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What determines the health of a population?

The largest role to play in determining our health is our social context. Find out more by watching this video.
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According to the US Centers for Disease Control and Prevention, there are 4 determinants of health. Of course, our genes and our biological make-up is part of what determines our health. But as you can see here, it’s only a small part. Medical care, having access to good medical care is an important determinant of our health. Governments and populations spend so much money on health care, and again you can see it plays a relatively small part in determining our health. As we’ve seen so far, our health behaviours have a significant role to play in our health outcomes, but according to CDC less than 25%.
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But by far the largest role to play in determining our health is our social context, the characteristics of the societies we live in, and the position that we have in these, which can determine the opportunities and “choices” available to us. The Health Foundation (2018), which is a wonderful organisation for you to review, poses the
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following question: what causes coronary heart disease? To some people the clear answer would be blocked arteries. But what causes those arteries to become blocked? Perhaps it’s the unhealthy foods and beverages people eat and drink, or their lack of physical activity, or their stress levels. Let’s then think about what makes these people feel stressed and shapes their opportunities and chances to be active and determines the choices about what they eat and drink? The answers lie in the circumstances in which people are born, grow, live, work, and age in, these are called the social determinants of health. Social determinants of health can enable individuals and societies to flourish, or not. The social determinants of health are ‘the causes of the causes’.
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A person’s opportunity for health is influenced by factors outside the health system. The social determinants of health demonstrate that many people don’t have the same opportunities to be as healthy as others (Marmot, 2010). Here we use the term social determinants of health, sometimes these are called the wider determinants of health or the main determinants of health. The social determinants of health, or these ‘causes of the causes’ can influence our health and well-being in many ways, including through people’s individual health behaviours and their lifestyles choices. Yet the individual control over such behaviours is actually much more limited than you may think.
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Unhealthy behaviours and unhealthy lifestyles are usually not the origin of poor health but the end point of a long chain of causes and consequences in people’s lives. So let’s dive into the social context a bit more. We can’t consider the social determinants of health without considering social inequalities. Social inequality is really more than just about money. Economic inequalities are really important and often very shocking but social inequality as a concept is about more than just that. Social inequalities can also be about access to services, opportunities for education, and jobs, the quality of the place where you live, or your level of happiness.
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Social inequalities have always existed historically, and they’re not new but economies are growing overall and some poor countries are developing really well. However evidence shows that the poorest people all over the world are not keeping up and so extreme poverty remains a really significant issue (Warwick-Booth, 2019).

It was very interesting to read your examples and understanding of the determinants of health in the previous step. According to the US Centers for Disease Control and Prevention (CDC), there are four determinants of health.

Of course, our genes and biological make-up is part of what determines our health. Medical care and having access to good medical care is also an important determinant of our health. And as we’ve seen, health behaviours have a significant role to play in our health outcomes.

But by far the largest role to play in determining our health is our social context, the characteristics of the societies we live in, and the position that we have in these, which can determine the opportunities and “choices” available to us.

Watch the video on this step to find out more. You can also read more on the social determinants of health on the CDC website in the ‘See also’ section below

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Tackling Public Health Issues: Concepts and Evidence

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