Determinants of Health
At every stage of life, health is determined by complex interactions between social and economic factors, the physical environment and individual behavior. These factors are referred to as "determinants of health". They do not exist in isolation from each other. It is the combined influence of the determinants of health that determines health status
Summation of health outcomes
Wider environmental influences + psycho-social influences + biological influences + time = health outcomes
Whether or not an animal is healthy, determined by:
- Where they live
- State of their environment
- Ability of owners to care for them (income, education level)
- Access to Vet care
- Physiological and anatomical functioning
The big 3 categories of determinants
- Physical environment: shelter, stable economy, security, sustainable and secure food and water
- Social environment: animal social factors, human socialfactors
- Biological and Behavioral determinants: genetic factors, physiological function, anatomic integrity
Difference between health promotion and protection from clinical medicine
Fundamentally concerned with action and advocacy to address full range of potentially modifibiable determinants of health.
Iceberg of health
Health is the visible part, values and beliefs are below the surface and large.
Animal health layers
- Determinants: Ecosystem change, animal health interaction, pathogene/parasties/contaminants, socio-economic conditions, information/knowledge
- Global drivers: Globalization, advances in science & technology, population change and climate change
3 main obstacles to current goal
- No definition of health
- No known acceptable level of hazards in the population
- No data on how these hazards affect fish outside of a lab
- An approach to health that aims to improve the health of the entire population and to reduce health inequities among population groups
- Unifying force for the entire spectrum of health interventions - from prevention and promotion to health protection, diagnosis, treatment and care - and integrates and balances action between them.
Healthy population factors
- Population characteristics
- Population numbers (or density)
- Age (or stage) distribution
- Sex ratio
- Spatial distribution
- Population processes
- Population growth (changes in numbers or density)
- Changes in age distribution
Population health focuses on
- the interrelated conditions and factors that influence the health of populations over the life course
- identifies systematic variations in their patterns of occurance
- applies the resulting knowledge to develop and implement policies and actions to improve the health and well-being of those populations.
Pop health happens
- Action is directed at the health of an entire population, or sub-population, rather than individuals
- It focuses on things at that start of casual chains (the determinants of health; root causes)
- The outcomes extend beyond improve population health outcomes to include a sustainable and integrated systems
Population health 1-8
- 1. Focus on the health of populations
- 2. Address the determinants of health and their interactions
- 3. Base decisions on evidence
- 4. Increase upstream investments
- 5. Apply multiple interventions and strategies
- 6. Collaborate across sectors and levels
- 7. Employ mechanisms for public involvement
- 8. Demonstrate accountability for health outcomes
Population health in general
- No single measure
- Needs to reflect the distribution of health: condition specific outcomes, not just a single average
- Captures outcomes and determinants
- Captures perceptions and expectations
- Allows trends to be monitored
Who is the client with pop. health?
- The public!
- Population health often doesn't involve a single owner.
4 features of health indicators
- Precise: defined the same way by all people
- Sensitive: changes proportionately in response to actual changes in the condition being measured
- Consistent: not changing over time so that it always measures the same thing
- Measurable: able to be recorded and analyzed in quantitative and qualitative terms
Checkpoints for applying the population health approach
- What's the issue?
- If the issue were effectively addressed in society, what would be the result?
- Is it possible to make a meaningful difference?
- Who can help?
- What could we do together?
- What are we going to do and how?
- What impact are we having?