Determinants of Health
The health status of individuals and communities at any location is a factor of the combined effect of biological, environmental and sociological conditions. Bronfenbrenner (1979) Ecological System Theory (EST) describe the determinants of health for individuals through their interaction with the environments in which they live. The EST model is based on the notion that an individual’s health status is subject to both intrinsic personal factors and extrinsic environmental aspects. These factors, however, can be altered to improve or hinder a person’s development and thus, health status. For instance, a person living in an environment characterized by violence situations will be exposed to factors likely to impede his or her health status, and therefore, higher chances for developing mental illnesses and/or deteriorating physical health (Betancourt & Khan, 2008). Such health outcomes can, however, be minimized should these individuals have access to, and comply with the health care services in their locality. This implies that individuals can influence their own health status and thus are not a passive recipient of their environmental conditions. The EST model assumes three systems coherent to individual’s health, that is micro-system, macro-system and chronosystem. Micro-system consists of the factors immediately apparent to an individual while macro-system refers to socio-cultural factors. Chrono-system is the contexts or events influencing the community.
ETS and Determinants of Health
Determinants of health refer to a multitude of varying social, economic and environmental factors as well as person’s individual traits and behaviors that determine the quality of person’s health. To a large extent, factors related to places where we live, the condition of our environment, genetics, income and education, family relationships and friendships impact our health. The increasing concern and research on mental health have led to a detailed inquiry on biological and genetic factors, family and social factors and socio-cultural factors affecting mental health. According to Weir (2012), biological factors account for nearly 40% of mental illness such as dementia, autism and bipolar disorder among others. On the other hand, family and social factors highly influence person’s mental health as they play an essential role in the individual microsystem as described in the EST. This field provides a strong social intervention area for improving mental health. Socio-cultural factors present the external underlying factors in mental health. These include the environmental factors that affect the quality and safety of living conditions and thus influence both physical and mental health (Fisher & Baum, 2010). Different individuals are affected differently by these factors depending on their living conditions and access to healthcare services.
Response by Mental Health Clinicians to Coexisting Conditions
The occurrence of coexisting conditions often presents a challenge to the healthcare systems because of the high number of physical and mental conditions that can affect a person. For instance, people with chronic disease are more likely to have mental health issues. Various clinical approaches can be employed to assist people with coexisting conditions. They include dual diagnosis and psychopharmacology. Dual diagnosis is a simultaneous treatment of mental illness and drug/alcohol disorder. This approach helps eliminate impacts of rehabilitative programs such as stigma, self-shame and inability to treat both disorders efficiently (Deans & Soar, 2005). Psychopharmacology, on the other hand, involves the use of medication to treat mental illness. The effectiveness of this method is dependent on various factors such as person’s affordability of the medicine, regulation of chemical levels, coping with side effects and managing the symptoms. Effective treatment of mental illness requires an evaluation of the physical needs of the affected individual and proper management of health care system.
1. Betancourt, T. and Khan, K. (2008) The Mental Health of Children Affected by Armed Conflict and Pathways to resilience. Internal Review Psychiatry, 20(3), 317-328.
2. Bronfenbrenner, U. (1989). Ecological Systems’ Theory. Annals of Child Development. 6(1), 187-249.
3. Weir, K. (2012). The Roots of Mental Illness: How Much Can Mental Illness be Explained by the Biology of the Brain. American Psychological Association, 43(6), 30-37.
4. Fisher, M., & Baum, F. (2010). The Social Determinants of Mental Health: Implications for Research and Health Promotion. The Australian And New Zealand Journal of Psychiatry, 44(12), 1057-1063,
5. Deans, C., & Soar, R. (2005). Caring for Clients with Dual Diagnosis in Rural Communities in Australia: The Experience of Mental Health Professionals. Journal Psychiatric Mental Health Nursing, 12(3), 268-274.