Health Promotion and Determinants of Health

Health is the state of being physically, mentally and socially well. It is not just the absence of disease or infirmity, but a sense of well-being that encompasses an individual’s physical, mental and social wellbeing.

Health has a wide definition and can be seen as an umbrella concept that includes the prevention of diseases, promotion of healthy lifestyles, and the provision of healthcare services. The World Health Organisation defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” This approach also considers an individual’s perception of their own health and how they cope with ill health.

In the past, many attempts to improve health have focused on preventing or treating disease. However, the underlying drivers of illness often have not been addressed. In a changing environment, these determinants of health need to be considered in the context of health promotion.

A number of factors determine an individual’s health, including their genetic endowment, their immediate environment, and the wider social and economic environment in which they live. These factors are called determinants of health and they include both risk and protective factors (see Glossary). They influence the capacity to make choices and take actions that promote or protect health.

Increasingly, there is recognition of the need to tackle these determinants of health in addition to preventing or treating disease. This is reflected in the emphasis in many countries on developing community-level responses to the social determinants of health.

The traditional targets for intervention have been specific diseases or behaviors and the current funding streams for research and health delivery encourage this approach. A shift towards a focus on health generation rather than sickness, however, opens up new avenues for action and requires consideration of the range of factors that can contribute to an individual’s sense of wellbeing and their health.

For example, if adolescents feel less alienated and hopeless could unintended pregnancies, alcohol and drug use and crime all be reduced? This would require a combination of actions from a variety of actors, including schools, the media and parents.

In order to improve health, it is important for individuals to set clear goals and stick with them. Identifying what these goals are will vary from person to person. For some, this may be a particular diet or activity level, for others it might be a feeling of fulfilment or satisfaction with life. Whatever your goal, it is essential to take small steps, such as those outlined by BJ Fogg in Tiny Habits, to build momentum and move towards your desired outcome. This is especially important for people with limited time and resources.