Determinant of Health and Health Promotion

Determinant of Health and Health Promotion

World Health Authority 1949, described health as a complete state of being physically psychologically and socially wellbeing, ruling out the mere inexistence of disease and infirmity. This definition identifies a complete state of mind as having a positive balance in all factors that affects health at all time (Naidoo & Willis, 1994). The writer believes this is impracticable. However, the definition was modified by World Health Authority 1986 to include community concepts, defining health as an individual or a group extent of ability to recognise needs and or be able to cope with environment. Arriving at concluding health as resources for everyday life (Naidoo & Willis, (1994), putting health responsibility on individual or community for resources maximisation and effectiveness. This sees by the writer as an improved and a weighted definition.

A major western world concerns is a chronic disease, a long-term disease such as obesity and cancers. To certain extent, many of these diseases are as a result of our behaviour and lifestyle choice. Risk factor for lung cancer is smoking while poor diet (Obesity) could be the risk factor for Type II diabetes.  This is an example of shifts to chronic disease and modern life moving away from infectious acute disease. For people to stay healthy and to improve health is through promotion of health which was in Ottawa Charter for health promotion as a process, step by step stages, allowing the enabling of people to take control over and the improvement of their health (World Health Organisation WHO, 1886).

The concern of the health promoter is to enhance health and prevent disease. Individual behaviour, aspect of attitudes and beliefs has to be taken into a consideration in order for a better health promotion to take place (Barnett & Murphy 1988). Health promotion, is the act of being able to support and encourage to take better approach to life. It is an act of empowerment, influencing people (powerless)take control over their health (Bersma, 2004).

 The determinants of health


Many factors combine together to affect the health of individuals and communities. Whether people are healthy or not, is determined by their circumstances and environment. To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health, whereas the more commonly considered factors such as access and use of health care services often have less of an impact.

The determinants of health include:

  • the social and economic environment,
  • the physical environment, and
  • the person’s individual characteristics and behaviours.

The context of people’s lives determines their health, and so blaming individuals for having poor health or crediting them for good health is inappropriate. Individuals are unlikely to be able to directly control many of the determinants of health. These determinants—or things that make people healthy or not—include the above factors, and many others:

  • Income and social status – higher income and social status are linked to better health. The greater the gap between the richest and poorest people, the greater the differences in health.
  • Education – low education levels are linked with poor health, more stress and lower self-confidence.
  • Physical environment – safe water and clean air, healthy workplaces, safe houses, communities and roads all contribute to good health. Employment and working conditions – people in employment are healthier, particularly those who have more control over their working conditions
  • Social support networks – greater support from families, friends and communities is linked to better health. Culture – customs and traditions, and the beliefs of the family and community all affect health.
  • Genetics – inheritance plays a part in determining lifespan, healthiness and the likelihood of developing certain illnesses. Personal behaviour and coping skills – balanced eating, keeping active, smoking, drinking, and how we deal with life’s stresses and challenges all affect health.
  • Health services – access and use of services that prevent and treat disease influences health
  • Gender – Men and women suffer from different types of diseases at different ages.

Two views on aim of health promotion


Lifestyle change  

Getting people to change their behaviour or improve their lifestyle


Environmental change

Redress inequalities in health / address wider concerns

Channel of Communication

  • Interpersonal – individual ‘one to one’
  • Organisations – locations where people live, work and play
  • Community – mass media channels, political and structural

There may be overlap between methods

More than one method is the most effective

Interpersonal Communication

  • One to one, small groups – families, friends, peers, medical / health professionals
  • Use of narratives/ stories
  • Dialogue and discussion in health campaigns

(Jamie Oliver, Jade Goody,

Organisation Communication

  • Schools
  • Workplaces
  • Youth groups
  • Places of worship
  • Sporting organisations

Traditional / non-traditional

Mass Media

  • Any type of broadcast, printed or electronic communication media that is sent to the population at large’ (Corcoran 2007)
  • Any communication with the public that does not depend on person to person contact (Naidoo & Wills 2007)
  • Sending and creating of a message to a large audience

Community Communication

Mass Media

  • Print media – newspapers, magazines, leaflets
  • Electronic media – ‘new media’ – internet, mobile phones, computer packages
  • AV media – TV/ radio, video’s, CD’s, tapes

Use of Mass Media

  • Raise public awareness
    • Providing information
    • Reminding population of effects of behaviour and benefits of healthy life style
  • Create climate of opinion conducive to policy change
  • Shift attitudes and prompt behaviour change

Use of Mass Media in Health Promotion

  • Media advocacy

Effecting societal change, promoting health public policy

  • Unpaid coverage
  • Planned campaigns and advertising

Raising health awareness, increasing knowledge, self-empowering, influencing behaviour change and decision making