Importance of Health Determinants

Every one of us always wishes to live a healthy life. However, most of us do not know about various factors that are important to remain healthy. These factors determine the health of not only individuals but also nations. Improving these conditions can help to improve the health of individuals and nations as well. This will ultimately reduce the need of resources necessary to be spent on curative services for that nation. Following are some important health determinants;

Social determinants: These determinants include;

· Income: Income is directly related to good health due to many aspects. The people earning good income are able to buy good & balanced food that is essential to maintain the good health. Income also enables the people to maintain healthy living conditions that prevent them to suffer from many diseases.

· Education: Learning optimum education is very much necessary to understand the relationship of disease with so many factors. An educated person is able to prevent himself and his family from so many communicable and non communicable diseases.

· Living Conditions: These are so important that so many communicable diseases spread when living conditions are not hygienic. Whenever living conditions are not good in any country, its health indicators prove to be not well as well.

Biological determinants: These determinants include;

· Genes: These are related to many diseases that are transferred from parents to the off spring. An easy way to prevent from genetic disorders is to marry outside the first degree relatives.

· Age: There are many health conditions that manifest during different ages of life. Especially important are joint problems, heart disease and high blood pressure.

· Race: Many health conditions are prone to be present in particular races while absent in other races. Examples are stomach cancers in Japanese Race.

· Gender­: Some medical conditions are present in one race while not so prone in other gender. Osteoporosis is one of such example which is the decrease in calcium level in the bones of women in old age.

Environmental determinants: These determinants include;

· Air: Life is not possible in the absence of air even for few minutes. If the quality of air is not pure and clean, it can be related to many illnesses especially lung diseases.

· Water: Human body is made up of mainly water. We cannot survive without water. However, water is also a cause of so many diseases especially gastrointestinal diseases. Safe drinking water is one of the basic necessities of human.

· Land: So many diseases especially skin diseases can be transferred from land to the humans. Moreover, availability of neat & clean land around us versus polluted land also makes a difference in terms of better health.

Availability of Health Services: The availability of health services is very important with reference to the health of individuals and nations. Whenever people avail these services in the early stage of the disease, damage to their health is less. However, if these services are available to the people, damage to health becomes irreversible. These health services include;

· Availability of doctor

· Nurses

· Paramedical staff

· Health Centers including hospitals, clinics etc

Obama makes final appeal ahead of healthcare vote

US President Barack Obama has rallied the support of Democratic lawmakers on Capitol Hill ahead of a crucial vote on sweeping healthcare reform.

Urging them to back the measure in a House vote expected in the coming hours, he said: "Let's get this done."

Democratic leaders have spent days working to get the 216 votes needed to pass the highly-contested bill.

Democratic House Majority Leader Steny Hoyer said he believed the party now had the necessary support.

Senior House Democrats have decided on a direct vote to pass a Senate version of the reform bill, rather than using a procedural measure that would have "deemed" it passed without a vote.

Is this the single most important step that we have taken on health care since Medicare? Absolutely US President Barack Obama Full text of speech Q&A: US healthcare reform Your views on healthcare reform

And Democratic Senate Majority Leader Harry Reid assured House lawmakers he had the "commitment of a significant majority" in the Senate to pass the next stage of the legislation, amending that bill with changes the House wants.

However, Democratic leaders can't be certain of victory, says the BBC's Mark Mardell in Washington.

If passed, the reforms will deliver on Mr Obama's top domestic priority by providing insurance to some 32 million of the Americans who currently lack coverage.

The Republicans are unanimously opposed to the legislation, which they say is unaffordable and represents a government takeover of a large part of the country's economy.

In the party's weekly radio address, House Republican leader John Boehner criticised what he said were tax increases and cuts in some benefits to pay for the bill, saying: "This is not reform."

Protesters opposed to the Democrats' proposals demonstrated outside the Capitol building in Washington, waving placards and chanting "kill the bill".

'Tough vote'

Speaking to Democrats in Washington, Mr Obama said the vote would be the single most important step taken on healthcare since Medicare, which helps the elderly, was passed four decades ago.

Obama is trying to work the old magic, the ability to connect, that made him think he could be president in the first place Mark Mardell BBC North America editor Read Mark's thoughts in full

He told lawmakers: "I know it's a tough vote."

But he said he was confident that doing the right thing for the American people would end up "being the smart thing to do politically".

"Don't do it for me, don't do it for the Democratic Party, do it for the American people. They're the ones looking for action right now," he said.

The president has held dozens of meetings and phone calls in recent days with Democratic House members wavering over whether to back the bill or not.

It remains unclear exactly how many votes the party can count on.

Some lawmakers have called for tighter language in the bill to make sure no federal money can be used for abortions, while others are concerned about cost or say its reforms do not go far enough.

If the House passes this the president will sign it in to law, although it would still go to the Senate for more changes.

Deficit reduction

The House of Representatives and the Senate adopted different versions of the bill in November and December.

Opponents of the reform bill say it represents a government takeover

The usual procedure would be for two versions of legislation to be combined into a single bill for President Obama to sign into law.

But after Senate Democrats lost the 60-seat majority required to defeat a filibuster by Republicans, Democratic leaders decided to use a controversial procedure to ensure the bill's passage.

Under the plan, the House will vote on a package of reconciliation "fixes" amending the Senate bill.

The Senate will then be able to make changes in a separate bill using a procedure known as reconciliation, which allows budget provisions to be approved with 51 votes - rather than the 60 needed to overcome blocking tactics.

According to Congressional Budget Office, the final version of the Democrats' healthcare plan will cut the federal deficit by $138bn over 10 years.

The non-partisan body said the proposed legislation would cost about $940bn over a decade.

The reforms would increase insurance coverage through tax credits for the middle class and expansion of the Medicaid programme for the poor.

If approved, they would represent the biggest change in the US healthcare system since the creation in the 1960s of Medicare, the government-run scheme for Americans aged 65 or over.

US HEALTHCARE AND WORLD COMPARISONS

US expenditure on healthcare is the equivalent of about 16.2% of GDP - nearly twice that of some other OECD countries.

US HEALTHCARE AND WORLD COMPARISONS

The US falls behind some OECD countries for life expectancy and has a higher rate of infant mortality. Almost 46m US citizens do not have health insurance.

US HEALTHCARE AND WORLD COMPARISONS

Healthcare reform is a priority for Barack Obama. The US spends about $2.2tn a year on its system - which includes private, federal or employer schemes.

Blood pressure fluctuations 'warning sign for stroke'

Fluctuations in blood pressure could be more important than consistently high readings as a warning sign for stroke, researchers have said.

Current guidelines focus on the need to lower blood pressure levels to reduce the risk of stroke.

It means doctors should no longer ignore an occasional high reading and prescribe the drugs that produce the most steady blood pressure levels.

The Stroke Association called for national guidelines to be overhauled.

In the first of the series of studies, UK and Swedish researchers looked at the variability in blood pressure readings at doctors' checks.

What we're saying is, don't discount that one-off high blood pressure reading Professor Peter Rothwell, study leader

They found those with fluctuating readings at different GP visits had the greatest risk of future stroke regardless of what their average blood pressure reading was.

A review of previous trials also found that the differences in effectiveness of several blood pressure drugs could be explained by how well they kept blood pressure on an even keel.

Some drugs, in particular beta blockers, were shown in a separate study in The Lancet Neurology, to increase variation in a patient's blood pressure.

'Major implications'

Professor Peter Rothwell of the Department of Clinical Neurology at the University of Oxford, who led the research, said the findings have major implications for how GPs spot and treat people at high risk of stroke.

"At the moment, the guidelines for GPs say not to believe a one-off unusual reading, to bring the patient back and measure again, and as long as it's not consistently high, there is no need to treat.

"What we're saying is don't discount that one-off high blood pressure reading."

He added that GPs would also need to make sure they prescribe the most effective drug combinations - ideally one that lowers blood pressure but also stabilises it.

It is not know exactly why occasional spikes would increase a person's risk of stroke but it is thought it puts undue stress on the system.

We urge GPs to read this research to help them prescribe the best treatment for people at risk of stroke Joe Korner, Stroke Association

"If you get rapid fluctuations that can cause turbulent flow of blood which can cause damage and stiffening in the arteries," said Professor Rothwell.

He said anyone with high blood pressure who tests themselves at home might want to mention to their GP if they spot variations in their results.

The National Institute for Health and Clinical Excellence's guidelines on high blood pressure is in the process of being rewritten and these latest studies will be taken into account.

Joe Korner, director of communications at The Stroke Association said people who have occasional high blood pressure readings - known as episodic hypertension - are often not treated.

"With this new research it is now important that the clinical guidelines about treating high blood pressure are reviewed.

"In the meantime we urge GPs to read this research to help them prescribe the best treatment for people at risk of stroke."

Experts stressed that those already prescribed medication for high blood pressure should not worry or stop taking their pills.

Professor Peter Weissberg, medical director at the British Heart Foundation said: "Current practice is not wrong, but this might add a new measure to help doctors make decisions on who to treat for hypertension and which drug to use."

Low-fat, Mediterranean and low-carb diets 'help heart'

Fatty deposits in arteries iincrease the risk of stroke and heart disease Three diets - Mediterranean, low-fat and low-carbohydrate - are equally effective in helping reverse blocked arteries, say Israeli researchers. The study of 140 people, reported in the journal Circulation, found diet could reduce the fatty build up in arteries. The Ben-Gurion University team found that by the end of the two-year study, the arterial wall had been cut by 5%. Experts said the study was interesting, but diet was not a "magic bullet". Atherosclerosis is a progressive condition in which the arteries thicken with fatty deposits, increasing the risk of heart attacks and strokes. It was very interesting to see that these very different diets had a similar effect Iris Shai, study author The authors of this Israeli study, which was carried out in collaboration with researchers in the US, Canada and Germany, set out to see if this natural part of ageing can be reversed through diet. Volunteers followed one of three diets - a low-fat diet, a low-carbohydrate diet or a Mediterranean diet, which is based on eating lots of fruit and vegetables, and using olive oil as the main source of fat. They were asked to stick to the diet for two years, and record what they ate in food diaries. The study was carried out among overweight volunteers, mostly men, who were aged 40 to 65. Using three-dimensional imaging, the researchers measured the volume of the wall of the carotid artery, the large artery in the neck which takes blood up to the brain. This was done at the start of the study and again after two years. Clogged arteries Lead researcher Iris Shai said: "It was very interesting to see that these very different diets had a similar effect. "Some people suggest that low-carbohydrate diets are more likely to clog arteries, but we did not see that." The research paper suggested the link could be related to falling blood pressure caused by the change in diet. This study shows you can do something to reduce plaque build-up, even without pills Dr Charles Knight, British Cardiovascular Society The findings were welcomed by UK experts. Dr Charles Knight, secretary of the British Cardiovascular Society and a consultant cardiologist, said although the study was "relatively small" and was not able to follow through to find out how many people eventually had heart attacks or strokes, the results were nevertheless "very interesting". He pointed out that the study adds weight to the growing body of research that suggests that atherosclerosis is a modifiable disease. Ten to 15 years ago, it was thought that fatty build-up in the arteries was irreversible, but since then drugs trials have shown that it is possible for fatty deposits to be cut. "This study shows you can do something to reduce plaque build-up, even without pills," Dr Knight said. "It sends an effective message from a public health perspective." However, he warned that the scale of reduction in the volume of artery walls was relatively small and that changing diet, although helpful, was "no magic bullet".