1. Determinants of Health Jonathan Fielding Professor of Health Services and Pediatrics, UCLA Director of Public Health and Health Officer, LA County
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4. “ ...a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” World Health Organization, 1948
5. “… an individual’s capacity in relation to aspirations and potential for living fully in the social environment.” Alvin Tarlov, 1996
13. Family Environment Family Functioning Family Life-Cycle Family’s Characteristics Community, Society & Culture Individual’s Innate Characteristics Individual Health Individual’s Development Individual’s Community Community and Family Pathways to Health Family Functions
14. Family’s Characteristics Health Biological Psychological Health Behaviors Demographic Income Education Occupation Race Ethnicity Housing Residence Employment Religion Language Household Marital Status Composition Relation
15. Family Effects on Physical Aggression by Children Trembly et al., 1996
16. Hostility and Mortality by City Williams et al., 1980 Honolulu Minneapolis Seattle Denver Cleveland Detroit Des Moines New York Philadelphia Chicago
17. Psychological Problems Within Families With at Least One Child with a Psychological Diagnosis Mother (-) Mother (+) Father (-) Father (+) Father (-) Father (+) 36% 47% 68% 72% (-) Individual without diagnosis (+) Individual with diagnosis Child (+)
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20. Determinants of Individual Health Social Environment Physical Environment Genetic Endowment Individual Response -Behavior -Biology Health & Function Disease Health Care Well-Being Prosperity Source:R.G.Evans & G.L. Stoddard, Why Are Some People Healthy , p. 53
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22. Leading Causes of Death in Los Angeles County, 1997 Number of Deaths in 1999 Los Angeles County Department of Health Services
23. Overall Burden of Disease Among Men in Los Angeles County Based on DALYs, 1997
24. Overall Burden of Disease Among Women in Los Angeles County Based on DALYs, 1997
25. Among Adults (Age 18 years and older), Average Number of Activity Limitation Days by Chronic Health Condition, Los Angeles County, 1999
26. Social Ties and and 9 year Mortality in Alameda County, CA Berkman L et al. Social networks, host resistance, and mortality: A nine year follow up study of Alameda County residents. Am J Epidemiol 109:186-204, 1979. Males
27. Social Ties and and 9 year Mortality in Alameda County, CA Berkman L et al. Social networks, host resistance, and mortality: A nine year follow up study of Alameda County residents. Am J Epidemiol 109:186-204, 1979. Females
28. Income & Health Relative risk of coronary heart disease death by civil service rank- male civil service workers Marmot MG et al. Employment grade and coronary heart disease in British civil servants. J Epidemiol Community Health 3:244-249, 1978
29. Environmental Exposure Haile RW, et al. The Health Effects of Swimming in Ocean Water Contaminated by Storm Drain Runoff. Epidemiology. July 1999 10(4)p 355-363 Selected Attributable numbers/10,000 exposed subjects for total to fecal coliforms HCG- highly credible GI illness with vomiting, diarrhea, and fever or stomach pain and fever
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31. Prevalence of Asthma Among Children (Age 0 to 17 years) by Race/Ethnicity and Age, Los Angeles County, 1999 - 2000 * Estimate may be unstable due to small sample size
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35. Determinants of Health regulation regulation GENETIC ENVIORNMENT INDIVIDUAL RESPONSE: BIOLOGICAL BEHAVIORAL PSYCHOLOGICAL investment consumption workforce THE ECONOMY PUBLIC HEALTH SERVICES (POPULATION-BASED) DISEASE <------> POOR <------> OKAY <------> OPTIMUM DISABILITY HEALTH HEALTH HEALTH HEALTH SERVICES SOCIAL ENVIORNMENT PHYSICAL ENVIRONMENT
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