Determinants of Health

Question 1

Whitehall I

Answer 1

Noticed that mortality improvements were not equal across the classes.

Higher employment grade meant lower mortality from coronary heart disease.

Results of the study showed that age-adjusted mortality rate was higher for lower employment status groups. 4.73% of the administrator group at the top compared to 12-16% in the other groups.

Question 2

Whitehall II

Answer 2

Focused on morbidity, not mortality.

Self-perceived health was much lower in the lower status jobs.

Differences in mortality, morbidity, and self-perceived health are only partly accounted for by genetic/biological factors.

Question 3

Whitehall Studies - Combined Results

Answer 3

Showed that low control over your surroundings translates to low satisfaction at work.

Lower job status increases behavioural factors such as smoking and obesity, which can have negative health effects.

Question 4

Determinants of Health

Answer 4

12 factors that combine together to affect the health of people and communities.

1. Income and social status: higher income = better health
2. Gender: men and women suffer different diseases at different times
3. Health services: access to health services = better health
4. Employment and working conditions: more control over working conditions = healthier
5. Education: lower education = less healthy
6. Physical environment: safe water and air, healthy workplace, housing, roads = better health
7. Social support networks: greater support = better health
8. Personal behaviour and coping skills: balanced eating, activity, no smoking, no drinking, low stress = better health
9. Social environment: healthy social networks = better health
10. Healthy childhood development: good early experiences and good school readiness = better health
11. Culture: health is impacted by customs and traditions and the beliefs of the family and community
12. Genetics: inheritance plays a role in health

Question 5

Environmental Determinants of Health

Answer 5

External agents causally linked to health status in populations. For our sake, these are all physical factors that influence health which are not under voluntary control.

For example, second hand smoke would qualify, but smoking would not.

It is important to consider the type of exposure, route of impact, and location of exposure.

Question 6

Health Inequity

Answer 6

Systemic disparity in health that is judged to be unnecessary, avoidable, unjust and unfair.

Question 7

Potential Mechanism for Biological Embedding

Answer 7

Epigenetics

Prolonged cortisol release results in hippocampal neuron damage detrimental to learning and memory.