EUR/RC62/wd08 (Eng) - WHO/Europe - World Health Organization

EUR/RC62/8
page 31
Addressing the interacting determinants of health
130. Health 2020 as a whole highlights the very real health challenges that countries face
across the Region. Although the pattern in each country may vary, the key overarching issues
increasingly apply to all. However, Health 2020 goes beyond merely describing the issues; it
focuses on potential solutions and areas where the evidence suggests that positive action can
have important effects. In doing so, it provides an underpinning framework based on the
importance of adopting strategic approaches that assess challenges from a whole-system
perspective.
131. It does this by recognizing that the various determinants of health are interrelated, with a
mix of biophysical, psychological, social and environment factors all being important. This
reinforces the importance of developing multifaceted strategies that avoid a one-off or isolated
campaigns approach and instead seek to mobilize action across a range of areas to achieve a
combined synergistic effect on the challenges being addressed.
132. The classic and well-known model shown below (Fig.1), helps illustrate the
interrelationships between the different determinants of health, recognizing that it is important
to consider both the factors that directly influence individual and community behaviour, and the
important wider social determinants. The social determinants are especially important to address
because not only can they directly influence health (such as the effects of poor housing or
sanitation) but, importantly, they also influence the genuine options and choices people have,
their life chances and circumstances, which in turn affect their personal decisions and choices
and lifestyles.
Fig. 1. The interacting determinants of health