The Determinants of Health

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The Determinants of Health

The determinants of health can be described as the underlying structural conditions of daily life that play a major role in influencing health inequalities among populations. It is simply what makes people unhealthy and what makes others healthy. The determinants of health are spread over a wide range of categories which include the policy framework, social factors, individual behavior, genetics, and biological makeup (Marmot, 2005). The interplay among these factors determines the health of individuals within a population.

Challenges in Accessing Essential Services and Support

The residents of the East Village find it difficult to access essential services and support. Most of these people are low income earners. The community is composed of a total of 453,626 occupied dwellings and 311, 782 owner-occupied dwellings (Bartley et al., 2006). For people living on a low income, or those facing critical social issues like domestic violence and social exclusion, opportunities to build a good life are not equally available. These barriers are often amplified for vulnerable individuals—including seniors, people living with disabilities, and newcomers—and can lead to social isolation and mental health issues.

Homelessness and Health Inequalities

Homelessness in East Village is linked to high instances of health inequalities which may include shorter life expectancy and a higher morbidity. This is because people who are homeless are less likely to get preventive health care service and have poor control of manageable conditions such as diabetes. The access to shelter is a basic human right and is regarded as a social determinant of health. However, homelessness itself is determined through factors that may include economic and interpersonal factors at the individual level. Therefore, we have to recognize that it is almost futile to try to treat medical conditions associated with homelessness unless we first address the underlying issues in the community (O’Toole et al, 2016).

Compound Health Issues Faced by Homeless People

The health issues experienced by homeless people in East Village are compounded with other determinants of health such as trauma, poverty, and social disconnection. The combinations of these social issues are not regarded as medical problems even though they are major underlying issues that determine health. Traditional hospital data does not capture this background information that is vital. Among homeless people, medical care is often sought during the advanced stages of illness because of the need to meet the most urgent need. A homeless person would likely choose food or shelter before visiting a hospital. Such choices may be seen as carelessness but they simply describe the struggle for survival.


Bartley, M., Ferrie, J., Montgomery, S. M., Marmot, M., & Wilkinson, R. (2006). Social determinants of health. The solid facts. Copenhagen: Centre for Urban Health World Health Organization Regional Office for Europe, 1-32.

Marmot, M. (2005). Social determinants of health inequalities. The lancet, 365(9464), 1099-1104.

O’Toole, T. P., Johnson, E. E., Aiello, R., Kane, V., & Pape, L. (2016). Peer Reviewed: Tailoring Care to Vulnerable Populations by Incorporating Social Determinants of Health: the Veterans Health Administration’s “Homeless Patient Aligned Care Team” Program. Preventing chronic disease, 13.

October 13, 2023

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