Factors such as access to expert medical care, a good diet, and regular physical activity are important to good health. But health is complex and there are many other factors that combine to make people healthy, or not.

The factors influencing our health are inter-related and change over the course of our lifetime. They are known as the determinants of health and include:

Income and social status: There is growing evidence that the level of our income and social status have the greatest effect on our health. The more financially secure Canadians are, the longer their life expectancy and the better their overall state of health.

Social support networks: Strong relationships within the family and the community help build a sense of caring, respect and resilience that contributes to well-being. Studies have showed that people with more social contacts are less likely to die premature deaths.

Education and literacy: Education plays a big role in our health because it gives us knowledge and skills that lead to effective problem solving, and helps provide a sense of control over life’s ups and downs. Higher education can mean higher income and job satisfaction.

Employment and working conditions: People who are unemployed, underemployed or feeling stressed at work suffer poorer health. By contrast, people with a higher degree of control over their work conditions and less job-related stress are healthier and have a longer life expectancy.

Social environments: The type of social supports available in the broader community influence our health. Cohesive communities, social stability and recognition of diversity are examples of how strong networks can provide resources and enable us to reach out to one another to create a supportive society in which potential health risks are reduced.

Physical environments: Health can be compromised as a result of contaminants in our natural environment -- our air, water, food and soil. Similarly, the quality of our homes and the way our communities and transportation systems are designed also influence our well being.

Biology and genetics: Our genetic makeup gives us curly or straight hair; it can also give us an inherited potential to develop particular diseases or health problems, such as heart disease.

Personal health practices & coping skills: Lifestyle choices we make affect our health. Behaviours such as smoking, overeating, abusing drugs and/or alcohol can certainly have a negative impact on our well-being. Such choices are affected by our upbringing and our living and working conditions.

Healthy child development: Early childhood sets the foundation for future well-being or ill health. A child’s healthy development depends on the quality of his or her housing and community, the family’s income level and parents’ education, as well as on secure relationships and a safe environment.

Gender: Men and women have different life expectancies; more men die prematurely than women. But women tend to suffer more from depression, arthritis, and injuries from family violence.

Culture: Cultural barriers can prevent some segments of a population from achieving optimum health. Attitudes towards medical professionals, a lack of language skills, cultural beliefs, and stigma can make it difficult for some people to address health issues.

Health Services: It benefits people’s health when they have access to services that prevent disease, as well as maintain and promote health. Canada’s publicly funded health care system, known to Canadians as “medicare,” provides access to universal, comprehensive coverage for medically necessary hospital and practitioner services. Access to these and other services can, however, be an issue for rural and remote communities, populations with low literacy or language barriers, immigrants and ethnocultural minorities and people living on low incomes.

A lot has been learned in recent decades about what determines health. Much of the research tells us that we need to look at the big picture of health to examine underlying factors both inside and outside the health care system that affect our health. At every stage of life, health is determined by complex interactions between social and economic factors, the physical environment and individual behavior. It is the combined influence of the determinants of health that determines what makes us healthy. Inequalities in access to the determinants of health create inequalities in health outcomes.

For more information, see:

1. Determinants of health
   Public Health Agency of Canada
   
2. Social determinants of health: the solid facts
   World Health Organization
   
3. Commission on Social Determinants of Health Link