OBJECTIVES By the end of this lecture Students have to know the following factors that affect human health: 1-Genetic factors 2-Environmental factors 3-Social &economic factors 4-Lifestyle factors 5-Mental factors 6-Health services

(Factors affecting health) Health determinants (Factors affecting health) -Genetic factors -Environmental factors -Social &economic factors -Lifestyle -Mental factors -Health services

Determinants of Health Biological Behavioral Environmental Socio-economic Health system Socio-cultural Ageing of population Science & technology Information & communication Gender Equity & Social justice Human rights

Many factors combine together to affect the health of individuals and communities. Whether people are healthy or not, is determined by their circumstances and environment.

Factors affecting health are divided into two categories: 1-INTERNAL DETERMINANTS 2-EXTERNAL DETERMINANTS

1- Internal determinants Include factors that associated with man himself such as: -Heredity(genetic determinant ) - Age - Sex - Race - Immunity

Genetic determinants:- Heredity is a predisposing factor when a trait inherited from a parent puts an individual at risk for certain diseases. Cystic fibrosis, sickle cell anemia, and Down syndrome are examples of hereditary diseases related to genetic abnormalities

Hereditary diseases Are the result of a person’s genetic makeup. Hereditary diseases do not always appear at birth e.g. Mild hemophilia may go undetected until adolescence or adulthood.

Thousands of genetic diseases are identified in humans, some are fatal Thousands of genetic diseases are identified in humans, some are fatal. These are common ones:

1- Sickle cell anemia: A disease affecting mostly black populations around the world. It occurs because the body produces a defective form of hemoglobin causing red blood cells to become sickle shaped.

2- Diabetes mellitus: A disorder of carbohydrate, fat, and protein metabolism. The disease is due primarily to insufficient insulin production by the pancreas

3- Hemophilia: A rare bleeding disorder caused by a deficiency of specific types of serum proteins called clotting factors. A person with hemophilia bleeds longer following any kind of injury because the blood does not clot normally.

4- Down syndrome: The condition is more likely to occur in children born to parents ages 35 to 50. Infants with this condition typically have a sloping forehead and folds of skin over the inner corners of their eyes, and they may have heart defects.

2-EXTERNAL DETERMINANTS

1-Socio-cultural determinants Life style(social determinant) - Education(socio- economic determinant) - Occupation (economic determinant) - Income (economic determinant)

Life style: A way of living of individuals, families (households), and societies e.g. smoking, alcoholism, drug abuse, physical exercise, nutritional habits … etc.

Smoking greatly increases the risk of : - lung cancer. - heart attack - chronic lung disease. - stroke.

Possible hallucinations Alcoholism: Alcohol, the ordinary name for a substance called methyl alcohol, grain alcohol Side Effects: Confusion Disorientation Unsteady gait Possible hallucinations

Education Education is associated with better health and lower level of education, usually, leads to poorer health. Having a good education leads to better prospects, the chance of securing a job, a better home … etc

2- Environmental determinants Environment is the sum of all living and non living things that compose the surroundings of man.

E T N N V E I M N O R

Factors that associated with external environment in which man is living are: A- Physical environment: - Temperature Humidity

- Radiation. Noise. Lighting . Infrastructure and health services. -Weather-related disasters such as tornados, hurricanes, and earthquakes

- Insecticides and fertilizers - Chemical gases. B- Chemical environment: - Insecticides and fertilizers - Chemical gases. - Heavy metals (Lead, Arsenic, Cadmium ...etc) - Food additives Others

- Pathogens (viruses, bacteria, parasites ... Etc). C- Biological environment: - Pathogens (viruses, bacteria, parasites ... Etc). - Animals (domestic and wild animals-reservoirs of disease),insects as vectors of diseases.

3-Health services Health care is defined as “multitude of services rendered to individuals, families or communities by the health service professionals, for the purpose of promoting, maintaining, monitoring and restoring health”

Health services fall into two broad categories: 1- personal health services: These include the whole range of preventive, curative and rehabilitative services provided for individuals.

2- public health services. These are concerned with the control and prevention of disease in the community, advice on public health policies for promotion, assessment of the health care needs of the population, and planning and evaluation of health services.

Characteristics of health care: 1- appropriateness (relevance): Service versus need 2- comprehensiveness: preventive + curative + promotional 3- availability: associated with ratio e.g. - Health centre to population - Doctors to population

4-accessibility: - Geographic accessibility - Economic accessibility - Cultural accessibility 5- affordability: the service should be affordable to the individual and the state 6- feasibility

The purpose of health service is to improve the health of the people e The purpose of health service is to improve the health of the people e. g.Immunization of children decrease incidence and prevalence of particular diseases ,provision of safe water supply prevent morbidity and mortality of water-borne diseases, care of pregnant women and children decrease maternal and child morbidity and mortality. 4-Others:-as access to medical information,food, agriculture,employment,rural development…etc