This chapter provides a summary of published literature and a framework for understanding those influences. Determinants of health are a range of factors that influence the health status of individuals or populations. At every stage of life, health is determined by complex interactions between social and economic factors, the physical environment and individual behaviour. It is the interrelationships among these factors that determine individual and population health.
Both human epidemiological and animal experimental studies support the hypothesis that relative undernutrition in the fetus results in significant and relatively permanent changes in important physiological systems . Perinatal programming indicates that sensitive or critical periods of development may have lifelong effects and influence the development of chronic diseases later in life . The role and effect of biological, behavioral, and environmental influences change as children grow. For example, a pharmacological agent like thalidomide is highly toxic within a narrow window during pregnancy but not afterward, an attachment to a caring adult is especially critical during infancy, and peer influences appear to grow steadily from toddlerhood through adolescence.
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At each new exposure, the child may respond in a variety of ways that in turn unleash a variety of reactions in his or her caregiver and in others around him. In humans, the relationship between fetal growth, postnatal growth, and the risk of such diseases as hypertension, coronary heart disease, and non-insulin-dependent diabetes have been frequently studied (Bertram and Hanson, 2002; Barker, 1998).
The hallmark of childhood is the constant exposure to new developmental challenges. As children acquire new physical and cognitive skills and experiences, their behaviors change. They explore, practice, and experiment and as a result they change and are changed. The resulting behaviors are both manifestations of their health and have significant implications for it.
- We will thus provide evidence to policymakers, researchers and health advocates which can be used to develop evidence-based economic policy interventions and clarify priorities for further research.
- Whilst we acknowledge that this list is not exhaustive, it provides an initial framework to guide our search strategy.
- We also propose an a priori simplified framework (Fig.1) to show the broad relationships between economic factors and health that we are investigating.
- Table1 presents these seven categories, related subtopics for each category at the local, national and international level as well as illustrative examples of potential health implications.
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Emotions are fundamental for human attachments, social interactions, and self-satisfaction. Therefore, testosterone supplements the extent to which infants evoke sympathetic and empathetic emotions in others and eventually develop these emotional expressions themselves greatly influences their subsequent health. The complex interplay of genetics, parenting, and societal reactions illustrates just how precarious the early years are and how central infant behavior is for subsequent health .
Even within a childhood stage, health influences can act in very different ways because of the differing cultural interpretations that families attach to them. Children’s health is determined by the interaction of a multitude of influences, reflecting complex processes. We divide these influences into biological, behavioral, and environmental even though our model of children’s health views their effects as highly intertwined and difficult to isolate.
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