{"id":1692,"date":"2018-04-25T20:48:31","date_gmt":"2018-04-25T20:48:31","guid":{"rendered":"http:\/\/localhost\/sigmify\/resources\/?p=1692"},"modified":"2025-03-12T06:32:05","modified_gmt":"2025-03-12T06:32:05","slug":"what-determines-our-healthfive-health-determinants","status":"publish","type":"post","link":"https:\/\/sigmify.com\/resources\/what-determines-our-healthfive-health-determinants\/","title":{"rendered":"What determines our health\u2026Five Health Determinants"},"content":{"rendered":"<p>In my last blog I had talked about how we are paying more for our healthcare but paying more does not seem to be helping. It is certainly not helping us become healthier or lead longer lives. In fact, recent reports indicate that life expectancy has fallen in the United States.<\/p>\n<p>If our investments are not getting the desired results then we need to look hard to figure out what else to do. Do we need to do something better? Should we look at what\u00a0 we are not doing? Do we need to look at what determines our Health , the Five Health Determinants.<\/p>\n<h2>What should we do? What can we do?\u00a0The Five Health Determinants<\/h2>\n<p>I asked myself a basic question. What is Healthcare? What determines that we have good Healthcare? That are we doing well. What are we improving.<\/p>\n<p>According to McGovern, Miller and Hughes-Cromwick in their article in Health Affairs in Aug 2014,\u00a0there are five major categories of health determinants:<\/p>\n<ul>\n<li>Genetics<\/li>\n<li>Behavior<\/li>\n<li>So\u00adcial Circumstances<\/li>\n<li>Environmental and Physi\u00adcal influences<\/li>\n<li>Medical Care.<\/li>\n<\/ul>\n<p>The paper highlights a couple of important points.<\/p>\n<p>It summarizes findings from 10 studies. All of them show that <u>Behaviors and Social circumstances have the same, if not larger impact on health<\/u>. They have an impact larger than the other three determinants, Environment and Physical influences, Medical Care and Genetics put together.<\/p>\n<p><span style=\"color: #09c4d9;\"><em><strong>Think about that! Behaviors and Social circumstances have the largest impact on our health!<\/strong><\/em><\/span><\/p>\n<p>This paper also notes that Behavior change is one of the most difficult things to accomplish.<\/p>\n<h2>What health determinant\u00a0 has our attention?<\/h2>\n<p>Next, I tried to establish how much attention we are paying, relatively speaking to each of these five determinants of health. I thought that the money spent on each of these \u2018<em><strong>categories<\/strong><\/em>&#8216; would be a good proxy for attention. I looked into this.<\/p>\n<figure id=\"attachment_1694\" aria-describedby=\"caption-attachment-1694\" style=\"width: 618px\" class=\"wp-caption alignright\"><a href=\"http:\/\/https:\/\/www.cdc.gov\/socialdeterminants\/docs\/sdh-white-paper-2010.pdf\"><img fetchpriority=\"high\" decoding=\"async\" class=\"wp-image-1694\" src=\"http:\/\/sigmify.com\/resources\/wp-content\/uploads\/2018\/11\/Social-Determinants-WHO.png\" alt=\"\" width=\"618\" height=\"507\" \/><\/a><figcaption id=\"caption-attachment-1694\" class=\"wp-caption-text\">Determinants of Health<\/figcaption><\/figure>\n<p>I did not find any studies (yet\u2026 though I am sure they are out there) that quantify investments on these five determinants. However, anecdotal information based on my conversations with healthcare practitioners, both doctors and administrators, seems to indicate that most of our investment dollars are spent on medical care, on just<em><strong>\u00a0One<\/strong><\/em> of the <em><strong>Five<\/strong><\/em> determinants.<\/p>\n<p>Let me take a step back and put this picture back together.<\/p>\n<p><em><strong>We are paying more for our healthcare<\/strong><\/em>. It is not helping us become healthier or lead longer lives. Don\u2019t get me wrong. Modern medicine is almost miraculous. The gains that advances in medical care have delivered have slowed or plateaued. We can do more.<\/p>\n<figure id=\"attachment_2178\" aria-describedby=\"caption-attachment-2178\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/http:\/\/www.countyhealthrankings.org\/sites\/default\/files\/differentPerspectivesForAssigningWeightsToDeterminantsOfHealth.pdf\"><img decoding=\"async\" class=\"wp-image-2178 size-large\" src=\"http:\/\/sigmify.com\/resources\/wp-content\/uploads\/2018\/11\/Social-Determinants-weightage-1-1024x377.png\" alt=\"Relative importance of Health Determinants\" width=\"640\" height=\"236\" srcset=\"https:\/\/sigmify.com\/resources\/wp-content\/uploads\/2018\/11\/Social-Determinants-weightage-1-1024x377.png 1024w, https:\/\/sigmify.com\/resources\/wp-content\/uploads\/2018\/11\/Social-Determinants-weightage-1-300x110.png 300w, https:\/\/sigmify.com\/resources\/wp-content\/uploads\/2018\/11\/Social-Determinants-weightage-1-768x283.png 768w, https:\/\/sigmify.com\/resources\/wp-content\/uploads\/2018\/11\/Social-Determinants-weightage-1-1568x577.png 1568w\" sizes=\"(max-width: 640px) 100vw, 640px\" \/><\/a><figcaption id=\"caption-attachment-2178\" class=\"wp-caption-text\">Relative importance of Health Determinants<\/figcaption><\/figure>\n<p><span style=\"color: #09c4d9;\"><em>There are five \u2018<strong>Categories<\/strong>\u2019 that affect our health. We are focused on just one of them. Medical Care. That\u2019s where we invest most of our money.<\/em><\/span><\/p>\n<h2>How does this help\u2026<\/h2>\n<p>All this points to something. Doesn\u2019t it?<\/p>\n<p>What about the other four determinants? Genetics, Behavior, So\u00adcial Circumstances, Environmental and Physi\u00adcal influences. Can we do something about them? Is there any evidence that working on these other determinants\u00a0 will help with better outcomes?<\/p>\n<p>As it turns out, there is. I will talk about<span style=\"color: #09c4d9;\"> <em><strong>Blue Zones<\/strong> <\/em><\/span>in a forthcoming blog\u2026<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\t\t\t\tLearn about the Five categories of Health determinants. See where your healthcare dollars are spent. \t\t<\/p>\n","protected":false},"author":3,"featured_media":2235,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ocean_post_layout":"","ocean_both_sidebars_style":"","ocean_both_sidebars_content_width":0,"ocean_both_sidebars_sidebars_width":0,"ocean_sidebar":"footer-one","ocean_second_sidebar":"0","ocean_disable_margins":"enable","ocean_add_body_class":"","ocean_shortcode_before_top_bar":"","ocean_shortcode_after_top_bar":"","ocean_shortcode_before_header":"","ocean_shortcode_after_header":"","ocean_has_shortcode":"","ocean_shortcode_after_title":"","ocean_shortcode_before_footer_widgets":"","ocean_shortcode_after_footer_widgets":"","ocean_shortcode_before_footer_bottom":"","ocean_shortcode_after_footer_bottom":"","ocean_display_top_bar":"default","ocean_display_header":"default","ocean_header_style":"","ocean_center_header_left_menu":"0","ocean_custom_header_template":"0","ocean_custom_logo":0,"ocean_custom_retina_logo":0,"ocean_custom_logo_max_width":0,"ocean_custom_logo_tablet_max_width":0,"ocean_custom_logo_mobile_max_width":0,"ocean_custom_logo_max_height":0,"ocean_custom_logo_tablet_max_height":0,"ocean_custom_logo_mobile_max_height":0,"ocean_header_custom_menu":"0","ocean_menu_typo_font_family":"0","ocean_menu_typo_font_subset":"","ocean_menu_typo_font_size":0,"ocean_menu_typo_font_size_tablet":0,"ocean_menu_typo_font_size_mobile":0,"ocean_menu_typo_font_size_unit":"px","ocean_menu_typo_font_weight":"","ocean_menu_typo_font_weight_tablet":"","ocean_menu_typo_font_weight_mobile":"","ocean_menu_typo_transform":"","ocean_menu_typo_transform_tablet":"","ocean_menu_typo_transform_mobile":"","ocean_menu_typo_line_height":0,"ocean_menu_typo_line_height_tablet":0,"ocean_menu_typo_line_height_mobile":0,"ocean_menu_typo_line_height_unit":"","ocean_menu_typo_spacing":0,"ocean_menu_typo_spacing_tablet":0,"ocean_menu_typo_spacing_mobile":0,"ocean_menu_typo_spacing_unit":"","ocean_menu_link_color":"","ocean_menu_link_color_hover":"","ocean_menu_link_color_active":"","ocean_menu_link_background":"","ocean_menu_link_hover_background":"","ocean_menu_link_active_background":"","ocean_menu_social_links_bg":"","ocean_menu_social_hover_links_bg":"","ocean_menu_social_links_color":"","ocean_menu_social_hover_links_color":"","ocean_disable_title":"default","ocean_disable_heading":"default","ocean_post_title":"","ocean_post_subheading":"","ocean_post_title_style":"","ocean_post_title_background_color":"","ocean_post_title_background":0,"ocean_post_title_bg_image_position":"","ocean_post_title_bg_image_attachment":"","ocean_post_title_bg_image_repeat":"","ocean_post_title_bg_image_size":"","ocean_post_title_height":0,"ocean_post_title_bg_overlay":0.5,"ocean_post_title_bg_overlay_color":"","ocean_disable_breadcrumbs":"default","ocean_breadcrumbs_color":"","ocean_breadcrumbs_separator_color":"","ocean_breadcrumbs_links_color":"","ocean_breadcrumbs_links_hover_color":"","ocean_display_footer_widgets":"default","ocean_display_footer_bottom":"default","ocean_custom_footer_template":"0","ocean_post_oembed":"","ocean_post_self_hosted_media":"","ocean_post_video_embed":"","ocean_link_format":"","ocean_link_format_target":"self","ocean_quote_format":"","ocean_quote_format_link":"post","ocean_gallery_link_images":"off","ocean_gallery_id":[],"footnotes":""},"categories":[9],"tags":[71,72,73,76],"class_list":["post-1692","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthcare","tag-health-determinants","tag-healthcare","tag-healthcare-costs","tag-healthcare-spend","entry","has-media"],"_links":{"self":[{"href":"https:\/\/sigmify.com\/resources\/wp-json\/wp\/v2\/posts\/1692","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sigmify.com\/resources\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sigmify.com\/resources\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sigmify.com\/resources\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/sigmify.com\/resources\/wp-json\/wp\/v2\/comments?post=1692"}],"version-history":[{"count":5,"href":"https:\/\/sigmify.com\/resources\/wp-json\/wp\/v2\/posts\/1692\/revisions"}],"predecessor-version":[{"id":7016,"href":"https:\/\/sigmify.com\/resources\/wp-json\/wp\/v2\/posts\/1692\/revisions\/7016"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sigmify.com\/resources\/wp-json\/wp\/v2\/media\/2235"}],"wp:attachment":[{"href":"https:\/\/sigmify.com\/resources\/wp-json\/wp\/v2\/media?parent=1692"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sigmify.com\/resources\/wp-json\/wp\/v2\/categories?post=1692"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sigmify.com\/resources\/wp-json\/wp\/v2\/tags?post=1692"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}