A working map for tracking factors
influencing or producing health:
S McDonnell MD MPH
Factors Influencing Health - Topics Map
8. Health
System
2. Biology
7.Environment
Outputs
Behavior
Vertical Axis
Individual
Family
Community
Population
6. Policy
3. PsychoSocio-cultural
Health Status
4. Economics
5. Education
Input and outcome
Factors influencing health: Complex Adaptive Systems
Population
Community
Groups
Individual
The vertical axis
The horizontal Axis
The positive and negative
Factors “determinants”
These interact in every axis. From here we would have
The two lines braid and re-braid and re-braid.
Health in balance: Analyze forces and weight
Pathology & stressed
Resilience & well-being
--Non-random distribution of many forces interacting at
multiple levels -- between individuals and populations
--Forces may be positive or negative but, the issue is how
they balance in total
--The effects are not just emotional or temporary. Instead,
reflect patterns of advantage or loss in society that
accumulate over a lifetime = “pile up” of risk or advantage
Factors Influencing Health” - Topics Map
1. Overview
8. Health
System
2. Biology
7.Environment
9. Outputs
Behavior
Vertical Axis
Individual
Family
Community
Population
6. Policy
3. PsychoSocio-cultural
10. Health Status
4. Economics
5. Education
Input and outcome
The context of individual and community “health” - Topics Map
1. Overview
genetics
pathology
biochemistry
8. Health
System
2. Biology
9. Outputs
Behavior
7.Environment
Vertical Axis
Individual
Family
Community
Population
6. Policy
3. PsychoSocio-cultural
10. Health Status
4. Economics
5. Education
Input and outcome
Cultural model and forces on health
The mind-body connection --over time and across cultures
the interaction and effects have been explain or dismissed,
obvious or invisible
In our culture of medical science the question of how and
perhaps, whether our thoughts and emotions are important
to our health and physical well-being is controversial
How are the most important elements in our lives embodied?
Explanatory models existed but were disconnected from
medical science and public health
The context of individual and community “health” - Topics Map
1. Overview
8. Health
System
9. Outputs
Behavior
2. Biology
7.Environment
Anthropology
Vertical Axis
Individual
Family
Community
Population
6. Policy
3. PsychoSocio-cultural
religion
10. Health Status
sociology
race
class
4. Economics
5. Education
Input and outcome
Determinants “Map”
1. Overview
8. Health
System
2. Biology
7. Environment
9. Outputs
Behavior
3. PsychoSocio-cultural
Vertical Axis
Individual
Family
Community
Population
10. Health Status
6. Policy
4. Economics
Input and outcome
5. Education
Individual
wealth
Social
wealth
Socio-econ
gradient
Determinants “Map”
1. Overview
8. Health
System
2. Biology
7. Environment
9. Outputs
Behavior
3. PsychoSocio-cultural
Vertical Axis
Individual
Family
Community
Population
10. Health Status
6. Policy
4. Economics
Input and outcome
5. Education
Individual
wealth
Social
wealth
Socio-econ
gradient
Determinants “Map”
1. Overview
8. Health
System
2. Biology
7. Environment
9. Outputs
Behavior
3. PsychoSocio-cultural
Vertical Axis
Individual
Family
Community
Population
10. Health Status
6. Policy
4. Economics
Input and outcome
5. Education
Literacy
Years of
education
Health
literacy
Determinants “Map”
1. Overview
8. Health
System
2. Biology
7. Environment
9. Outputs
Behavior
Vertical Axis
Individual
Family
Community
Population
3. PsychoSocio-cultural
10. Health Status
Government
6. Policy
4. Economics
5. Education
Enforcement
Legislation
Input and outcome
Determinants “Map”
Built
Natural
1. Overview
8. Health
System
2. Biology
7. Environment
9. Outputs
Behavior
Vertical Axis
Individual
Family
Community
Population
6. Policy
3. PsychoSocio-cultural
10. Health Status
4. Economics
5. Education
Input and outcome
Determinants “Map”
Clinical
Medicine
Public
Health
1. Overview
8. Health
System
2. Biology
7. Environment
9. Outputs
Behavior
Vertical Axis
Individual
Family
Community
Population
6. Policy
3. PsychoSocio-cultural
10. Health Status
4. Economics
5. Education
Input and outcome
The context of individual and community “health” - Topics Map
1. Overview
8. Health
System
2. Biology
7.Environment
9. Outputs
Behavior
Vertical Axis
Individual
Family
Community
Population
6. Policy
3. PsychoSocio-cultural
10. Health Status
4. Economics
5. Education
Input and outcome