DETERMINANTS OF HEALTH
HEALTH CARE SERVICES
Health care services refer to the quality and quantity of medical services available to individuals and
families in the community. These include:
Health Care Services

Medical practitioners such as doctors,
nurses, chiropractors, dentists,
physiotherapists and so on…

Health promotion and aid
organisations and associations.

Hospitals and medical centres.

Health insurance companies.
Impact on Health Status
The availability of these services can help
people achieve a better quality of life and
assist them with aspects of their health,
growth and development.
Health promotion organisations such as
QUIT encourage mothers not to smoke
during pregnancy, therefore ensuring the
physical development of the foetus.
Aid agencies such as World Vision assist
communities to provide the requirements
for development and health.
Immunisation of children against measles
helps to prevent illness and possible death.
Maternal and childcare centres monitor a
child’s growth and development, whilst
providing the necessary advice to the
mother to ensure the health, growth and
development of the child.
Health insurance companies assist those
fortunate enough to achieve quality care,
whilst covering doctor’s liabilities, which
inturn, means doctors that can treat any
member of society regardless of their socioeconomic status.
Read pages 29-35 of text.
BIOMEDICAL FACTORS
Biomedical determinants relate to the way our bodies are working and whether they are in good repair. When we
have blood tests, X-rays or ultrasounds, genetic screening or measurements of height and weight, we are making
judgements on how sound our bodies are. High blood pressure, obesity and high cholesterol have been identified
as the most important biomedical determinants of Australia’s health status
Biomedical Factors

Overweight and obesity
Impact on Health Status
Possible decrease in life expectancy.
Increased chance of suffering a range of
serious health conditions including heart
disease, diabetes, stroke, arthritis, cancer
and high blood pressure.

High blood pressure
Can lead to death and disability from heart
disease, stroke and kidney failure.

High cholesterol
High levels of cholesterol can lead to
clogging of the arteries that bring on angina,
heart attacks or stroke.

Sex and gender
Males on average die younger than females.
Males on average see doctors less.
Males on average engage in more healthdamaging behaviours, suffer more violence
and injury and commit suicide in higher
numbers.
Females report higher levels of chronic and
minor illnesses, are less physically active and
have higher levels of depression.
Each gender are predisposed to certain
conditions.

Genetics
Read pages 32-36 of text
Predisposition to genetic diseases such as
cystic fibrosis.
GENETICS
Read page 36 of text.
Read pages 102-103 that relate to genetics
Read article ‘Living to an older age may all be in the genes’ by John Von Radowitz. Page 248 of text.
PHYSICAL / BIOLOGICAL ENVIRONMENT
The Commonwealth government defines the environmental determinants as “physical, chemical,
biological and social factors” affecting the health status of individuals positively or negatively.
Physical / Biological Environment
Impact on Health Status

An individual’s type of housing or
accommodation.
A homeless person lacks the physical, social,
emotional and mental support.

Geographical location eg, city,
metropolitan, rural or remote.
Access to better facilities and opportunities
can promote improved health, growth,
development and general wellbeing.

Community resources eg, medical
facilities, sanitation, schools, parks.

The amount and type of pollution
found in the air and water.

Impact of natural disasters.
Read page 47 of text.
The availability of recreational facilities can
assist physical development.
Unsafe drinking water can cause severe
diarrhoea which may limit a child’s growth
and physical development.
Environmental damage may result in loss of
farming land and lead to famine, poverty and
possible death.
SOCIAL ENVIRONMENT
The WHO commissioned a team of researchers that provided strong scientific evidence that social and
economic conditions impact directly on people’s health.
Social / Economic Environment
Impact on Health Status

Socio-economic status /
Social Gradient
Unemployment
The higher the socio-economic status of an
individual, the greater the opportunities and access
to resources, thus, better health. Job insecurity can
also lead to stress and illness.

Stress
If stress levels are frequent and too long, people can
experience depression, diabetes, high blood pressure
and links to heart disease. This can be caused by
people ‘struggling’ with life for a variety of reasons –
social isolation, lack self-esteem, struggling
financially or having a violent home life.

Early life.
Early years of life are the foundations of adult health.
Slow growth and lack of emotional support have a
significant impact on long-term development,
physical, emotional and social health.

Social Exclusion
Many groups and individuals in society are
marginalised and suffer social exclusion. This
includes people suffering disability, ethnic groups,
people with particular illnesses (HIV) or the elderly.

Work.
Work contributes to developing a sense of
achievement, identity and social interaction.
However, stress and the conditions of our work can
increase the risk of disease and death.

Social Support

Transport.
Families, friend’s, social supports and networks are
important for health. For example, married men
have better health status than single or divorced
men. Belonging to a social group, with aspects of
care and mutual support, have considerable heath
advantages.
Providing quality public transport and encouraging
its use also increases walking and cycling. Benefits
include more exercise, decreased road toll, greater
social contact between community members, access
to health care services and reduced air pollution.
Read pages 48-53 of text.
Read pages 296-301 of text for further understanding of the impact on early life, family, socio-economic
status and access to health care.
LIFESTYLE BEHAVIOUS
Lifestyle refers to the sum of people’s behaviours in everyday life, their patterns of living that can clearly
impact on their health status.
Lifestyle Behaviours
Impact on Health Status

Tobacco Smoking
Smoking is our number one cause of preventable death. Lung cancer,
pulmonary disease, heart disease arise from it. Yet lung cancer will soon
overtake breast cancer as the main cancer cause of death amongst females
because of increased smoking rates in young women.

Physical Inactivity.
Exercise Patterns.



Alcohol Misuse.
Illicit Drug Use.
Knowledge, Attitudes,
Beliefs
Clearly, physical activity can contribute to better health status, not just
physical health. Studies show improved quality of life, decreases in anxiety
and depression, higher self-esteem, development of social skills, stronger
family relationships and greater sense of belonging. However, one must not
forget the physical effects of inadequate exercise (e.g. heart disease)
Alcohol has both harms and benefits!
Excessive alcohol is responsible for increased cancers, liver disease, diabetes
and stroke. But the range of injuries such as road traffic accidents, falls,
drownings, burns, suicides and violence are the biggest burden associated
with alcohol. However, moderate use is linked to the reduction in heart
disease, stroke and gallstones.
Illicit drugs are a direct cause of death (overdosing), as well as, being risk
factors for conditions such as HIV/AIDS, hepatitis, low birth weight, heart
disease, poisoning, suicide and self-inflicted injuries. It refers to those drugs
that are illegal (heroin) and legal drugs (panadol) or legal products (petrol)
that are used inappropriately.
Increased knowledge hardly ever leads to change in attitudes or beliefs.
Strategists realise they must change people’s attitudes and beliefs before new
knowledge can be acted upon to improve the health status of an individual /
community. For example, think about smoking, sun smart and driving
behaviour. Why is changing their attitudes and beliefs more important than
giving them a bunch of statistics?
A diet high in fat and sugar can contribute to obesity and dental caries. ‘Diets’
themselves can cause problems due to the variety of essential nutrients
required by the body not being consumed.
Any form of sexual behaviour without taking the proper precautions can lead
to health related problems.

Nutritional Status.
Food Consumption.

Sexual Practises
Read pages 36-46 of text.