When thinking about the factors that determine our health, what comes to your mind? Genetics? Lifestyle? What if I told you that much of our health is also determined by an array of physical, social, and environmental factors?
While our genetics predispose us to a range of health conditions, our lifestyle can often modify this predisposition. However, individual behaviour alone due to personal lifestyle choices (e.g. diet, exercise, and smoking) often cannot completely modify our health outcomes. Rather, a complex interplay between physical, social, and environmental factors also shape our health.
In Canada, the government has identified 12 key determinants of health:
- Income and Social Status
- Social Support Networks
- Education and Literacy
- Employment/Working Conditions
- Social Environments
- Physical Environments
- Personal Health Practices & Coping Skills
- Healthy Child Development
- Biology and Genetic Endowment
- Health Services
You may now be wondering what many of these determinants have to do with our health. First it is important to understand that health is much more than the absence of illness or disease. According to the World Health Organization (WHO), “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.
Based on this definition, if we examine income and social status as a determinant of health, the research evidence reveals that individuals with a higher income and social status often have a better health status. This is also true in Canada, a country where there is universal health care. For instance, compared to 73% of Canadians in the highest income group, only 47% of Canadians in the lowest income group rate their health as very good or excellent. Importantly, individuals with lower incomes are also more likely to die earlier than those with higher incomes.
So why is this the case?
A high income and social status affords good living conditions in safe neighbourhoods, along with food and family security. Compared to individuals with low income and social status, they do not stress as much about where their next meal will come from and if they will be able to pay rent, childcare, or for extended healthcare.
Similarly, individuals with greater social support, a higher education, stable employment, etc. are better able to provide themselves with higher living standards because they have greater access to material goods and services. Unfortunately, individuals who are discriminated against (women and minorities), do not have access to healthcare, or reside in neighbourhoods with poor water quality and infrastructure often suffer greater health adversities. Consequently, it is important to stress that communities need to invest in policies and programs that work to create a fairer society to create a healthier society.