What makes us ‘healthy’? The Determinants of Health.
Most people would automatically say the main determinants of a person’s health are their diet, the amount of physical activity, their mental outlook and their personal life choices. Well, yes of course - they are important. But would you be surprised if I told you that our individual behaviours only account for 36% of our individual health outcomes?
The remaining 64% is made up of the ‘social or wider determinants of health’ - our social circumstances, our genetics & biology, our medical care and our environment. (Data from Determinants Of Health)
My work is focused on encouraging you to look at the 36%, your individual behaviours -
finding ways to increase your physical activity
using physical activity to help improve your sleep patterns
supporting your mental health through joyful movement
looking at your diet through intuitive eating and gentle nutrition
giving a greater sense of body appreciation and acceptance through education and positive reinforcement
But what about the remaining 64%? Let’s break it down…
Social Circumstances (24%)
These reflect the social environment we have lived and grown up in. Our social status, childhood development and culture impact directly on our personal health. This category includes many factors that we cannot change about ourselves such as race, ethnicity, disabilities and sexual orientation.
Poor social circumstances such as discrimination, poverty and low education levels often result in a lower quality of life alongside poor health outcomes.
This is why there has been such an outpouring of support from the health and fitness community for the ‘Black Lives Matter’ movement. Due to the effects of systemic racism and discrimination, BIPOC communities are more likely to have to deal with lower income levels, lower education quality, issues with citizenship status, histories of incarceration and poor work conditions. All of which are noted as having a large impact of health outcomes.
These inequalities also apply to LGBTQ communities, disabled people and many more marginalised groups. These inequalities are not inevitable, they are avoidable and unfair.
Genetics and Biology (22%)
Basic measures such as age, height, gender, body structure, bone density and our genes make up this category.
We can use physical activity to work on some of the factors such as building bone density with strength training but most of this is pre-determined by our genetics.
Medical Care (11%)
Medical Care only accounts for a small portion of our overall health outcomes - we are very lucky in the UK to have the NHS as one of the biggest issues round the world is the lack of access to medical services. Distance from resources, availability and the quality of insurance can have a big impact if you do have to seek medical care.
Environment (7%)
Environment encapsulates the natural and human environments we live in, it is an important aspect of our health but has the smallest impact - factors such as air quality, water quality, crime levels, exposure to firearms, public space quality and access to healthy foods.
I hope this has given you a deeper understanding on how much external factors affect our health - it has helped me as a personal trainer and ‘health coach’ to understand how to best help my clients. Not everyone has easy access to medical care, organic foods or an expensive gym environment. The health and fitness industry can be very elitist, encouraging people to buy into expensive (both in terms of money and time) ‘solutions’ in order to boost your health. It is important that we increase health availability to everyone.
If we are to increase the population’s overall health outcomes, yes we need to encourage people to adopt joyful movement and gentle nutrition but we also need to help work on improving social circumstances, access to medical care and environmental factors.
I have linked some interesting articles if you would like to do any further reading;
Key findings from Public Health England's report on Covid-19 deaths