Now a day’s health has become a complex issue. While studying determinants of health, all its aspects viz. physical, mental, social and spiritual must be borne in mind. All those factors that affect the various aspects of health should be considered as determinants of health. Determinants of health depend on:
(1) Individual Factors:
(i) Heredity:
The state of health of an individual depends on genetic characters received from parents. Genes play a very important role in the health and development of a child. Many diseases are heredity e.g. hemophilia and sickle cell anemia.
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Hemophilia is disease in which the blood of the patient clots very slowly due to deficiency of one of the coagulating factors. Sickle cell anemia is a hereditary disease in which the red blood corpuscles become sickle shaped due to a defective type of hemoglobin, and their oxygen carrying capacity is greatly reduced.
They ultimately lead to anemia. Another simple example is that if parents are suffering from diabetes, their children may also suffer from diabetes.
(ii) Life Style:
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Life style of an individual plays a great role in health. It may affect health in both ways i.e. it may promote and maintain good health as it may adversely affect the health.
Life style includes many personal activities like care of body, bathing, washing, care of teeth, hair, nails, posture and habits which include food, exercise, and sleep, use of alcohol, narcotics and drugs.
An individual learns lifestyles from his personal experiences or from others’ experiences. If a person is having good habits, has better attitude towards others and has positive attitude towards life then he will enjoy physical, mental, social and spiritual health but on the other hand if a person has bad habits, he quarrels with others, indulges in the use of alcohol, narcotics or other drugs then he will not only be a problem for himself but will also affect the health of whole family, society and community.
(2) Environmental or Surrounding Factors
(i) Socio-Economic Factors:
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The health of an individual depends on the socio-economic factors which are governed by set rules and regulations framed and accepted by the society in which he lives.
Certain customs of a particular community or society are good for healthy living but there are certain customs which are detrimental to health e.g. to serve wine on social functions. Dowry system which is a curse greatly affects health of an individual or family directly or indirectly.
The development of any society depends on the socio-economic factors of individuals. If they are financially sound there will be all round development in education, housing, social relations and hygienic conditions.
With all these developments there will be improvement in standard of living which will affect the health status of an individual in many ways. Poverty is the root cause of most of the problems.
Poor nutrition, illiteracy, slums, lack of basic needs, unhygienic conditions all lead to ill health. The development should not be limited to the satisfaction of basic needs only but it should go much further than that.
Apart from the satisfactory provision of basic needs there should be provision for proper hygienic conditions, sewer system, pacca roads, well built houses, educational and recreational facilities.
From all these facilities there will be development of all individuals, communities and societies which will overall affect the development of the country, thus the health of all its subjects will be affected to a great extent. Hence health and development are closely related to each other.
Financial health is the controller of all the ingredients of health, pleasure, peace of life and development. The financial health and physical health are dependent on each other.If an individual is physically healthy, he will do hard work to earn money and to remain physically fit he requires good nutrition for which money is needed.
Thus financial health and physical health are interdependent. But physical and mental healths are the most important among all aspects of health.
Role of Poverty in Health:
Poverty is one of the major reasons for ill health of the people due to the following reasons:
1. Due to poverty, people are unable to buy sufficient food and if they buy food generally that is devoid of nutritive values which leads to deficiency disease and ruins the health of a person.
2. Poor people are mostly uneducated. They do not understand the value of balanced diet or the value of cheap articles from where they can get good nutrition. The lack of which leads to many diseases just because of ignorance.
3. Poor people live in slums which are unhygienic and breeding ground for disease-causing germs. They do not bother about their own cleanliness or unhygienic conditions of their surroundings.
4. Due to poverty, poor people are unable to get the best available medical treatment due to which the disease lingers on for a long time and ultimately leads to death of the patients.
5. Generally poor people are illiterate. They do not understand the harmful effects of alcohol, tobacco or other drugs. The use of these items ruins the health as well as financial condition of a person.
(ii) Political Will:
As already discussed that poverty is the root cause of most of the health problems. The poor people living in slums are the easy target of diseases because they are deprived of all basic facilities like fresh water, proper food, houses, lighting system, environment, education and health facilities.
They live under unhygienic conditions therefore specially the children as well as other persons living in these slums are easily affected by diseases. They neither get preventive nor curative measures.
But if political decisions are taken and policies are framed then within no time all types of facilities like fresh water, pacca houses, pacca roads, electricity, educational and medical facilities are provided free of cost or at reasonable cost which can certainly affect and promote the health status of these people living in slums. But all these issues are primarily of political nature.
(iii) Availability of Health Care Services:
To be a healthy person is the fundamental right of all the individuals and communities of any country therefore it is the duty and responsibility of all the state governments as well as central governments of all the respective countries to provide health care facilities to all its subjects, be it human beings, animals or plants etc. at affordable costs so that all their subjects are hale and hearty.
World Health Organization (W.H.O.) has set up a goal of achieving “Health for all by 2000 A.D.” To achieve this goal greater emphasis is laid on primary health care facilities/services provided by the government as well as non-government organisations.
It is not only the government or non-government organisations which should provide the basic health care facilities/services but all individuals at their own level must contribute to achieve this goal so as to promote preventive, curative and primitive’s health care. The basic facilities which should be provided for primary health care are as follows:
(i) Adequate supply of safe drinking water.
(ii) Adequate supply of nutritious food.
(iii) Proper hygienic conditions and facilities for disposal of excreta and other wastes.
(iv) Maternal and Child Health (M.C.H.) care and family planning services.
(v) Preventive measures against diseases and immunisation against infectious diseases.
(vi) Educating the people regarding healthy ways of living.
(vii) Provision of essential drugs preferably at doorsteps in slum areas.
(viii) Provision for adequate medical facilities.