FACTORS THAT

INFLUENCE HEALTH
BY E. CHAULUKA
INTRODUCTION
• There are a great many factors that affect the
health of a community.
• As a result, the health status of each community is
different.
• These factors may be physical, social, and/or
cultural.
• They also include the ability of the community to
organize and work together as a whole as well as
the individual behaviors of those in the community
1. Physical Factors

• Physical factors include the influences

of geography, the environment,
community size, and industrial
development.
GEOGRAPHY
• A community’s health problems can be directly influenced by its
altitude, latitude, and climate.
• In tropical countries where warm, humid temperatures and rain
prevail throughout the year, parasitic and infectious diseases
are a leading community health problem
• In many tropical countries, survival from these diseases is made
more difficult because poor soil conditions result in inadequate
food production and malnutrition.
• In temperate climates with fewer parasitic and infectious
diseases and a more than adequate food supply, obesity and
heart disease are important community health problems.
Environment

• The quality of our environment is directly related to the

quality of our stewardship over it.
• Many experts believe that if we continue to allow
uncontrolled population growth and continue to
deplete nonrenewable natural resources, succeeding
generations will inhabit communities that are less
desirable than ours
• Many feel that we must accept responsibility for this
stewardship and drastically reduce the rate at which
we foul the soil, water, and air.
Community Size

• The larger the community, the greater its range of health problems
and the greater the need for its number of health resources.
• For example, larger communities will need more health
professionals and better health facilities than smaller communities.
• These resources are often needed because communicable diseases
can spread more quickly and environmental problems are often
more severe in densely populated areas.
• It is important to note that a community’s size can impact both
positively and negatively on that community’s health.
• The ability of a community to effectively plan, organize, and utilize
its resources can determine whether its size can be used to good
advantage.
Industrial Development

• Industrial development, like size, can have either positive or negative effects on
the health status of a community.
• Industrial development provides a community with added resources for community
health programs, but it may bring with it environmental pollution and
occupational illnesses.
• Communities that experience rapid industrial development must eventually
regulate the way in which industries:
Ø obtain raw materials,
Ø discharge by-products,
Ø dispose of wastes,
Ø treat and protect their employees, and
Ø clean up environmental accidents.
• Unfortunately, many of these laws are usually passed only after these communities
have suffered significant reductions in the quality of their life and health.
2. Social and Cultural Factors

• Social factors are those that arise from the interaction of individuals or groups within
the community.
• For example, people who live in urban communities, where life is fast-paced,
experience higher rates of stress-related illnesses than those who live in rural
communities, where life is more leisurely.
• On the other hand, those in rural areas may not have access to the same quality or
selection of health care (i.e., providers, hospitals, or medical specialists) that is
available to those who live in urban communities.
• Cultural factors arise from guidelines (both explicit and implicit) that individuals
“inherit” from being a part of a particular society.
• Culture “teaches us what to fear, what to respect, what to value, and what to regard as
relevant in our lives.”
3. Beliefs, Traditions, and Prejudices

• The beliefs, traditions, and prejudices of community members can

affect the health of the community.
• The beliefs of those in a community about such specific health
behaviors as exercise and smoking can influence policy makers on
whether or not they will spend money on creating recreation playing
ground and no-smoking ordinances.
• The traditions of specific ethnic groups can influence the types of food,
restaurants, retail outlets, and services available in a community.
• Prejudices of one specific ethnic or racial group against another can
result in acts of violence and crime.
• Racial and ethnic disparities will continue to put certain groups, such as
certain religious groups or tribes, at greater risk.
4. Economy
• Both national and local economies can affect the health of a community through
reductions in health and social services.
• An economic downturn means lower tax revenues and fewer contributions to
charitable groups.
• Such actions will result in fewer financial resources being available for programs
such as welfare, food distribution, community health care, and other
community services.
• This occurs because revenue shortfalls cause agencies to experience budget
cuts.
• With less money, these agencies often must alter their eligibility guidelines,
thereby restricting aid to only the neediest individuals.
• Obviously, many people who had been eligible for assistance before the
economic downturn become ineligible.
• Employers usually find it increasingly difficult to provide health benefits for their
employees as their income drops.
• The unemployed and underemployed face poverty and deteriorating health.
• Thus, the cumulative effect of an economic downturn significantly affects the
health of the community
5. Politics
• Those who happen to be in political office, either nationally or
locally, can improve or jeopardize the health of their community
by the decisions they make.
• In the most general terms, the argument is over greater or lesser
governmental participation in health issues
• For example, there might be long-standing discussion on the
extent to which the government should involve itself in health
care.
• However, as the cost of health care continues to grow, the
government can see the need for some kind of increased
regulation.
• Local politicians also influence the health of their communities
each time they vote on health-related measures brought before
them.
6. Religion

• A number of religions have taken a position on health care.

• For example, some religious communities limit the type of medical
treatment their members may receive.
• Some do not permit immunizations; others do not permit their
members to be treated by physicians.
• Still others prohibit certain foods.
• Some religious communities actively address moral and ethical issues
such as abortion, premarital intercourse, and homosexuality.
• Still other religions teach health-promoting codes of living to their
members.
• Obviously, religion can affect a community’s health positively or
negatively
7. Social Norms

• The influence of social norms can be positive or negative and can

change over time.
• Previously, smoking was acceptable in the communities
• The lawsuits against tobacco companies by both the state
attorneys general and private citizens provide further evidence
that smoking has fallen from social acceptability.
• As such many public places do give instructions not to smoke
many public places, with the aim to improve the health of the
community.
• Unlike smoking, alcohol consumption represents a continuing
negative social norm in many communities especially on college
campuses.
8. Socioeconomic Status (SES)

• The gap in health status and mortality between those commanding, and those
who lack, economic power and social resources continues to widen.
• These parallel trends—of growing economic inequalities and growing social
inequalities in health—reflect, in part, the relationship between people’s
socioeconomic position as consumers and employers or employees and their
social, biological, and mental wellbeing.”
• That is, those in the community with the lowest socioeconomic status also have
the poorest health and the most difficulty in gaining access to health care.
• The point of entry into the health care system in Malawi is the health post
• The economically disadvantaged seldomly go to the higher level of health care.
• In addition to health care access, higher incomes enable people to afford better
housing, live in safer neighborhoods, and increase the opportunity to engage
in health promoting behaviours
9. Community Organizing
• The way in which a community is able to organize its resources directly influences
its ability to intervene and solve problems, including health problems.
• Community organizing “is a process through which communities are helped to
identify common problems or goals, mobilize resources, and in other ways
develop and implement strategies for reaching their goals they have collectively
set.”
• It is not a science but an art of building consensus within a democratic process.
• If a community can organize its resources effectively into a unified force, it “is
likely to produce benefits in the form of increased effectiveness and productivity
by reducing duplication of efforts and avoiding the imposition of solutions that
are not congruent with the local culture and needs.”
• For example, many communities in Malawi have faced shortage of classroom
blocks for their children
• Some have been able to organize their resources e.g. molding of bricks to reduce
or resolve these problems while others have not.
10. Individual Behaviour
• The behavior of the individual community members contributes
to the health of the entire community.
• It takes the concerted effort of many—if not most—of the
individuals in a community to make a program work.
• For example, if each individual consciously recycles his or her
trash each week, community recycling will be successful.
Likewise, if each household would have their own toilet and
bathroom, there would be significant reduction of diarrheal
diseases and conflicts with neighbours
• In another example, the more individuals who become
immunized against a specific disease, the slower the disease
will spread and the fewer people will be exposed.
• This concept is known as herd immunity.