Overview

Mei, age 11, and her family live in an apartment in the city. Every day, they hear the noise of the cars, trucks, and buses that drive past their home. As she and her younger sister, Chao, walk to school, they cross many busy streets. The school has been funded to provide breakfast and lunch for all students, but this funding is ending soon. Mei takes Chao to the corner park after school each day, unless Chao’s asthma is bad, where they play with neighborhood children for a while before heading home. In the evening, their mother arrives home from work before their father and makes dinner for the family. Then the girls work on homework and go to bed. On the weekends and on school vacations, the family likes to get out of the city so they can explore parks and natural areas near their home.

Many aspects of our daily lives influence our health. Beyond physical activity and genetics, environmental, sociological and cultural factors can have profound effects on physical, mental and emotional health. In the preceding scenario, Mei and her family may experience environmental exposures from living in the city and from traffic pollutants. They also may experience structural and institutional racism and disparities that affect their environments, their education and their careers. On a positive note, exposure to nature in the local park and while on vacation can have a beneficial effect on the health of Mei and Chao. Social connections through family, friends and their community as well as cultural and religious support can also have positive effects on health.

In this chapter, you will be introduced to the ways in which our own decisions, our families, schools, communities and cultures affect our health through what are called social determinants of health. You will learn about ways in which public health programs and campaigns can work through primary, and secondary, and tertiary interventions to help communities lower their risks for certain illnesses, you will explore ways in which different communities may be at increased risk for illness, and you will investigate your own social determinants of health in an effort to understand how factors beyond exposure to infectious diseases can have an impact on your health and that of your patients.

Attributions

1. Chapter opening image: ILN Insights 2012 14982 – Version 3 by Ted Eytan is released under CC BY-SA 2.0