page_title: Health
section_title: Determinants
hierarchical_section_title: Health / Determinants
caption_attribution_description: English: Standing left to right, this 1966 image showed Dr. Donald A. Henderson, Dr. J. Donald Millar, Dr. John J. Witte, and, Dr. Leo Morris, standing in one of the Centers for Disease Control and Prevention’s (CDC) former offices discussing what may have been epidemiologic findings related to the eradication of smallpox, an effort in which the CDC was integrally involved at the time. Dr. Donald A. Henderson, headed the international effort during the 1960s to eradicate smallpox. Dr. J. Donald Millar, was the former Director of the National Institute for Occupational Safety and Health (NIOSH) from 1981 through 1993 From 1963 until 1970, he directed CDC's Smallpox Eradication Program. Dr. John J. Witte, was the former Chief of the organization’s Immunization Branch, and Dr. Leo Morris who specialized in statistical analysis, and implementation of the newly-introduced jet injector vaccine-delivery system in the battle against smallpox.
context_page_description: Health is a state of physical, mental and social well-being in which disease and infirmity are absent.
context_section_description: Generally, the context in which an individual lives is of great importance for both his health status and quality of their life. It is increasingly recognized that health is maintained and improved not only through the advancement and application of health science, but also through the efforts and intelligent lifestyle choices of the individual and society. According to the World Health Organization, the main determinants of health include the social and economic environment, the physical environment and the person's individual characteristics and behaviors.
  More specifically, key factors that have been found to influence whether people are healthy or unhealthy include the following:
  
  
   
  Income and social status
  Social support networks
  Education and literacy
  Employment/working conditions
  Social environments
  Physical environments
   
  Personal health practices and coping skills
  Healthy child development
  Biology and genetics
  Health care services
  Gender
  Culture
   
  An increasing number of studies and reports from different organizations and contexts examine the linkages between health and different factors, including lifestyles, environments, health care organization and health policy, one specific health policy brought into many countries in recent years was the introduction of the sugar tax. Beverage taxes came into light with increasing concerns about obesity, particularly among youth. Sugar-sweetened beverages have become a target of anti-obesity initiatives with increasing evidence of their link to obesity.– such as the 1974 Lalonde report from Canada; the Alameda County Study in California; and the series of World Health Reports of the World Health Organization, which focuses on global health issues including access to health care and improving public health outcomes, especially in developing countries.
  The concept of the "health field," as distinct from medical care, emerged from the Lalonde report from Canada. The report identified three interdependent fields as key determinants of an individual's health. These are:
  Lifestyle: the aggregation of personal decisions (i.e., over which the individual has control) that can be said to contribute to, or cause, illness or death;
  Environmental: all matters related to health external to the human body and over which the individual has little or no control;
  Biomedical: all aspects of health, physical and mental, developed within the human body as influenced by genetic make-up.
  The maintenance and promotion of health is achieved through different combination of physical, mental, and social well-being, together sometimes referred to as the "health triangle." The WHO's 1986 Ottawa Charter for Health Promotion further stated that health is not just a state, but also "a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities."
  Focusing more on lifestyle issues and their relationships with functional health, data from the Alameda County Study suggested that people can improve their health via exercise, enough sleep, spending time in nature, maintaining a healthy body weight, limiting alcohol use, and avoiding smoking. Health and illness can co-exist, as even people with multiple chronic diseases or terminal illnesses can consider themselves healthy.
  The environment is often cited as an important factor influencing the health status of individuals. This includes characteristics of the natural environment, the built environment and the social environment. Factors such as clean water and air, adequate housing, and safe communities and roads all have been found to contribute to good health, especially to the health of infants and children. Some studies have shown that a lack of neighborhood recreational spaces including natural environment leads to lower levels of personal satisfaction and higher levels of obesity, linked to lower overall health and well being. It has been demonstrated that increased time spent in natural environments is associated with improved self-reported health , sugg
caption: Donald Henderson as part of the CDC's smallpox eradication team in 1966.
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