The Social Determinants Of Healthy Aging

Health, as defined by the World Health Organization, is “the condition of a human body at its best possible health.” A variety of other definitions have also been used over the years for various purposes. For some it means having optimum health, while for others it simply means being healthy. For most, there is an emphasis on personal wellness, such as improving one’s self-image and increasing their sense of physical and mental health and well being. Although the definition has been in use for decades, there are many changes in the way health is often perceived and discussed today, largely owing to developments in the medical and pharmaceutical industries, and the resulting focus on disease prevention and treatment.


The current definition of health can be seen in a number of places, both in legislation and in everyday life. In Canada, for example, the Canadian Health Act defines “health” as “the maximum well being of a person that includes quality of life, physical security, functional capacity, physical independence, the ability to undertake functions of daily living, and preservation of life”. A similar but more detailed definition is found in the Mental Health Act (section 12). In that provision, the maximum well being of a person is described as “being in good health with respect to the person’s physical, emotional, mental and other physical resources.” This more detailed definition is seen to include aspects of the quality of life that most people consider to be basic health.

In the United States, however, the United States Department of Health and Human Services (HHS) defines “well-being” as “the ability to cope with the demands of life”, and “healthy persons” as those who have attained a minimum level of health. The Department of Health describes health insurance as “an insurance program that provides coverage for medical expenses and other health-related issues for individuals”. Finally, the Department of Education defines wellness education as “establishing a positive attitude and a sense of self-worth that guides individuals through all their experiences”. Those three broad elements describe the public’s conception of health insurance, health care, and health education. By considering these broad items in isolation, it is not clear how health insurance relates to the well-being of the general population.

Most recent research on public health disparities does not attempt to create a comprehensive definition of “well-being”. Instead, researchers have sought to identify which behaviors or conditions are associated with greater health disparities. The National Cancer Institute, for example, has suggested that poor diet, lack of exercise, smoking, and other medical conditions can contribute to both the development of and the progression of cancer. Similarly, the British Medical Journal has suggested that poor diet, lack of exercise, and alcohol consumption may contribute to the progression of cardiovascular disease.

Research on health disparities has also typically focused on the development of unhealthy lifestyle choices, such as smoking and drinking, as a means of coping with stress or managing disease. However, there is also a strong relationship between unhealthy diet and lack of exercise, and even healthier choices such as fruits and vegetables can lead to increased risks of developing heart disease, obesity, diabetes, and other chronic conditions. Unfortunately, this research frequently does not address the effects of changing dietary practices over time, such as how changes in diet can affect healthy aging. As noted, even a healthy diet can provide inadequate nutrition for an older adult.

In addition, some researchers argue that certain social determinants, such as income level and gender, play an important role in determining health and wellness. Researchers have suggested that social factors may account for approximately forty percent of the variation in health and wellness, and that these factors can explain much of the difference in health and illness among racial and ethnic groups. While these explanations are not mutually exclusive, they do highlight the potential for change, especially in health disparities that are found to exist even when controlling for some of the more obvious sociological variables. By examining these things like family income, educational attainment, employment, physical activity, and social network size, health education researchers hope that greater understanding of health and its underlying causes can help lead to greater opportunities for health equity in communities across the country.