Midcourse Review Data Are In! Check out our interactive infographic to see progress toward the Social Determinants of Health objectives and other Healthy People topic areas. Goal Create social and physical environments that promote good health for all. Overview Health starts in our homes, schools, workplaces, neighborhoods, and communities.
These behaviors involve motivational and reward systems within the individual that develop through gene interactions with the social environment.
Therefore, a better understanding of the genetic, social environmental, and individual determinants of risk behaviors, such as tobacco use, unhealthy eating behaviors, and physical inactivity could contribute to improved strategies for primary, secondary, and tertiary disease prevention.
Models of gene, environment, and behavior interactions in disease have been proposed, one of which has been adapted here to illustrate the central role of health risk behaviors Rebbeck, Risk behaviors such as tobacco use, unhealthy eating behaviors, and physical inactivity play an important role in models of genetic and environmental interactions in health outcomes.
As illustrated in Figuregene-environment interactions contribute to the initiation and maintenance of these risk behaviors, which in turn increase risk for poor health outcomes pathway a. In addition, gene-environment interactions can modify the effects of these risk behaviors on disease states and health outcomes pathway b and also can have direct effects on health outcomes pathway c see also models of gene-environment interactions in Chapter 8 and Appendix E.
The goal of this chapter is three-fold: Increasingly, studies of the determinants of tobacco use, including genetic studies, are using more refined behavioral definitions to characterize trajectories of smoking initiation and progression, as well as phenotypes related to nicotine addiction and smoking persistence Audrain-McGovern et al.
The definition of obesity is more straightforward. Broadly speaking, physical activity includes any bodily muscular movements that produce energy expenditure Caspersen et al.
To reduce health risks, it is recommended that healthy adults engage in at least minutes of moderate intensity physical activity per week Pate et al. The importance of phenotype definition for investigations of genetic risk factors and gene-environment interaction cannot be overestimated.
Increasingly, studies are focusing on intermediate phenotypes, the intermediate measures of these health behaviors that are considered more proximal to the biological determinants. For example, in studies of tobacco use, laboratory-based intermediate phenotypes have included individual differences in the rewarding value of nicotine, the psychophysiological and cognitive effects of nicotine, as well as the effects of nicotine tolerance and deprivation Munafo et al.
In obesity studies, psychological intermediate markers have included the reinforcing value of food, food preferences, food intake, and satiety see Appendix C for additional discussion. As discussed in more detail below, these intermediate phenotypes also may include the dimensions of personality and temperament that are partly biologically based and that may increase the likelihood that an individual will engage in health risk behaviors.
Smoking rates remain higher in persons who have less than a high school education, compared to college graduates. Furthermore, 18 percent of year-olds and 58 percent of high school students report having smoked a whole cigarette CDC, b.
Tobacco use is the leading cause of preventable mortality in the United States, accounting for one in five cancer deaths CDC, ; Mokdad et al.
Furthermore, continued smoking following a diagnosis of cancer increases the risk of recurrence and reduces the likelihood of survival Browman et al.
The nicotine in cigarettes is known to have significant adverse effects on cardiovascular function Benowitz and Gourlay,and smoking cessation following an acute myocardial infarction can reduce mortality rates Kinjo et al. Nicotine, thiocyanate, and other toxins in cigarette smoke also can impair thyroid, pituitary, and renal function and contribute to insulin resistance Kapoor and Jones, Evidence from rodent models suggests that nicotine also may alter antibody formation and T-cell function Friedman and Eisenstein, Genetic and Environmental Determinants of Tobacco Use Motivation to begin smoking is strongly influenced by the social environment, although genetic factors also play a role Audrain-McGovern et al.
Risk factors for smoking initiation in youth include peer and family smoking, family conflict, and exposure to tobacco industry promotional campaigns Pierce et al.
In contrast, physical activity has protective effects on youth smoking Audrain-McGovern et al. The importance of the social environment also is supported by evidence for the efficacy of some anti-tobacco media campaigns, smoke-free environment policies, and cigarette taxes Holm, ; Chaloupka et al.
Once tobacco use has been initiated, smoking cessation can be difficult because of the development of an addiction to nicotine. There is abundant evidence from animal and human studies for an inherited susceptibility to the rewarding effects of nicotine and to nicotine addiction.
In fact, data from twin studies indicate that as much as 70 percent of the variance in nicotine addiction is attributable to genetic factors Sullivan and Kendler, While several genetic associations have been reported in the literature, heterogeneity in ascertainment, population stratification, and limitations in phenotype definition have contributed to nonreplication Lerman and Swan, ; Munafo and Flint, ; Redden et al.
Given the importance of smoking persistence to health outcomes, efforts are increasing to elucidate the role of inherited genetic variation in response to pharmacotherapies for nicotine dependence Lerman et al.
Clearly, tobacco use and nicotine addiction are complex traits arising from the interactions among social-environmental, psychological, and genetic factors Swan et al. For example, evidence from twin studies suggests that the importance of genetic factors in cigarette smoking depends, in part, on family functioning Kendler et al.
Specifically, the heritability estimates for cigarette smoking were lower in families with reports of higher levels of family dysfunction. This finding highlights both the importance of gene-environment interactions in risk behaviors, as well as the potential for identifying and quantifying such interactions through careful research.
Furthermore, the genetic effects on the progression to regular smoking among adolescents are greatest among those with higher levels of depressive symptoms Audrain-McGovern et al.Abstract. We review three approaches to the genetic analysis of the biology and pathobiology of human aging.
The first and so far the best-developed is the search for the biochemical genetic basis of varying susceptibilities to major geriatric disorders.
There are many determinants of health, most of which can be found from official sources like the World Health Organization. As for what, in general, they are, they can be viewed as factors, influences or general variables which affect an individual's health.
The determinants of health Introduction. Many factors combine together to affect the health of individuals and communities. Whether people are healthy or not, is . Jun 16, · Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
An ecological approach focuses on both individual-level and population-level determinants of health and interventions. About Determinants of Health.
The range of personal, social, economic, and environmental factors that influence health status are known as determinants of health.
Biology and genetics; Examples of social determinants. Sep 15, · This is why it is critical to improve the social determinants of health — because, in addition to the growing evidence base, it is the fair and just thing to do. Several papers in this issue contribute to the literature on social determinants and their indicators and are grounded in these key concepts of resources and relationships.