Determinants of Health
Determinants of health are factors that contribute to a person's current state of health. These factors may be biological, socioeconomic, psychosocial, behavioral, or social in nature. Scientists generally recognize five determinants of health of a population [1,2]:
- Genes and biology: for example, sex and age
- Health behaviors: for example, alcohol use, injection drug use (needles), unprotected sex, and smoking
- Social environment or social characteristics: for example, discrimination, income, and gender
- Physical environment or total ecology: for example, where a person lives and crowding conditions
- Health services or medical care: for example, access to quality health care and having or not having insurance
Estimates of how each of the five major determinants influence population health .
Other factors that could be included are culture, social status, and healthy child development. The chart above represents rough estimates of how much each of the five determinants contributes to the health of a population. Scientists do not know the precise contributions of each determinant at this time.
As the chart shows, in theory, genes, biology, and health behaviors together account for about 25% of population health. Social determinants of health represent the remaining three categories of social environment, physical environment/total ecology, and health services/medical care. These social determinants of health also interact with and influence individual behaviors as well. More specifically, social determinants of health refer to the set of factors that contribute to the social patterning of health, disease, and illness.
- Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, N.Y., 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.
- U.S. Department of Health and Human Services, Healthy People 2020 Draft. 2009, U.S. Government Printing Office.
- Tarlov, A.R., Public Policy Frameworks for Improving Population Health. Annals of the New York Academy of Sciences, 1999. 896(SOCIOECONOMIC STATUS AND HEALTH IN INDUSTRIAL NATIONS: SOCIAL, PSYCHOLOGICAL, AND BIOLOGICAL PATHWAYS): p. 281-293.
For more information, click on:
New Mexico Public Health Association (website)
CDC Social Determinants (PDF, 214KB)
Frieden Health Impact Pyramid (PDF, 72KB)
The Maternal, Child Health (MCH) Pyramid (PDF, 46KB)
The County Health Rankings Model of Population Health (PDF, 245KB)
BARHII Health Inequities Diagram (PDF, 77KB)
Healthy People 2020 Framework (PDF, 247KB)