The health of individuals and communities is determined by many different factors that we call the determinants of health.
When I coach many of my patients, especially my younger patients, I encourage them to pursue their dreams, do meaningful work, build strong relationships, take risks, find their calling and live it out, do great work for their companies, and take steps to be extremely productive for their companies. I do this because I know that income is the greatest determinant of health.
I frequently tell them that their zip code, their level of education, the kind of work, the kinds of relationships they have will have a bigger impact on their health than a short visit to see me yearly, taking vitamins, or undergoing cancer screening. Of course, all of these things are important as well.
The things that really determine health lie beneath the surface. Only wise people notice them and work on them.
People’s circumstances and environment play a huge part in determining whether they are healthy or not. We know that nature (genetics) and nurture (environment) determines our health.
Many people consider things like genetics and access and use of healthcare resources to be determinants of health. And they do. However, what many people don’t know is that those things have much less impact on people’s actual health. The things that are not commonly spoken of such as where we live, the state of our environment, our income and education level and our relationships with friends and family all have a much bigger impact on health.
If you spend a significant amount of time in the medical world, like those of us nurses, physicians, etc, who work in that field, It will not be long before you notice someone blaming a patient for not losing weight, quitting smoking, lowering their cholesterol, exercising or something like that. Some medical professionals have outright blamed patients for their predicament. The truth of the matter is that the context of people’s lives determines most of their health outcomes. A lot of times, people aren’t directly able to control many of the determinants of health so blaming them for poor health or congratulating them for good health isn’t really something that a single person gets credit for. Forces much bigger than us often help us get where we are.
Don’t get me wrong, I don’t mean that we should see ourselves as helpless victims. I also don’t mean that we have no part to play in determining our health outcomes. We definitely do. We are the pilots of our own planes. But we don’t determine the weather. We are the sailors of our own ships but we don’t control the winds and the storms. The weather is just worse for some people regardless of how skillful they are as sailors. Some people are just so lucky the weather is not only good but the wind is blowing in their direction and life has worked for them so much better to help them get where they are.
