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Towards a Wholistic View of Determinants of Health

by | Sep 6, 2022

Today, more than ever before, life must be characterized by a sense of Universal responsibility, not only nation to nation and human to human, but also human to other forms of life.
    – the Dalai Lama 

In this brief introductory article, we will identify 5 important determinants of health topics that have not been consistently part of the conversation. But like our global climates, that is changing.

  • Non-human species (animals and plants)

Countless wild and domesticated animals are integral to human society and have been so for millennia. As the dominant species on the planet, humans significantly impact the health of animals, as our activities interact with every environment. Most of the major frameworks for human determinants of health, however, make little mention of this well-established connection.

While more attention is paid to humans and other animals, plants also play important roles in the schema of health determinants. Plants may even contribute more significantly than animals to the determinants of health. Healthy flora not only replenishes oxygen but sequesters carbon, provides food sources, prevents soil erosion, and maintains water/humidity sources for the benefit of other living things. Conversely, connections between deforestation and negative impacts on the health of humans and animals have been well described.

  • Individual behaviors/choices

The behavioral and lifestyle choices made by every human are commonly known to be a factor in a person’s individual health and well-being. But the impact of those choices does not stop at the individual. Even if not immediate, one person’s choices ultimately will affect at least one other person or animal or environment. This all but guarantees that the impacts of individual choices will compound, either for the benefit or detriment, of determinants of health at multiple levels.

  • Shared environments

Regardless of size and composition, shared environments are like jigsaw puzzles – every piece is interconnected and the entire picture cannot be appreciated fully without every piece in its place. The interdependence of all species and their environments must be appreciated. We need to sort out in which ways we are supporting our shared environments as healthy living spaces from paths that are destructive or disruptive.

  • Regional environments

Micro-environments and macro-environments, spanning the most intimate and the most global, tend to receive the greatest share of the limelight in determinants of health discussions. What lives between, though, in regional environments also deserves our attention. This space can serve to buffer, for good or for ill, the determinants of health originating within either extreme. 

  • Mental health environments 

With renewed support this year, mental health as a determinant of health finally is taking its place alongside other key determinants of health. These settings span the range from individual to family/tribe, group to community, and regional to global. While violence, crime, and exposure to warfare have been ever present in the determinants of health conversation, factors beneficial to health tend to receive far less recognition.

  • Tribal and extended families

Studies show that, in cultures where the nuclear family is the norm to the exclusion of the extended or tribal family, health outcomes for the same illnesses are different than in cultures where these norms are reversed. This is similarly true for animals – the benefits and threats to health for animals in a group vs living in isolation are not the same. 

Over the coming weeks, the articles in this series will explore more closely these and other lesser-known yet important determinants of health. And we will do so through the lens of a wholistic view of health and well-being for all living things.

Allison A. Sakara, N.P., M.S.N., R.N., P.H.R.N.
Founder & Executive Director, High Alert Institute, Inc. (a 501c3 Not-for-Profit)

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