Considering the recent natural disasters affecting people around the world; it is a good reminder to underscore the factors that affect health beyond just health behaviors. Look around you – where you live, work, learn, and play - are there factors that affect your ability, your neighbors, or your community’s ability to be healthy? Those factors or often referred to as social determinants of health, including education, income, access to care, etc., affect a wide range of health, function, and quality-of-life outcomes.
The news has highlighted the public health threats to residents affected by recent events, such as poor housing and disease, air quality, access to care. While there are many new factors that affect residents, some factors have affected residents before, and likely will for years to come. Take low income populations living in these affected areas who may normally have reduced access to quality health care, good housing, healthy foods – then add in a natural disaster, and many of those factors are exacerbated because they simply do not exist anymore or there is limited resource available.
Access to and the availability of resources to enrich the quality of life, social engagement, and health behavior patterns are affected by where people live. Research findings that have emerged over the past 10 years, highlight what factors truly affect our health…and it is not just genetics. The University of Wisconsin Population Health Institute’s County Health Ranking model has identified that a population’s health is shaped 40 percent by social and economic factors, 30 percent by health behaviors, 20 percent by clinical care, and 10 percent by the physical environment. Chronic diseases have topped infectious disease as the leading cause of mortality and morbidity across the world. Populations are also migrating from rural communities to urban communities, however, they both have their challenges with supporting a healthy community as a result of social determinants of health.
The community I reside in - a city of approximately 175,000 people – would presumably have an abundance of resources available to all residents to ensure healthy living. There are a high number of restaurants per capita. Grocery stores are present throughout the city. Educational opportunities of all levels are available. The unemployment rate is considerably lower than other cities in the state and across the nation. However, take a second look and the reality is gaps in resources exist, which are sometimes exacerbated due to the size, such as poor housing, crime, or income gaps.
As I recently drove through rural communities outside of the city limits, I observed similar factors that affect rural and urban communities. My neighborhood is quiet, but just like some of the rural communities I drove through, sidewalks are not readily available to access safe areas to be physically active. And forget crossing the busy street in my neighborhood at rush hour, unless I want to play ensue in a game of “Frogger”. Access to grocery stores and healthy foods can also be a challenge, based on transportation available, types of food available, food costs, and the distance to the nearest grocery store. Even in a large city where I live there are food deserts, where a substantial share of residents who are low-income also have low access to a supermarket or large grocery store.
I sometimes overhear comments that a person considered overweight or obese, “should just exercise and eat healthy to lose weight.” While those behaviors are important, it especially important to remember there are many of factors that could be contributing that individual’s health, such as living in a poor housing development with no access to sidewalks and a high crime rate. If that individual does not have the resources to engage in physical activity, getting outside for a walk does not sound too appealing considering the factors against that person. That same individual may not have access to healthy foods and relies solely on a convenience store for food, which often is limited in the availability of healthy foods.
So as you go about your day, living, working and learning – pay attention to what factors affect the health of your colleagues, neighborhood or community. To truly improve health of a population it is important to understand what truly affects health and start there.