coverage in disadvantaged population groups.

Good health is more than just freedom from illness, it includes the total well-being of an individual and we should all strive to attain, maintain and promote it.

We must understand the factors that influence our health status and make necessary adjustments where possible to get the best for our health.

We need to get serious about Universal Health Coverage to avoid catastrophic expenditure in health care.