Factors Related to Human Health

Social, Political and Economic

There is growing recognition that there are many social determinants of health. To fully understand the impact on health we must recognize a persons character and environment. The WHO categorizes these determinates as Structural and  Intermediary. Structural determinants refers to socioeconomic and political context such as governance, polices and values which lead to an unequal distribution of material and monetary resources, changing their socioeconomic position. Intermediary determinants are material circumstances such as work and home environment, as well as psychological and behavioral factors. Social cohesion and social capital bridge the gap between structural and intermediary determinants. They describe the willingness of people in a community to cooperate for the greater good.

Around 1830, a french physician named Louis Villerme correlated morality by the district in Paris. The result showed a correlation between death and the rate of poverty in the district. The Whitehall study was a prospective cohort study which studied mortality in British civil servants in 1967. The result showed at each occupational grade, health status was higher and mortality was lower. This is apparent in most industrialized countries, but the inverse was true in developing countries. In Nigeria, for example, obesity is found more commonly in the upper classes.

Ultimately, it is only through collective action we can bring problems to light and determine a solution through social policy. In 1842 Sir Edwin Chadwick published a paper called "Report into Sanitary Conditions of the Labouring Population of Great Britain" which concluded life expectancy was higher in the countryside than in towns. He argued the solution was not more doctors, but civil engineers to improve sanitary conditions in the city. These were eventually brought to parliament and legislation was passed to reform public health in the UK.

• Nuisances Removal Act (1846) - Gave local justices the power to prosecute landlords for infractions having to do with sanitation.
• Public Health Act (1848) - Created a general board of health that could create local boards and deal with environmental filth.
• The Epidemiological society of London was formed in 1850 to present papers related to public health
• John Snow wrote a paper in 1853 that sparked further reform.

Politics dictate who are provided with services and how the budget is spent. The Organization for Economic Cooperation and Development (OECD) which categorized governments; Social democratic, christian democratic, liberal, and authoritarian conservative/dictatorship. The authors concluded that redistribute polices are positive associated with health outcomes.

Mental Health

In 2015, an estimated 43.4 adults reported having a mental illness. About 25% of US adults have mental illness and nearly 50% will develop one during their lifetime. Mental health is associated with chronic medical diseases such as heart disease, diabetes and obesity. Both intentional (suicide) and unintentional death (car crashes) are 2-6x higher in people with mental illness. Mental health is also greatly influenced by our environment and socioeconomic standing.

Critical periods are windows in which the impact of exposure to stressors and protective factors are heightening and can have long-term effects. These periods include:

• Prenatal/pregnancy
• Early childhood
• Adolescence
• Working and family building years
• Older ages

There are several terms used to determine a person's mental well-being. Well-being is associated with numerous health, job, family, and economic benefits such as self-perceived health, longevity, healthy behaviors, and social connectedness and productivity.

Hardiness is an individual's sense of control, involvement and willingness to change and grow

Acculturation is the psycho-social adjustment and adaptation to a new culture of a person from another culture

Resilience is the process of successful adaptation after trauma

Social support alleviates the negative impact of stressors

Factors influencing mental health include income, crime, family, and so much more.

Strategies for improving mental health include:

1. Surveillance - providing estimates on existing mental illness in a society
2. Screening and early identification - about 50% of mental health conditions begin by age 14 and 75% by age 24.
   
3. Preventive intervention - prevention practices for selected at risk youth reduces the biological and psychological risk. Some individuals have genetic predispositions for certain mental illnesses, but environmental factors can contribute (exposure to drugs, poor nutrition or toxins)
4. Health promotion - efforts to enhance an individual's ability to achieve developmentally appropriate tasks and a positive sense of self-esteem, well-being, and inclusion
   
   1. Building healthy public policy
   2. Creating physical and social environments supportive of individual change
   3. Strengthening community action
   4. Developing personal skills - such as increased self-efficacy and feelings of empowerment
   5. Reorienting health services to the population and partnership with patients
5. Community action - Reduce barriers to accessing qaulity education, adequate mental health care, and improve health outcomes among community members by providing resources and skills, as well as screening and early treatment for mental health and substance abuse.
6. Policy interventions - policies and laws that increase access to and quality of education, access to employment opportunities and healthy food, and improve housing standards.
   

Globalization

The global transportation networks has fostered trade, economic development, and the spread of pathogens to distant locations. Imported foods may lack sanitary safeguards. In many countries globalization lead to an increase in life expectancy starting in the 1950s, however this is accompanied by a increased risk of chronic disease. For example, in the 90's Mexico had an obesity rate of 7%, in 2010 it was 20% this is attributed to the NAFTA. Globalization is also invariably associated with increased energy consumption.

Environmental Health

The environment includes air, water food, products we use, and social, political and economic factors. A framework that connects hazards and adverse outcomes is called the source-exposure-disease conceptual model.