Purpose of the review Environmental and social determinants of health often co-occur, particularly among socially disadvantaged populations, yet because they are usually studied separately, their joint effects on health are likely underestimated. Building on converging bodies of literature, we delineate a conceptual framework to address these issues.
Recent findings Previous models provided a foundation for study in this area, and generated research pointing to additional important issues. These include a stronger focus on biobehavioral pathways, both positive and adverse health outcomes, and intergenerational effects. To accommodate the expanded set of issues, we put forward the Integrated Socio-Environmental Model of Health and Well-Being (ISEM), which examines how social and environmental factors combine and potentially interact, via multi-factorial pathways, to affect health and well-being over the life span. We then provide applied examples including the study of how food environments affect dietary behavior.
Summary The ISEM provides a comprehensive, theoretically informed framework to guide future research on the joint contribution of social and environmental factors to health and well-being across the life span.
Keywords Total environment . Social determinants . Cumulative exposures . Life course . Health disparities
The aim of this article is to show how a life-course approach can be extended to all health topics, age groups and countries by building on a synthesis of existing scientific evidence, experience in different countries and advances in health strategies and programmes. Aligned with the Sustainable Developmental Goals and Universal Health Coverage, a life-course approach can facilitate the integration of individual, social, economic and environmental considerations. Read More
Health is a component of and a key resource for human development. It results from a cumulative process of continuous interaction between exposures and experiences, which have an impact at both the individual and population levels, not only episodically but over time, and with trans-generational effects (1). The increase in human life expectancy by approximately 30 years over the last century provides a compelling reason to expand health-related goals beyond simple survival (2, 3).
In the Region of the Americas, the effort to increase life expectancy has been successful; however, the increase in healthy life expectancy has not kept pace. On average, 8 of every 10 people who are born in the Region will live beyond age 60, and more than 4 in 10 will live past 80 (4). One-quarter of those who live past 80 will live with poor health (4). According to estimates, people in the Region live on average 9 years with functional limitations or disability (5). An increased lifespan, but with longer periods of illness and dependence on care provided by others, is a great burden for States, societies, and families, and a significant challenge for public health.