Social Determinants of Health

This month’s article focuses on the definition of health. This past summer, I spent a significant amount of time in various communities, meeting and talking to various people about health and wellness. Through these experiences, I saw first-hand where people live, places they eat, work and socialize. Many shared personal stories about their health experiences, including their attitudes, beliefs, knowledge about health in general and health risks. One thing that stood out, time and time again, was that the definition of health differs from person to person. Furthermore, how their definition of health directly impacts the approaches they use for living healthfully.

Some of the people I talked to said, “Health is defined as having no aches or pain in the body.” Others said, “Health is feeling good and able to eat and drink everything without getting sick.” Still others said, “Health is having a sound mind, no diseases and no physical limitations.”  And the list of different definitions goes on and on.

So what is the official definition of health, and who is the authority for defining it?

The definition of health dates back to 1946 when the World Health Organization (WHO) defined health as “the absence of disease or infirmity.” In 1948, WHO changed the definition and defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” This definition has not been amended by WHO since 1948.

Forty years later, in 1979, several health indicators were highlighted in the United States Department of Health and Human Services Healthy People reports, which provides science-based, 10-year national objectives for improving the health of all Americans.  To date, four reports have been released.

These Healthy People reports recognize that factors like poverty, income, education, housing, access to care, availability of healthful food, exposures to life-threatening toxins, health literacy, cultural competency and others can impact a person’s current health status, risk for certain conditions and diseases as well as affect disease onset or postponement.

Today, in 2015, the definition of health is more inclusive of physical and psychosocial factors due to the Healthy People reports, advances in modern medicine and discussions among the medical and scientific community about factors that contribute to a person’s current state of health.  These factors are defined by the Centers for Disease Control (CDC) as the Social Determinants of Health.

According to the CDC, “Social Determinants of Health are the circumstances in which people are born, live, learn, work, play, worship and age as well as the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies and politics.”

To learn more about social determinants of health, visit the CDC’s website at

You can also send your health questions to ¡Hola, Oralia! at  Together we can help keep Pennsylvania residents healthy.  ¡Salud!

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