What are the Determinants of Health?
- Shabin Mere
- Oct 14, 2023
- 3 min read
Updated: Dec 1, 2023
According to the World Health Organization (2023) “[t]he context of people’s lives determine their health, and so blaming individuals for having poor health or crediting them for good health is inappropriate.” The common theme between Canada Health, the Government of B.C., and the WHO is that the determinants of health comprise personal, social, economic, environmental, and behavioral factors (2023). Social determinants of health are the “non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life” (WHO, 2023). Both medical and non-medical factors are interconnected in the way that they both influence health and are interchangeable in determining health outcomes.
As a manager at my Home Health office, I recently became involved in a case of one of our clients who is an 85-year-old frail elderly living with a 48-year-old daughter and 10-year-old grandson. The client has multiple co-morbidities from a chronic condition of heart disease and Type 2 diabetes. The client’s daughter is a single mother with a mental health condition preventing her from being able to work. The grandson is an only child and attends elementary school but is socially isolated. The family lives in a rented basement suite which is very poorly built, has mold in her home, and only one bedroom which the client and her grandson have to share, and with their extremely limited income, they cannot afford good clothes for the boy, or nutritious groceries and snacks for the son to have at school. The client’s daughter has only a high school education and does not know how to navigate the social or healthcare system to help her child or mother.
While the son is in elementary school, there are no other social connections aside from the temple the family attends, where they also encounter isolation due to the daughter’s ex-husband being from the same congregation and of a higher social status. This makes it awkward for other members to try and build friendships with her. Additionally, this ex-husband who is the boy’s father, has also become estranged from his son. Furthermore, the family physician happened to be a personal friend of the ex-husband, which negatively impacted her ability to seek appropriate medical attention for her mental health, social services, or resources. The effects this situation has had on the family are a clear example of the poor determinants of health demonstrating the impact on their personal, social, economic, environmental, and behavioral factors.
Seeing the situation from a Nursing lens helps to work on the factors that influence each member of that family separately and collectively. From a nursing standpoint, it is important to be able to assess not only the client being referred, but also the surroundings that may be impacting that person’s well-being or ability to self-manage, or simply survive. Having this critical information and understanding would assist the nurse in her/his care management of the client. “At a broader level, nurses need to know how the health of their patients can be improved by advancing progressive policies that address the social determinants of health” (Canadian Nurses Association, 2023).
To support this family, the CHN created a care plan to not only support the physical health of the client, but also the financial, environmental, and social factors impacting the whole family’s well-being. Their overall health has slowly started to change to a more positive outcome due to the CHN's interventions based on his assessment. This included the involvement of a multi-disciplinary team who each have the expertise to address the various aspects affecting this family's physical, social, environmental, economic, and behavioral factors. Thereby supporting the entire family's determinants of health.
References
Canadian Nurses Association. (2023). Social determinants of health. Accueil - CNA | AIIC.
Determinants of good health [Figure]. (2023). Mind Help.
Determinants of health. (2023). World Health Organization (WHO). https://www.who.int/news-
Government of Canada. (2023). Determinants of Health.
Let's Learn Public Health. (2017). What makes us healthy? Understanding the social determinants of
health [Video]. YouTube.
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