Unveiling the core determinants of health: beyond the stethoscope
Hello, my name is Jen and I’m Associate Director Improving Population Health – Core Determinants. I’m a public health consultant and work jointly between the West Yorkshire Integrated Care Board (WYICB) and the West Yorkshire Combined Authority (WYCA).
In this blog, we're stepping outside of a clinical setting to explore a concept that's often overlooked in the hustle and bustle of medical practice: the core determinants of health. We recognise that health is influenced by much more than just your individual genetics and the health care that you receive. That's where the core determinants of health come into play.
So, what exactly are these determinants? Simply put, they're the broader factors that shape our health outcomes, extending far beyond the walls of a hospital or clinic.
Let's explore some of these factors.
1. Socioeconomic status
Socioeconomic status encompasses factors like income, education, and occupation, all of which have a profound impact on access to healthcare, nutrition, and living conditions. Think about it – someone living in poverty may be experiencing daily stress and worry and may struggle to afford nutritious food, while those in higher income brackets have more resources at their disposal to maintain good health.
2. Environment
The air we breathe, the water we drink, the neighbourhoods we live in and the way we get around – they all contribute to our well-being. Environmental factors such as pollution, access to green spaces, public transport and community safety can either support or undermine our health. For instance, people living in areas with high levels of air pollution may face an increased risk of respiratory problems, while those with access to parks and recreational areas are more likely to engage in physical activity, boosting their overall health.
3. Education
Knowledge is power, especially when it comes to health. Education equips people with the information and skills they need to make informed decisions about their well-being. From understanding the importance of preventive care to deciphering nutrition labels, education empowers people to take control of their health outcomes. Conversely, limited access to education can perpetuate health disparities, leaving certain populations at a disadvantage when it comes to navigating the complexities of healthcare.
4. Social support networks
We're social beings by nature, and our connections with others play a vital role in our health journey. Strong social support networks provide emotional, practical, and even financial assistance during times of need, buffering against stress and adversity. Whether it's a shoulder to lean on during tough times or a workout buddy to keep you accountable, fostering meaningful relationships is essential for overall well-being.
5. Cultural factors
Culture shapes our beliefs, values, and behaviours – including those related to health. From dietary preferences to attitudes toward medical treatment, cultural factors influence how we perceive and approach health and illness. Understanding and respecting cultural differences is crucial in providing culturally competent care that meets the diverse needs of individuals and communities.
6. Policy and governance
Last but certainly not least, policy decisions and governance structures have far-reaching implications for public health. From healthcare reform to urban planning initiatives, government policies shape the environments in which we live, work, and play. Advocating for policies that prioritise health equity and social justice in national, regional and local policy making is essential in addressing the root causes of health disparities and promoting the well-being of all individuals.
There’s a strong recognition in West Yorkshire Health and Care Partnership and the West Yorkshire Combined Authority that these things that generate and sustain good health can lie outside of healthcare. We recognise that the contribution of combined authorities and local authorities is hugely influential in the health of the population, and powers and resources that are within the control of these organisations should be looking at ways of positively maximising their impact on the population’s health. That’s why partnership and voice matter so much in West Yorkshire.
Local authorities in West Yorkshire are supported to deliver this impact through the statutory role of the Director of Public Health and team. NHS West Yorkshire ICB (NHS WYICB) is supported through the Improving Population Health Programme, and the West Yorkshire Combined Authority (WYCA) is now supported through the appointments of Fatima Khan-Shah as Inclusivity Champion and myself as Associate Director for Improving Population Health (both joint appointments with the ICB).
In September 2023, a partnership agreement was signed between WYCA and NHS WYICB, as partners committed to improving the physical, mental, economic and social wellbeing of people in West Yorkshire. This also helps us deliver on one of the key purposes of an integrated care system: help the NHS support broader social economic development.
The partnership agreement sets out a set of shared commitments to working together on the factors that affect population health:
- Fair economic growth
- Climate emergency
- Tackling inequality
- Determinants of health
The agreement also sets out reciprocal governance arrangements: the West Yorkshire Health and Care Partnership Board has extended its membership to include the Mayor and Chief Executive of the Combined Authority. This agreement is supported by a work plan that includes embedding a ‘health in all policies’ approach in WYCA; programme delivery on work and health and creative health; and development of future ambition for the region.
In conclusion, the core determinants of health remind us that good health is about more than just the absence of disease – it's about creating environments and systems that support flourishing and resilience. As healthcare professionals, it's our responsibility to look beyond the symptoms and diagnoses, recognising the intricate web of factors that influence health outcomes. By addressing the wider determinants of health, we can work towards a future where everyone has the opportunity to thrive.
Thank you for reading,
Jen
@jenniferen
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