Title: Determinants of human health
Course: Level 3 - Health Education and Promotion > Section: Human behaviour and health

The context of people's lives determines their health, and so sometimes blaming individuals for having poor health or crediting them for good health is inappropriate. Individuals are unlikely to be able to directly control many of the determinants of health. For example, polluted water, unsafe environment and the likes influence the health status of the community. There are four general determinants of health. These are human biology, environment, lifestyle, and healthcare services.

1. Human biology includes all those aspects of health, both physical and mental, which are developed within the human body as a consequence of the basic biology of human beings and the organic make-up of an individual. For example, age is one of the biological determinants of health because older people are more at risk of developing non-communicable diseases such as cancer.
2. The environment includes all those matters related to health which is external to the human body and over which the individual has little or no control. Some examples include geography, climate, industrial development and the economy. For example, people living in the lowland areas (geographic factors) are more exposed to malaria than people living in the highlands. If the economic environment gets worse than more people will have to live in poverty - and this is very bad for their health.
3. Lifestyle is made up of the habits and usual practices of human beings which affect their health and over which they more or less have control. For example, people who are not sleeping under insecticide-treated bed nets are at more risk of acquiring malaria. A person's lifestyle or behavior can be a risk factor or a reason for the development of health problem.
Risk factors can be divided into two categories:
  - Modifiable (changeable or controllable) risk factors. These are things that individuals can change and control such as their sedentary lifestyle-- refers to the collection of behaviors that make up a person's way of life-including-smoking, drinking alcohol, or poor dietary habits.
  - Non-modifiable (non-changeable or non-controllable) risk factors. These are factors such as age, sex and inherited genes and are things that individuals cannot change or do not have control over. These two categories of risk factors may be interrelated and in fact, the combined potential for harm from some risk factors is greater than the sum of their individual parts. For example: If an old person (old age - as a non-modifiable factor) smokes and drinks (smoking and drinking are modifiable risk factors) to excess as well they are especially likely to become ill with problems related to smoking and drinking. In developing countries like Ethiopia, more than 80% of the disease burden and its related morbidity and mortality is due to communicable diseases, and the cause of these diseases are usually the changeable /modifiable risk factors. Therefore, much of the focus of your health education work as a health extension worker needs to be helping individuals identify and control their modifiable risk factors.
4. Health care services consists of the arrangement and resources that are used in the provision of healthcare - often referred to as the healthcare system. For example, if someone is sick from malaria and there are no health facilities nearby to treat the patient, the patient is more likely to develop a severe complication and may even die. Therefore, the question of availability, accessibility and affordability of the health care organisations as well as services should be raised and answered here.