Health and its Determinants: What Makes us Healthy?

Written by Naima Sullivan, MS, RD, LDN

Edited by Sarah Criscuolo MS, RD, LDN, CSN, CPT

 

What is health?

While it may seem obvious, the concept of health and what it means for human life has not always been easy to define. Once thought of as simply the absence of disease, our understanding of health has grown to encompass physical, mental, and social wellbeing. Health can be thought of as a “resource for everyday life, not the objective of living.” It represents our ability to “realize aspirations, satisfy needs, and to change or cope with our environment.”

Health can be applied to individuals and to larger populations. If we think of health as a dynamic and changing state, it makes sense that many aspects of life and society impact our health. Social conditions, the environment, genetics, and our individual behaviors all play an important role in our ability to grow and thrive. Let’s take a look at some of the factors that influence our health.

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Social Determinants of Health

By some estimates, social determinants of health (SDOH) account for anywhere from 40% to 60% of your health. Where you live is one of the most significant determinants of your health and longevity. SDOH are at the root of health disparities and inequities. For example, people who lack access to quality food are less likely to have good nutrition, which in turn raises their risk of health conditions like heart disease and diabetes, and may even lower life expectancy.

While individual behavior is an important part of your health, lifestyle choices like diet and exercise will not eliminate the health disparities that affect people in our society. Health equity prioritizes systemic changes to create the social, physical, and economic conditions needed for people to attain their full health potential.

Some examples of the social determinants of health include:

• Housing, transportation, and neighborhoods
• Quality of air and water
• Economic stability
• Food access
• Education access and quality
• Social community and relationships
• Racism, discrimination, and violence
• Healthcare access and quality

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Genetics and Biology

Genetics and biology account for about 20% of your health status. This means that certain traits, including height and weight, as well as risk for certain diseases have been passed down to you from your parents and grandparents through their genes. Genetic predisposition is an increased chance that you’ll develop a certain disease based on your genetic makeup. Genes alone do not determine whether the disease will develop; it’s the interaction between your genes, the environment, and your lifestyle that can trigger its development. Knowing your family health history can help you to understand your own health risks and make choices that are right for you. Sometimes, a genetic pre-disposition means that even after making lifestyle changes, you may still need medication or other interventions to manage the condition.

Some of the conditions that have been linked to genetic pre-disposition include:

• Addiction
• Alzheimer’s Disease
• Arthritis
• Asthma
• Certain cancers
• Celiac disease
• Diabetes
• Depression and other mental health conditions
• Eating disorders
• Heart disease
• High blood pressure
• Irritable bowel syndrome

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Individual Behaviors

Individual behaviors account for about 30% of your health. Diet, exercise and sleep are all examples of individual behaviors that impact your physical health, mental health, and overall well-being. Positive behavior change can help to prevent and manage complex health conditions, but it is not just about willpower or knowing exactly what to do – some behaviors are directly related to the environment in which you live, work, and play. For instance, even though we know that walking is a great form of movement with many health benefits, someone who lives in a neighborhood with heavy traffic and no sidewalks is not likely to take a lot of walks.

To maximize the benefits of positive behaviors, habits need to be realistic and sustainable for the long-term. Restrictive diets, which may result in lower weight and improved health in the short term, are extremely difficult to maintain. Going on and off diets and the associated weight cycling can be more damaging to your health than just maintaining a higher weight. Focusing instead on sustainable behavior changes that are tailored to your unique needs and background is the best way to prevent disease and improve your health over the long term.

At Karuna, we practice Lifestyle Based Health Promotion. When you work with a Karuna dietitian, we consider the many aspects of your life that affect your behavior and health, including your family health history and social determinants. We work with you to develop a customized plan that fits your unique needs, utilizing the resources that are available to you.

Some of the lifestyle factors that we can help you with include:

• Nutrition
• Physical activity
• Green space interaction
• Social connectedness
• Restorative sleep
• Stress management and relaxation

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Putting it All Together

It’s important to understand the dynamic interplay between your environment, social conditions, behavior, and unique genetic makeup when it comes to your health. Knowing your family health history and talking about it with your healthcare providers is a great way to help you understand your health risks and decide what choices are right for you. Tailoring your behaviors based on your unique genetic makeup and the environment in which you live is essential for making sustainable changes.

Understanding that many factors of health are outside of your control can help to cultivate self-compassion, prioritize self-care, and embrace community support in whatever ways they are accessible to you. Lastly, advocating for systemic change to address health inequities helps us all to work towards a society where everyone can attain their full health potential.

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Resources:

1. https://www.healthpolicypartnership.com/what-is-health-the-search-for-an-accurate-definition/
2. https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference
3. https://www.goinvo.com/vision/determinants-of-health/
4. https://www.rwjf.org/en/insights/our-research/interactives/whereyouliveaffectshowlongyoulive.html
5. https://health.gov/healthypeople/priority-areas/social-determinants-health
6. https://www.cdc.gov/genomics/famhistory/index.htm
7. https://www.healthline.com/health/fitness-nutrition/healthy-lifestyle-benefits