Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Health determinants”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Understanding the determinants of health: key decision makers in Saskatchewan Health districts and Saskatchewan Health, 1998.

This research inquiry used qualitative and quantitative methods to examine how key decision makers from Saskatchewan health districts and Saskatchewan Health understand the determinants of health. The inquiry was based on the premise that key decision makers' understanding of the determinants of health, and the consensus regarding these understandings, hinder or facilitate dialogue, choice of effective strategies, and achievement of health promotion goals. Interviews indicated variation in perspective and emphasis regarding how key decision makers understand the determinants of health. A survey of key decision makers found: 1) inconsistencies in respondents' understanding of the determinants of health, particularly between stated beliefs and priorities for actions; and 2) that the degree of consensus among decision makers was higher for stated beliefs and lower for choices of action. Results indicate a need for clarification and consensus-building processes concerning the determinants of health, as well as for clear policies that foster consistency between beliefs and actions and minimize inappropriate or undesirable differences in interpretations.

Health Status Indicators↗
PubMedDate not supplied

Social determinants of health inequalities.

The gross inequalities in health that we see within and between countries present a challenge to the world. That there should be a spread of life expectancy of 48 years among countries and 20 years or more within countries is not inevitable. A burgeoning volume of research identifies social factors at the root of much of these inequalities in health. Social determinants are relevant to communicable and non-communicable disease alike. Health status, therefore, should be of concern to policy makers in every sector, not solely those involved in health policy. As a response to this global challenge, WHO is launching a Commission on Social Determinants of Health, which will review the evidence, raise societal debate, and recommend policies with the goal of improving health of the world's most vulnerable people. A major thrust of the Commission is turning public-health knowledge into political action.

Adult↗
PubMed1990

Determinants of health care satisfaction: a national study of HMO and fee-for-service consumers.

This study examines the extent to which different health care attributes determine health care satisfaction. It employed two national cross-sectional samples, one of HMO members and the other of NON-HMO health care users. The comparative analysis revealed that the pattern of results for both samples were similar. The two most important attributes for both samples were health care costs and availability of specialists. Results suggest different marketing and related management strategies.

Consumer Behavior↗
PubMed2006

Building healthy and equitable societies: what Australia can contribute to and learn from the Commission on Social Determinants of Health.

The Commission on Social Determinants of Health (the Commission) was launched by the World Health Organization in 2005. It aims to support countries and global health partners to act on social factors leading to ill-health and health inequalities. Taking action on the social determinants of health is not new for Australia. This paper provides a description of the work of the first 18 months of the Commission and relevant Australian examples. Taking action on the social determinants of health is never simple or easy even in the most supportive of policy environments. The global focus of the Commission should ensure that knowledge and examples of successful action will be collected from a diverse range of country and policy environments, particularly low to middle-income countries. Given Australia's experience, we encourage practitioners to contribute to the deliberations of the Commission. It is also critical that Australian practitioners engage with the Commission's different actors and stakeholders, particularly knowledge networks, to derive important policy lessons from the knowledge generated by the Commission.

Adult↗
PubMed2004

Gender differences in health: a Canadian study of the psychosocial, structural and behavioural determinants of health.

Gender-based inequalities in health have been frequently documented. This paper examines the extent to which these inequalities reflect the different social experiences and conditions of men's and women's lives. We address four specific questions. Are there gender differences in mental and physical health? What is the relative importance of the structural, behavioural and psychosocial determinants of health? Are the gender differences in health attributable to the differing structural (socio-economic, age, social support, family arrangement) context in which women and men live, and to their differential exposure to lifestyle (smoking, drinking, exercise, diet) and psychosocial (critical life events, stress, psychological resources) factors? Are gender differences in health also attributable to gender differences in vulnerability to these structural, behavioural and psychosocial determinants of health? Multivariate analyses of Canadian National Population Health Survey data show gender differences in health (measured by self-rated health, functional health, chronic illness and distress). Social structural and psychosocial determinants of health are generally more important for women and behavioural determinants are generally more important for men. Gender differences in exposure to these forces contribute to inequalities in health between men and women, however, statistically significant inequalities remain after controlling for exposure. Gender-based health inequalities are further explained by differential vulnerabilities to social forces between men and women. Our findings suggest the value of models that include a wide range of health and health-determinant variables, and affirm the importance of looking more closely at gender differences in health.

Adult↗
PubMed2005

Can education policy be health policy? Implications of research on the social determinants of health.

Research on the social determinants of health has demonstrated robust correlations between several social factors, health status, and life expectancy. Some of these factors could be modified through policy intervention. National-level public policies explicitly based on population health research are in various stages of development in many Western countries, but in spite of evident need, seemingly not at all in the United States. Because research shows such a strong association between education and good health, we offer evidence to show that at least two pressing problems in American society, namely the uneven distribution of educational attainment and health disparities linked to socioeconomic position, may be ameliorated through policy initiatives that link quality early childhood care, child development programs, and parental training in a seamless continuum with strengthened K-12 education.

Educational Status↗
PubMedDate not supplied

Individual and neighbourhood determinants of health care utilization. Implications for health policy and resource allocation.

OBJECTIVES: To investigate the importance of both individual and neighbourhood socioeconomic characteristics for health care utilization. METHODS: Various linkage procedures generated a longitudinal dataset with information on 2,116 Nova Scotians, their residential neighbourhoods, 8 years of health care utilization and vital status. Unilevel and multilevel regression analyses were employed to examine the effects of both individual and neighbourhood characteristics on health care use. RESULTS: Individual income and education determined physician and hospital use. Also, neighbourhood characteristics, specifically average income and percentage of single mother families, were found to determine health care use. When considering individual and neighbourhood characteristics simultaneously, individual income and education determined physician and hospital use independently, while neighbourhood income determined physician use independently. CONCLUSIONS: Both individual and neighbourhood socioeconomic characteristics determine health care use. Acknowledging this allows better targeting of health policy and planning, and enables more accurate needs-based resource allocation.

Adolescent↗
PubMed2001

An analysis of health levels and various indicators of urban environments for Healthy Cities projects.

STUDY OBJECTIVES: (1) To identify and to categorise the various city indicators that are related to health levels; (2) to demonstrate the extent of the influence on health of these categorised health determinants; and (3) to demonstrate both the interactive associations among the health determinants and the magnitude of influence of each health determinant on the people's health. DESIGN: By using city statistics of study areas, the health index and health determinant indices were formulated. The extent of influence of health determinants on the health index was examined by regression analysis; the interrelations between the health determinants and the health index were examined by correlation analysis. SETTING: All the administrative units in Japan with populations more than 100 000 were selected as study areas to analyse the relation of health and health determinants. MAIN RESULTS: The nine health determinant indices used-healthcare resources, preventive health activities, environmental quality, housing, urban clutter, local economy, employment, income, and education-explained 51.6% of the variances of the health index as a whole in the cities studies. The health determinant indices showed interrelations with each other, in addition to individual health determinant indices having a high correlation with the health level index of the population. CONCLUSIONS: Both individually and collectively the health determinants are closely related to the health status of a population and individual determinants interact with each other. Simultaneous analysis of the interrelations among health determinants and health status would contribute to widen integration oriented perspective in policy interventions based on collaboration between different sectors of society.

Environmental Health↗
PubMed1993

Health transition: the cultural, social and behavioural determinants of health in the Third World.

The paper defines 'health transition' and outlines the development of recent research programmes. Evidence is reviewed as to the cultural, social and behavioural determinants of health in the Third World, and the extent to which they interact with the provision of health services in reducing mortality. Specific attention is given to the impact on mortality of education, and the historic experience of the now developed countries is compared with contemporary developing countries. Consideration is also given to the role of cultural factors and to radicalism, egalitarianism and the role of women in traditional society as well as fertility control and various forms of deleterious behaviour in contemporary society. The extent to which all these changes are facets of a single social transformation is discussed. Finally, the future of health transition research and its value for planned health interventions are summarized.

Cross-Cultural Comparison↗
PubMed1990

Levels of health development: a new tool for comparative research and policy formulation.

Levels of health development are formed by mathematically clustering countries using six health status indicators: crude birth, crude death, infant mortality and child death rates, and male and female life expectancy. Stratifying two international samples of 128 and 163 countries into levels of health development--groups with similar health status profiles--improves the results of regression analyses used to identify economic, political, social, educational, health and other health determinants. For this reason, health development levels are a systematic framework for delineation of health determinants. Earlier large scale statistical studies have been limited in their success in part because they did not partition their data sets prior to analysis, or used inappropriate criteria that blurred rather than heightened developmental differences in underlying social systems. These developmental differences regulate the way in which health status inputs are converted into health status outputs, defining the relative importance of health determinants at various developmental levels. At lowest health development levels (countries with poorer health status), the under-development of economic, health and educational infrastructures creates a vacuum which allows international intervention (aid, investment, export/import activities) to play a dominant role in health status determination. At middle health development levels, health and educational infrastructures are better developed, but still secondary in importance as health status determinants to basic economic infrastructure. Demographic problems are particularly apparent at these levels. At higher health development levels, education, women's status, and political structure are especially important health status determinants. This research has facilitated the identification of health status determinants for use in health policy analysis. Recommendations for future research include use of findings in health policymaking by individual countries and by comparative researchers, and development of appropriate health systems models for each level of health development.

Cross-Cultural Comparison↗
PubMed1998

The interplay of drinking patterns and other determinants of health.

The health effects of alcohol are determined not only by level of intake but also by patterns of alcohol use and many other health determinants. This study seeks to identify groups of individuals who share various features in terms of drinking styles and other health indicators. Data used are a subset of the 1990 Ontario Health Survey, corresponding to men and women aged 20-64 with complete data in four substantive areas: alcohol use; demographic characteristics; current health status; and various behavioural risk factors for chronic disease. Cluster analysis was used to groups of male and female respondents who were similar in terms of their style of alcohol use, along with other constructs relevant to health risk and health status. For both sexes, clusters were identified which matched expectation in terms of drinking patterns and other relevant variables. For both sexes, clusters were found with generally higher social class indicators, generally positive health behaviours and health status and drinking patterns which did not include drinking to excess. Clusters were also found for which high-volume drinking occasions corresponded with poor health status and high levels of risk factors for chronic disease. Other unanticipated patterns were also identified. This information may assist in identifying confounding effects in epidemiological studies as well as identifying the characteristics of unique sub-populations which are likely to be the focus of primary prevention efforts.

Journal Article↗
PubMed1994

The determinants of excellent health: different from the determinants of ill-health?

BACKGROUND: In the famous definition of the World Health Organization, health is 'a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity'. Until now, the distribution and determinants of the positive end of the health spectrum have not been studied extensively. In an exploratory analysis, we have compared the determinants of excellent health and of ill-health using data from a postal survey among 18,973 people in a region in the southeastern Netherlands. METHODS: Excellent health was defined as the presence of a very good self-assessment of health in the absence of any self-reported chronic condition or health complaint, and was present in 8.2% of the survey population. Ill-health was defined as the presence of two or more self-reported chronic conditions, four or more health complaints and a less-than-good self-assessment of health, and was present in 10.5% of the survey population. The remainder of the survey population was used as a reference group. Two sets of explanatory variables were available: a set of seven socio-demographic variables and a set of nine specific risk factors. Logistic regression analysis was used to assess the strengths and patterns of the associations between the determinants and the two outcome variables, excellent health and ill-health, controlling for age and gender. RESULTS: Both the socio-demographic variables and the specific risk factors had largely similar (but mirrored) patterns of association with excellent health and with ill-health. Important socio-demographic determinants of excellent health (and of ill-health) were education, employment status and urbanization (as well as age and gender). Important specific risk factors were leisure exercise, housing problems, smoking, negative life events, obesity and alcohol intake. The percentage of deviance accounted for by each of these sets of determinants was two to three times as large in the case of ill-health as in the case of excellent health. CONCLUSION: The processes by which excellent health is generated probably have much in common with those which generate ill-health. At the same time it is obvious that our understanding of the determinants of ill-health is better than that of the determinants of excellent health, and further study of the latter is recommended.

Adolescent↗