Many different factors influence human health and well-being, and there are a great many different ways of defining health and well-being, from the simple absence of measurable disease to a more abstract sense of physical and social actualization. Regardless of how we define the outcome, decades of research suggest that there are a host of variables that interact and have an influence on the human condition.
The Public Health Agency of Canada acknowledges 12 such determinants of health, one of which is labeled, “personal health practices and coping skills.” Essentially, this determinant describes that amorphous thing we call “lifestyle” and the social and environmental factors that interact with it.
One can argue that a healthy human being must be self-reliant, able to cope with challenges, solve problems, practice self-care, and make choices that are good for his or her health. So-called life skills, stress, culture, social relationships, a sense of belonging of control can all influence personal health by interacting with behaviours. For example, consuming a diet high in refined sugar is a personal choice, but social and economic circumstances can influence whether that choice is made. And, of course, elevated consumption of refined sugar is a known risk factor for obesity, cardiovascular disease, and type II diabetes.
Smoking is strongly related to negative health outcomes, including lung cancer, coronary heart disease, stroke, and respiratory diseases. It is the leading cause of preventable death in Canada. Most people start smoking in their adolescent years, at a time when they are highly influenced by their peers. In fact, adolescents who smoke have more close friends who are also smokers. Their parents are often also smokers. A young adult’s risk for taking up smoking is influenced by social relationships as well as personal beliefs. A substantial decline in the prevalence of smoking in Canada from 49.5% in 1965 to 17.3% in 2011 has largely been due to anti-smoking campaigns and health education (Reid, Hammond, Burhkhalter, Rynard, & Ahmed, 2013), which targeted the determinants of that behaviour –its social acceptability– and not necessarily the behaviour itself.
Figure 1 – Prevalence of smoking in Canadians aged 15 and over, 1965-2010
Another important behavioural determinant is physical activity. Health professionals know that physical activity is beneficial, that it can reduce stress, promote cardiovascular health, control bodyweight, and reduce risk for certain types of cancers. However, less than 10% of children and youth and only 15% of adults currently meet the minimum physical activity guidelines of 60 minutes of moderate to vigorous physical activity per day for children, and 150 minutes per week for adults (Garriguet & Colley, 2013). Scientists may ask why Canadians are engaging in such little physical activity; they also consider ways to increase people’s activity levels. In order to be successful, programs and campaigns must work towards creating an environment that is supportive of regular exercise.
In other words, to target specific outcomes of physical health, often a deterministic approach is the most effective: to address those factors –social, environmental, and economic—which are known to be highly correlated with the behaviours of interest.
Carbone, P. P. (2008). Factors associated with youth smoking in Wisconsin. Madison, WI: Tobacco Surveillance and Evaluation Program, University of Wisconsin.
Centers for Disease Control and Prevention. (2014). Health effects of cigarette smoking. Retrieved from http://www.cdc.gov/tobacco/data_statistics/ fact_sheets/health_effects/effects_cig_smoking/
Centers for Disease Control and Prevention. (2011). Physical activity and health. Retrieved from http://www.cdc.gov/physicalactivity/everyone/health/
Garriguet, D., & Colley, R. C. (2013). Daily patterns of physical activity among Canadians. Health Reports, 23(2). Retrieved from http://www5.statcan.gc.ca/ bsolc/olc-cel/olc-cel?catno=82-003-x&lang=eng
Hu, F. B., & Malik, V. S. (2010). Sugar-sweetened beverages and risk of obesity and type 2 diabetes: epidemiologic evidence. Physiology and Behaviour, 100(1), 47-54. doi:10.1016/j.physbeh.2010.01.036
Public Health Agency of Canada. (2013) What makes Canadians healthy or unhealthy? Retrieved from http://www.phac-aspc.gc.ca/ph-sp/determinants/determinants-eng.php#personalhealth
Reid, J. L., Hammond, D., Burkhalter, R., Rynard, V. L., & Ahmed R. (2013). Tobacco use in Canada: Patterns and trends. Waterloo, ON: Propel Centre for Population Health Impact, University of Waterloo
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