POPULATION HEALTH, SOCIAL DETERMINANTS AND HEALTH OUTCOMES

POPULATION HEALTH, SOCIAL DETERMINANTS AND HEALTH OUTCOMES

We will be starting our series of Preventive Health Intervention publications whose sole aim is to equip readers with reasonable and useful preventive health information, capable of positively influencing personal behaviour leading to improved health outcomes within and between population groups. This will be a foundational teaching of the entire series.

What is health? We all at some point misunderstood health as being the absence of disease but the World Health Organisation (WHO) in its 1948 constitution defined health as “a state of complete physical, mental and social well-being and not mere the absence of disease or infirmity”. This definition looks at health in totality and the outcomes capable of influencing our decisions, productivity, actions and the overarching effect on our personal health.

Every workplace, every neighbourhood, every settlement, schools and assemblage of people could be seen a population group and it is important to know the healthy population within these groups.

Healthy Population is the health outcomes of a group of individuals, including the distribution of such outcome within the group. When we have more of unhealthy work population, the work distribution term to place more pressure on the healthy population in trying to meet collective goals and this could also throw more people from the health population bracket into the unhealthy population pool. This is the reason why creating health programs and wellness initiatives towards maintaining healthy population have become the new global frontier.

Naturally, people are able to act or take hold of their health concerns within the level of health information at their disposal, this is necessary in reducing man-hour-loss through hospital visits, illness related absenteeism or even most recently presenteeism (physically present at work and not able to produce optimally). This further validates the need to build and develop within capacity in the area of health information and education.

SOCIAL DETERMINANTS OF HEALTH

This is referred to as the need to encourage physical and social environment that promotes health. We cannot isolate this exclusively to the work environment but also includes where we were born, where we live, what we eat, where we learn, where we worship and the effects they have on our functionality and quality of life. As already established in many studies, chronic diseases are fuelled by two factors spanning from these:

Non Modifiable Risk Factor: This is as a result of the inherited gene that each person has by virtue of parental traits. We see people having Type 1 Diabetes even if they fall within the healthy body size category, the Diabetes they have is hereditary and not as a result of their actions or social behaviour. This is the reason why people with diabetic parents are always advised to be mindful of their dietary pattern and social behaviour as alcohol use and frequently check their glucose level to know how well they are doing in this regard.

According to the study on nature-nurture debate on obesity for instance, it was reported that a child with non-obese parents stands 10% chance of being obese, a child with one obese parent stands 40% chance of being obese and a child with both obese parents has an 80% chance of being obese. This is just to illustrate how much parental genes can influence non modifiable health risk in their offspring.

Modifiable Risk Factors: These are all factors within our control and when modified, we just live a more functional and healthy life. Example is people with Type 2 Diabetes, this is the diabetic disease condition that comes not because of genetic factor but as a result of our life style which includes poor dietary pattern leading to overweight and obesity. Obesity is a confounder of diabetes and other cardiovascular diseases which can be controlled by life style modification such as healthy eating, physical activity and informed social behavioural choices capable of restoring functional health. We will leave this for now because there is a complete teaching coming on this issue in the weeks ahead.

It is obvious we all want to be healthy and active but at the centre of this desire is our personal actions which we are only able to take with the right information at our disposal and the level of our personal discipline. We cannot be eating high carbohydrate food at 10.00 pm or midnight with the assumption that it will not have effects on our body weight and overall health functionality. You can be thought all you need to know as it concerns your personal health but taking action is your responsibility. In trying to play your role in this cycle of change, you must have motivation within supported by commitment which Darl Bem propounded in his 1972 “Change Talk Theory”. The 4 types of change talk are represented in the D-A-R-N acronym.

D – Desire to change: There should be that “WILL”. Example, “I will”, “I want to”, “I am longing to run upstairs once I stop smoking”. This is all about desire; it is at the beginning of personal commitment to functional health.

A – Ability to change: This is the expression of that change “ABILITY”. Example, “I am thinking I really should be able to stop smoking because I remember when I was trying to lose weight a few years ago, I worked on it. I thought a lot about it, then I decided finally how to proceed and I actually maintained that. So stopping smoking; I should be able to do that”. Talking about ability to change builds your internal positive reinforcement and motivation.

R – Reasons to change: What drives or motivate us towards taking an action is the perceived benefit. We ultimately want to live healthy lives; we must create a mental picture of the overall benefits. Example, “I am worried that smoking is going to make my health worse. I am still young, I love to smoke with my colleagues but I know that chances are I am not going to feel this way the rest of my life. Maybe I should stop smoking to make sure I am as healthy as possible”. The need to be healthy is the reason for the change.

N – Need to change: Until you identify that “NEED” to do something differently, you cannot experience that change. Example, “I have been noticing recently, since I smoke I have troubles running up the stairs, I feel I am more breathless and I cough more, I really need to do something about this”. This is the need to change.

The D-A-R-N Change acronym tells us the role of our personal responsibility in activating the cycle of change towards a positive health outcome which we all crave for. The need to develop personal health plans and setting goals, every goal you achieve no matter how little, be excited about it, appreciate yourself and motivate yourself towards the next goal.

We will continue from here in our next series but before we draw the curtain, we need you to rate your personal health and wellness in a scale of 1 – 10 (1 being the least and 10 being the highest). This is for your personal use, so be honest as much as you can.

How do you rate your personal health and wellness in terms of:

  • Presence or absence of disease
  • Emotional Health
  • Social wellbeing
  • Intellectual health
  • Spiritual wellbeing
  • Physical health
  • Environmental

We will be looking at healthy food and eating behaviour possibly in our next publication.

About the author

Ehi Iden editor