Dr. Anuj Singh discusses the various determinants of health, which are factors that influence health outcomes. The main determinants are biological, environmental, lifestyle, socio-economic conditions, health services, aging population, and gender. Biological determinants refer to genetic factors. Environmental determinants include housing, water, and psychosocial stress. Lifestyle factors like smoking and alcohol consumption impact health. Socio-economic conditions such as education level, economic status, and occupation also determine health. Adequate health services, the aging population, and gender are other important determinants. Overall, Dr. Singh emphasizes that health has multiple influencing factors and is not simply the absence of disease.

1. Dr. Anuj Singh
Asst. Professor
Community Medicine Dept
UIMS , Prayagraj

2. Health Def:-
Health is a state of complete
Physical,
Mental,
Social wellbeing
and not merely absence of disease or
infirmity.

3.  Health is multifactorial.
 Many factors determine the outcome of
health.

5.  So, various factors which determine health are
called “Determinants of health”
 The various determinants of health are:
1.Biological
2.Environmental
3.Lifestyle
4.Socio-economic Conditions
5.Health Services
6.Aging of Population
7.Gender
8.Others

6. The physical and mental traits of every human being
depend upon the genetic make up of the individual.
The genetic make up is unique in that it cannot be
altered after conception.
1. Biological Determinants

7. The main part of DNA is the gene
made up by purines and pyrimidines.
If any of the parts of the molecule is
defective then the defect manifests as
a genetic defect.
The various defects are Down’s syndrome,
Turners , klinefelters, errors of metabolism,
Some types of diabetes, etc.

8. •In positive terms, from genetic point of view,
health may be defined as:
“The presence in the genetic constitution of the
genes that correspond to normal characterization
and to presence of normal karyotype”.

9. 2. ENVIRONMENT
 Hippocrates first related disease to environment.
 Petten kofer in Germany revived the concept of
disease-environment association.

10. Environmental factors range from:
Housing
Water supply
Psycho social, stress
Etc.
Organization of
health & social
welfare services
So environment has direct impact on
health of an individual.
Protection and Promotion of family and
environmental health is one of the major
issues in the world today.

11. ENVIRONMENT
INTERNAL
TISSUES
ORGANS
ORGAN SYSTEMS
Should be in harmony with
each other
EXTERNAL
PHYSICAL
BIOLOGICAL
PSYCHO SOCIAL

12. 3. LIFESTYLE
The lifestyle (the way the people live) also has an
important role to play on the health of the individual.
It reflects social values, attitudes, activities etc.
Habits like smoking, alcohol etc.. reflect on the health
of the person.
Example :

13. COPD
lung cancer, etc.

14. SMOKING
 Smokers can be of 2 types
Active smokers.
Passive smokers.
 There are many surveys stating that, passive smokers
are also prone to hazardous effects of smoking.

15. Gastritis
Hepatitis
Cirrhosis
Wernickes encephalopathy
Korsakoffs psychosis
Mallory weis tear
Myopathy etc.
ALCOHOLISM

16.  Many current day problems like coronary heart
disease, obesity, lung cancer are lifestyle diseases.
 In developing countries major risks for illness are:
 poor nutrition
 lack of sanitation
 lack of personal hygiene
 customs and cultural patterns
 So health requires promotion of healthy life styles.

17. 4. SOCIO-ECONOMIC CONDITIONS
ECONOMIC OCCUPATION
STATUS
EDUCATION POLITICAL
SYSTEM

18. ECONOMIC STATUS
The Per capita GNP is most
widely accepted measure of
economic status.
Economic status determines :
Purchasing power
Standard of living
Quality of life
Deviant behavior in community
Life expectancy

19. EDUCATION
 One of the major factor influencing health status is
education.

20.  Illiteracy can be a major cause of poverty,
malnutrition, ill health, high infant and child
mortality rates.
 Female literacy has a very important role to play.

21. EDUCATION
 The small state of kerala in India is a striking
example.
 Kerala has an estimated infant mortality rate
of 14% compared to 71% for all-India in 1999.
This was possible only due to highest female literacy
rate of 87.86% compared to 54.16%
for all-India.

22. OCCUPATION
 Occupation can lead to disorders like:
Silicosis
Coal workers pneumoconiosis
Asbestosis
Byssinosis etc.

23. POLITICAL SYSTEM
One of the main obstacles to the implementation of
health technology is of political origin.
Decisions concerning :
resource allocation,
man power policy,
choice of technology etc.

24. POLITICAL SYSTEM
 Degree to which health services can be made available
are all decided by political system of community.
 The percentage of GNP spent on health is a
quantitative indicator of political commitment.
 If poor health patterns are to be changed, entire socio-
political system is to be changed.

25. 5.HEALTH SERVICES
 The purpose of health services is to improve health
status of population.
 For example:
Immunization reduces incidence &
. prevalence of disease.
 Safe water prevent water borne diseases

26.  To be effective : The health services must reach
periphery, equitably distributed, cheaper in cost and
socially acceptable.
 All these are now termed PRIMARY HEALTH CARE.

27. 6. AGING OF POPULATION
 Major concern of rapid population aging is increased
prevalence of
chronic diseases
disabilities
 Some diseases of aged include :
Diabetes
Hypertension
coronary heart disease

28. 7. GENDER
Diseases common in male:
Hemophilia
Myocardial infarction etc..
Diseases common in females:
Thyrotoxicosis
Rheumatic mitral stenosis

29. GENDER
 Female health has a very great importance because, its
female health that’s going to determine the health of a
child.
 In 1993, the Global commission on women’s health was
established with an agenda for action on women’s
health.
 It covers aspects of nutrition, reproductive
health etc..

30. 8. OTHER FACTORS
 These may include :
Science and technology
Information and communication
Food and agriculture
Industry
Social welfare
Rural development
Adoption of policies in economic and social
fields.

31. BIOLOGICAL
BEHAVIOUR
AND
SOCIO-CULTURAL ENVIRONMENTAL
SOCIO ECONOMIC
EDUCATION
HEALTH SERVICES
THEREFORE HEALTH IS MULTI-FACTORIAL