"Factors Affecting Health of the Individual and Community" is a topic in medical-surgical nursing for nursing students.

1. NURSE AKINTAYO-USMAN, N.O.
NURSE TUTORS PROGRAMME,
UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA

2. The Determinants of Health
 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.
 To a large extent, factors such as where we live, the state of
our environment, genetics, our income and education level,
and our relationships with friends and family all have
considerable impacts on health.

3. The Determinants of Health 2
These include:
The physical factors
The chemical factors
The social factors
The person’s individual
characteristics and behaviours.

4. Physical Factors
Examples of physical determinants are:
 Natural environment, such as plants, weather, or climate
change
 Built environment, such as buildings or transportation
 Worksites, schools, and recreational settings
 Housing, homes, and neighborhoods
 Exposure to physical hazards
 Physical barriers, especially for people with disabilities
 Aesthetic elements, such as good lighting, trees, or benches

5. Physical Factors 2
 Exposures to contaminants in air, water, food and soil, are
associated with many chronic diseases and with emerging
communicable diseases.
 Climate change and the associated weather extremes will
also affect health: hyperthermia from extreme heat, injury
from extreme wind and rain.
 Changing distribution of vectors and infectious agents-
introducing disease to previously unaffected regions.

6. Chemical Factors
 Air pollutants can also cause climate change which will
affect communities differently.
 People in urban centres do not enjoy good air quality.
Indoor air may contain constituents such as asbestos,
moulds, radon gas, carbon monoxide and methane that
affect health.
 E.g. in counties where ozone pollution is high, there is often
a higher prevalence of asthma in both adults and children
compared with state and national averages. Poor air quality
can worsen asthma symptoms, especially in children.

7. Chemical Factors 2
 ‘The sick building syndrome’ describes a range of ailments
related to living or working in closed buildings with poor
air quality.
 Another threat to healthy indoor air quality is tobacco
smoke, especially for children living in the homes of
smokers. These children experience more asthma and
bronchitis; they are at a higher risk for sudden infant death
syndrome and have more lung and ear infections than
children living in homes without tobacco smoke.

8. Social Factors
Examples of social factors include:
 Availability of resources to meet daily needs, such as
educational and job opportunities, living wages, or
healthful foods
 Social norms and attitudes, such as discrimination
 Exposure to crime, violence, and social disorder
 Social support and social interactions
 Exposure to mass media and emerging technologies, such
as the Internet or cell phones

9. Social Factors 2
 Socioeconomic conditions, such as concentrated poverty
 Quality schools
 Transportation options
 Public safety
 Residential segregation
 Culture - customs and traditions
 Access to health services

10. Socioeconomic Status
 Higher income and social status are linked to better health.
The greater the gap between the richest and poorest
people, the greater the differences in health.
 A person’s social status is defined by a combination of their
wealth, education, occupation and lifestyle. Each of these,
alone or in combination, can exert positive or negative
influences on a person’s health.
 The association between social status and health is now
termed social inequalities in health.

11. Socioeconomic Status 2
 Absolute poverty refers to having inadequate resources to
meet basic needs for shelter, nutritious food, clothing, and
education. People living in poverty lack the resources and
opportunities to make choices that promote good health.
Being poor may also expose them to inferior physical
environments that place them at risk for health problems.
Absolute poverty is the leading health determinant in low-
income countries; infants and children are particularly
susceptible to its effects.

12. Social Factors- Education
 Low education levels are linked with poor health, more
stress and lower self-confidence.
 Education also has a more direct influence on health in that
it affects a person’s ability to navigate the health care
system, to interpret health information and to
communicate effectively with health professionals.
 ‘
 ‘Health literacy’ refers to the patient’s ability to
understand health information and to follow guidelines for
their treatment.

13. Social Factors- Employment
 Employed people are healthier, particularly those who have
more control over their working conditions.
 The WHO recognizes fair employment and decent work as a
cornerstone of health, and advocates for fair minimum wages,
full employment, and occupational health and safety standards.
 Work-related diseases, caused or exacerbated by the patient’s
work, are derived from the amount of a person’s perceived
control over demands at work, their work satisfaction, perceived
levels of physical risk, and job security.

14. Social Support Network
 This refers to support from families, friends and
communities.
 It is linked to better health.
 It is a source of emotional reassurance and provides a safe
place for a person to discuss his problems, which helps him
to cope with adversity.
 It provides information and practical support, such as
knowing someone who can assist in a time of need. It can
also support people in making healthier behaviour choices.

15. Health Services
 Access and use of services that prevent and treat disease influences
health.
 Both access to health services and the quality of health services can
impact health.
 Lack of access, or limited access, to health services greatly impacts an
individual’s health status. For example, when individuals do not have
health insurance, they are less likely to participate in preventive care
and are more likely to delay medical treatment.

16. Health Services 2
 Barriers to accessing health services include:
Lack of availability
High cost
Lack of insurance coverage
Limited language access
 These barriers to accessing health services lead to:
Unmet health needs
Delays in receiving appropriate care
Inability to get preventive services
Hospitalizations that could have been prevented

17. Individual Characteristics and
Behaviours.
 Individual behavior also plays a role in health outcomes.
For example, if an individual quits smoking, his or her risk
of developing heart disease is greatly reduced.
Examples of individual behavior determinants of health
include:
Diet
Physical activity
Alcohol, cigarette, and other drug use
Hand washing

18. Individual Characteristics – Biological
and Genetic Makeup
 Inheritance plays a part in determining lifespan, healthiness and
the likelihood of developing certain illnesses, personal
behaviour and coping skills.
 Some biological and genetic factors affect specific populations
more than others. E.g., older adults are biologically prone to
poorer health than adolescents due to effects of aging.
 Sickle cell disease is a common example of a genetic determinant
of health.

19. Individual Characteristics – Gender
 Gender refers to "the array of socially constructed roles and
relationships, personality traits, attitudes, behaviours, values,
relative power and influence that society ascribes to the two
sexes on a differential basis.“
 Men and women suffer from different types of diseases at
different ages.
 Examples include the exploitation of women in the sex trade,
underage marriage, or the work conditions in sweat shops in the
garment industry. Single parents are almost always women, the
lower income of women also affects their children.

20. Individual Characteristics – Early
Childhood Development
 Early nutrition, physical development and fitness are
important, as is emotional development which, if positive,
builds resiliency, and if negative, enhances vulnerability.
 Timing of exposures and experiences can be critical.
 For example, traumatic experiences in early childhood
shape personality and have a lasting impact on how a
person views his world, how he relates to others, and how
he interprets events.
 The impact of broken homes, chronic childhood stresses
etc. have non-specific effects, acting mainly to increase
emotional vulnerability in adult life.

21. Implication for Nursing
 Advances in health care have conferred immense benefits
on health and longevity for developed and many
developing countries.
 The invention of antibiotics, antisepsis, life-saving surgical
procedures, as well as advances in nursing process, have all
revolutionized the management of a wide range of diseases.
 Health interventions (sanitation, communicable disease
control measures, etc.) and disease prevention
(immunization, tobacco control measures, and screening)
have made major contributions to saving lives and
improving health.

22. Implication for Nursing 2
 Relatively simple measures, such as protecting water supplies,
often have the greatest impact on overall health. Similar
historical declines occurred for polio, smallpox, and whooping
cough, all of which responded dramatically to improvements in
hygiene long before effective medical treatments were
developed.
 Many public health and health care interventions focus on
changing individual behaviors such as substance abuse, diet,
and physical activity. Positive changes in individual behavior can
reduce the rates of chronic disease in this country.

23. Implication for Nursing 3
 The importance of holistic care to the client must be
emphasized- which can only be achieved with the use of
nursing process.
 Also, preventive care is a major aspect of nursing, which
nurses should render to their clients.