What does the concept of health mean for you?
What determines the health of your family members, your community, your nation?
Which factors have you noticed that seem to influence your health? Do you get sick during certain times more often?
Collectively these questions explore the ideas and theories of ‘Determinants of Health’. The office of disease prevention and health promotion have developed healthy people initiatives which elaborate on this concept. Simply put, the determinants of health include a range of personal, social, economic, and environmental factors that influence the health status of an individual and the population. These factors fall under 5 broad and scaled categories:
- Individual’s makeup and biological factors
- Individual’s behavioral factors
- Social and physical factors
- Health service related factors
- Policy related factors
Let’s define these a little bit further using an example…
During the current COVID-19 pandemic, we have seen the influence of all these factors across the world. Certain individuals are more susceptible to the respiratory complications due to the COVID-19 infection (individual factors), certain individuals are inconsistently following the recommended hand-washing & social distancing guidelines (behavioral factors), certain individuals are prone to be affected due to their living, commuting or work conditions (social and physical factors), certain individuals may not have access or quality of healthcare, for example due to hospitals reaching capacity (health service related factors), and lastly the implementation of local, state or federal guidelines to restrict further COVID-19 spread or to help businesses recover from the economic impact of the pandemic (policy related factors).
As I learn and grow as a clinician and an educator, I have come to realize the significant influence of determinants of health across multiple specialty fields of physical therapy. I have continued to teach and expand this concept to doctoral physical therapy students over the last 3-4 years at my institution and have developed my own interpretation of this. Here are a few of my thoughts listed as ‘clinical pearls’:
- In your practice, consider the sociocultural background your patient belongs to.
- Determine the presence of any of the factors discussed above in your patient.
- Determine the influence and interplay of these factors within your patient’s clinical presentation.
- Be aware of any local, state or national resources that your patient can benefit from if you identify the need to discuss any of these factors.
- Be willing to undergo a change in your personal clinical philosophy to acknowledge the influence of these factors in your patient.
Hope you find these pearls useful! I trust that these will help you in your quest for knowledge and the ever growing compassion towards your patients! In the next few blogs, I will bring forward the current evidence on health and its determinants in various populations. Also, check out the ‘Research Reviews tab’ for critiques on same or other clinical topics.
If you found this useful in your practice, please give me examples of any transformations that you noticed by writing in the section below. Look forward to our many discussions!
Written by:
Hina Garg
PT, MS, PhD, NCS, CEEAA
Associate professor
MS PT & Wellness Center Director
Rocky Mountain University of Health Professions
References:
Healthy People: https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health