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What is health, and how is it achieved? In trying to come to terms with what makes people healthy and unhealthy, researchers and policy makers have detailed a complex universe of factors that make and keep people healthy. These factors have been dubbed the determinants of health. They include a range of factors that explain why a person is or is not healthy – biological factors, lifestyle choices, environmental conditions, and the organization of the health care system itself. The determinants of health take a broad approach to health looks at not just the health of individuals but also at the health of the population as a whole and of sub-populations.

The current thinking is that the determinants of health include (in alphabetical order):

(This list is not exhaustive, and will change as understanding of health evolves.)

The reason why it's important to understand the determinants of health is because making people healthy and keeping them that way involves much more than simply supplying them with access to doctors and hospitals. In fact, Health Canada (where I got that list from) estimates that 25% of the health of the Canadian population is attributable to the health care system, 15% to biology and genetics, 10% to physical environments, and fully 50% to social and economic environments.

The implications are profound. If true, this means that much of the onus for health lies outside the traditional health sector. In fact, to maintain and improve the health of populations, government bodies must focus on more than the provision of health care. They must utilize broad-ranging health promotion and wellness strategies (anti-smoking and fitness campaigns, for example) as well as comprehensive prevention strategies (immunization, food safety, etc.). Further, they must engage in intersectoral efforts aimed at population health: poverty alleviation, particularly for children; access to mass education; environmental clean-up; and workplace safety, to name a few.

Canada has been a leader in this type of health research and policy, and the Health Canada website at www.hc-sc.gc.ca is a good place to look for information. It was a primary source for me in this write-up.

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