In a world in which everyone’s opinion is valid, it can sometimes be difficult to separate truth from misinformation. When it comes to an understanding of the determinants of health, opinions vary from total abdication of responsibility …
to a belief that the individual is fully accountable (and responsible) for everything related to personal health.
That either extreme is untenable should be evident. For instance, the Daily Mail recently published a piece that acknowledges that apparently healthy people sometimes have unexplained deaths, once consideration of all relevant lifestyle factors is taken.
Another way to look at this is to think of the factors that impact on any decision one makes to adopt a healthier lifestyle. For instance, should you be interested in accepting the growing evidence of a more beneficial impact on personal and environmental health associated with a vegan lifestyle, you have to consider the relative affordability of vegan foods when you go out. The price that you pay for your vegetables, fruit and grains will be influenced by the level of VAT set by the government. When you need to quench your thirst, you might find that bottled water is more expensive than soft drinks. Obviously the state then has a role in setting policies that favour healthy choices.
Moreover, we find that certain communities are more at risk of certain medical conditions due to dietary or lifestyle practices across those communities.
This is something that Dahlgren and Whitehead discuss at length and present diagrammatically in their summary of the determinants of public health, shown below:
This gives a more comprehensive view and shows that health will be determined by:
- Non-modifiable factors such as age, sex and genes
- Individual lifestyle factors (diet, exercise, weight)
- Social and community networks (including where the individual lives)
- General socioeconomic, cultural and environmental conditions, which are largely influence by political factors
In view of these considerations, you might want to pause before making a judgment next time you discuss an individual’s health.