Figure 1

A model of the determinants of health. Source: Reprinted from R.G. Evans and G.L. Stoddart, ''Producing Health, Consuming Health Care,''  Social Science and Medicine 31:1359, with permission from Elsevier Science Ltd, Kidlington, UK.

also differentiates among disease, health and function, and well-being. They are affected by separate but overlapping factors, and therefore, indicators selected to monitor health improvement programs may need to differ depending on which outcome is of primary interest. The model also reinforces the interrelatedness of many factors. Outcomes are the product of complex interactions of factors rather than of individual factors operating in isolation. It was suggested that the interactions among factors may prove to be more important than the actions of any single factor.

Each of the factors included in the model is considered briefly in turn.

Social Environment

Among the elements of the social environment that have been linked to health are family structure, the educational system, social networks, social class, work setting, and level of prosperity.



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement