What, in reality, Affects your Health ...
- Dr Anup Shah
- Nov 16, 2023
- 5 min read
Updated: Nov 18, 2023
“Health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” - World Health Organization
The Threads of Health: Social Determinants, Personal Choices, and Clinical Care
This quote from the World Health Organization helps to guide exploration into the complex area of what actually affects your health. Beyond personal choices and speed and type of clinical care you receive, the influence of social determinants, as illuminated by Michael Marmot's Whitehall studies, plays an outsized role.
In this post, we consider the causes of health outcomes, acknowledge the impact of social determinants, and discuss what is attributed to personal health behaviours and clinical care. Also, we discuss actionable steps individuals can take to shape their well-being.
* It should be noted, that this data is reflective of populations (large numbers), and when reduced down to an individual level, it cannot (and should not) be directly extrapolated to a single person's experience or predicted outcome, however it does serve to provide some level of understanding to factors involved.
County Health Rankings & Roadmaps | Source: Reprinted County Health Rankings & Roadmaps, http://www.countyhealthrankings.org/our-approach (accessed July 18, 2017).
I. Social Determinants of Health:
Income and Social Status: Socioeconomics heavily influence health disparities. Marmot's Whitehall studies underscored that those with lower socioeconomic status experienced poorer health outcomes. Alongside many other factors, limited access to resources, education, and employment opportunities creates breeding ground for health inequalities, emphasizing the ever-present link between economic standing and health.
Education: Education is key to empowerment. Higher education correlates with better health outcomes, partly, as it equips individuals to make informed choices. Marmot's research emphasizes the need to break down barriers to education, recognizing it as a potent force in dismantling the walls of health inequality.
Employment Conditions: The workplace isn't just where we earn a living; it's where health narratives affect your body and mind. Stressful work conditions, lack of control, and job insecurity can impact health significantly. Marmot's studies highlighted the importance of autonomy at work, revealing that the nature of employment is a critical determinant of overall well-being.
Social Support and Networks: The strength of social bonds is a protective shield for health. Marmot's research indicated that robust social networks correlate with improved mental and physical health. In contrast, social isolation can cast a long shadow over well-being. Building and nurturing social connections emerge as crucial aspects of a holistic approach to health.
II. Michael Marmot's Whitehall Studies:
Marmot's Whitehall studies, a cornerstone of public health research, delved into the lives of British civil servants. These studies uncovered a social gradient, revealing that even within a homogenous group, those with lower employment grades experienced poorer health. Marmot's work highlighted that beyond economic factors, the psychosocial effects of hierarchy play a profound role in shaping health outcomes.
III. Personal Health Behaviors and Clinical Care:
Personal Health Behaviors: Roughly 30% of health outcomes are attributed to personal health behaviors. Choices related to diet, exercise, and substance use cause a significant influence. Empowering individuals with knowledge to make healthier choices is key to improve well-being.
Clinical Care: Clinical care accounts for approximately 20% of health outcomes. Access to timely and effective healthcare services is undeniably crucial, but it's not the sole determinant. The quality of clinical care intersects with broader systemic factors, emphasizing the need for a holistic perspective on health.
IV. Empowering Individuals: What Can Be Done:
Health Literacy: Knowledge is a powerful tool. Improving health literacy empowers individuals to make informed decisions about their health. Understanding the impact of social determinants allows individuals to navigate a complex landscape and advocate for their well-being.
Community Engagement: Communities are the bedrock of support. Engaging with and contributing to community initiatives can foster a sense of belonging and shared responsibility. Collective efforts can address local health disparities, creating a ripple effect of positive change.
Advocacy for Change: Personal empowerment extends beyond individual actions. Advocacy for policies that address social determinants at a systemic level is paramount. Individuals can engage in advocacy to support initiatives promoting income equality, affordable housing, and improved healthcare access.
Holistic Well-being Practices: Embracing holistic well-being practices, including regular exercise, a balanced diet, and stress management, forms a foundation for personal health. These practices, complemented by societal changes, contribute to a healthier, more resilient individual.
How Social Determinants Affect the centenarians in the Blue Zones
Blue zones are areas around the world where people are reported to live longer and healthier lives compared to the global average. These regions have been studied to understand the factors that contribute to the well-being and longevity of their populations. While genetics can play a role, lifestyle and environmental factors, including social determinants of health, are crucial in shaping the health outcomes in these regions. Here's how social determinants of health are affected in the blue zones:
Community and Social Connections:
Strong Social Networks: Blue zones often have tight-knit communities where social connections and relationships are emphasized. Social support is linked to better mental and physical health outcomes.
Sense of Belonging: Residents in blue zones often report a strong sense of community and belonging. Social cohesion contributes to reduced stress and improved overall well-being.
Diet and Nutrition:
Plant-Focused Diets: Blue zones typically follow plant-focused diets rich in fruits, vegetables, and whole grains, which tend to be the mainstay of their calorie intake. Dietary habits influence health outcomes and can contribute to lower rates of chronic diseases.
Physical Activity:
Active Lifestyles: Residents in blue zones tend to have active lifestyles. Whether it's through walking, gardening, or other forms of moderate physical activity, regular movement contributes to better health outcomes.
Purpose and Meaning:
Sense of Purpose: Many blue zone inhabitants report a strong sense of purpose and meaning in their lives. Having a reason to get up in the morning is associated with better mental health and longevity.
Cultural Practices:
Cultural Rituals and Traditions: Blue zones often have cultural practices that promote well-being, such as daily rituals, community celebrations, and other traditions that contribute to a sense of identity and purpose.
Access to Healthcare:
Healthcare Systems: While blue zones may not always have advanced healthcare facilities, there is often an emphasis on preventive healthcare and lifestyle choices that contribute to overall well-being.
Environmental Factors:
Natural Environment: Blue zones are often located in environments with clean air, access to nature, and a generally healthy living environment. Environmental factors can impact health outcomes.
It's important to note that the concept of blue zones is a broad generalization, and individual experiences within these areas can vary. Additionally, these observations provide insights into lifestyle and social determinants associated with longevity, but they do not guarantee that everyone in these regions will experience exceptional health. Nonetheless, studying blue zones can offer valuable lessons for promoting health and well-being in other communities.
Conclusion:
The factors that affect health outcomes in populations are woven from threads of social determinants, personal choices, and clinical care. Michael Marmot's Whitehall studies serve as a valuable guide, highlighting the influence of social factors on health disparities, and informing there is often more to all of this than we can control. As we navigate this complex landscape, it's crucial to know the interconnectedness of these elements and the roles that individuals can play in shaping their well-being, and to take lessons from those who live well in the Blue Zones.
To delve deeper into the social determinants of health and their impact, explore additional resources