According to the World Health Organization (WHO), "of the 56.9 million deaths worldwide in 2016, more than half (54%) were due to the top 10 causes" (The top 10 causes of death, 2018). As of 2017, the top ten causes of death in the United States include heart disease, cancer, chronic lower respiratory disease, accidents, stroke, Alzheimer's disease, diabetes, influenza and pneumonia, kidney disease, and finally, suicide. From the list, it remains critical to note that the leading cause of death falls under chronic disease including cancer, heart disease, stroke, and diabetes. The only infectious diseases that make the list include chronic lower respiratory disease and influenza and pneumonia. Therefore, in a bid to understand this disparity, it remains fundamental to assess the various determinants of health. According to the WHO, the determinants of health are a “range of behavioral, biological, socioeconomic, and environmental factors that influence the health status of individuals or populations” (The top 10 causes of death, 2018).
Different factors combine to influence the health of individuals and societies. The five primary determinants of health include income and social status, education, physical environment, social support networks, genetics, and health services. The determinants can broadly be classified into the social and economic environment, physical environment, and the individual's characteristics and behavior. As earlier asserted, the top 10 leading causes of death list in the United States is composed of almost 50% chronic diseases (Preston, 2013). It, therefore, begs the questions why the determinants of health in the US predispose individuals to more chronic illness as compared to the infectious ones. To begin with, the social determinants of health (SDOH) have played a significant role in the causation of many chronic illnesses in the US. The SDOH include all the conditions in which individuals live, work, learn, and age. Research has shown that the social determines can both directly or indirectly impact health by influencing how individuals behave (Cockerham, Hamby, & Oates, 2017). The numerous fast food outlets have been associated with an increase in poor dietary behavior thus exposing individuals to cancer and heart diseases. The increased use of tobacco and alcohol in the US also has predisposed individuals to respiratory and kidney diseases respectively (Cockerham et al., 2017).
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The second determinant is known as the economic determinant which primarily deals with income and social status. As a convention, higher income including social status is linked to better health. Affluent individuals can manage infectious diseases since they can afford medication and are free from environmental factors that could expose individuals to such diseases. However, when it comes to chronic diseases, the case is different. The US is composed of a large population of individuals enjoying a good income. As such, this has caused them to employ a sedentary lifestyle characterized by minimal movement and a lack of physical activity. As such, this predisposes an individual to obesity and diseases such as diabetes and heart conditions due to the accumulation of body fat. Therefore, infection such as diabetes, cancer, and heart disease is known as the diseases of the affluent and are partly prevalent as a result of the economic viability of the Americans, a factor that alters lifestyle hence predisposing a person to the disease-causing agents. The third determinant of health that has caused a discrepancy between the chronic and infectious diseases includes the physical environment.
Most parts of the US enjoy a positive physical environment including clean air, safe water, safe houses, and healthy workplaces. People have also become control of their environment increasingly thereby limiting the spread of infectious diseases. However, several environmental factors can be associated with the increased risk of chronic diseases among the US population. The increased exposure of individuals to carcinogenic elements such as lead, cadmium, arsenic, and mercury in foods, drinking water, fish, and other consumer products have increased the prevalence of cancer in the US population. The increased consumption of products containing mercury has played a significant role in affecting the immune system. For instance, in 2015, there was a water crisis that occurred in Flint, Michigan. It was reported that the drinking water in the region contained a plethora of substances such as lead. Therefore, such environmental determinants have played a vital role in making cancer one of the leading causes of deaths in the country.
Another significant determinant of health is genetics. It primarily deals with inheritance, and it has a considerable part to play in determining an individual's lifespan. Examples of diseases with a genetic background include diabetes, cancer, Alzheimer's, and some heart diseases, all which make up the top ten causes of deaths in the country. Genetic predisposition of a disease means that an individual will probably inherit a disease from their parents. However, it remains critical to note that genetic factors are not a major concern when it comes to the spread of chronic infections. Research conducted in the US shows that genetics is responsible for between 20% and 25% of all the chronic illnesses leading to death in America (Egger & Dixon, 2014). Also, genetics does not have any vital role to play when it comes to infectious diseases. As such, it is directly responsible for the increased number of chronic disease-related deaths in comparison to the infectious ones. The last determinant is known as the health service. It is important to note that the access and use of appropriate medical services can enable one to manage their infections effectively.
The US is endowed with a plethora of hospitals and care facilities that can manage the infectious diseases and bring them to a halt. More significantly, it has a strong public health system that prevents the spread of diseases at the community level. The availability of the physicians, doctors, nurses, and public health officials has also enabled the country to deal with infectious diseases better. However, from the top 10 causes of death in the country, it is significantly apparent that the country needs to do better in terms of dealing with chronic infections. According to the Center for Disease Control and Prevention (CDC), the country uses up to $147 billion annually in dealing with chronic illnesses (Preston, 2013). It is therefore evident that the diseases have a toll on the economic welfare of the country. Some of the expenses are directed to drugs, diagnostic equipment, and procedure such as chemotherapy, and research among others. According to research by the CDC, 60% of adults in the US have a chronic disease with 40% of the individuals having two or more (National Center for Chronic Disease Prevention and Health Promotion NCCDPHP). The increased deaths due to this type of diseases have continued to show that the US healthcare system lags behind in effectively managing the chronic diseases in the country. More input in terms of financial resources needs to be put to ensure that the situation is resolved.
In conclusion, the five determinants of health include the social, economic, physical environment, genetics, and health services. They play a vital role in determining whether a population will be affected by a particular disease. Most importantly, they influence the nature of a disease that a population will significantly demonstrate as seen in the case of the US. The chronic illnesses compared to the infectious ones, continue to disproportionately cause death in the country as a result of the interaction of the five determinants. Therefore, in a bid to reduce the deaths, health professionals should increasingly explore the factors.
References
Cockerham, W. C., Hamby, B. W., & Oates, G. R. (2017). The social determinants of chronic disease. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328595/
Egger, G., & Dixon, J. (2014). Beyond obesity and lifestyle: a review of 21st century chronic disease determinants. Biomed Research International, 2014.
National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Retrieved from: https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm
Preston, S. H. (2013). Mortality patterns in national populations: With special reference to recorded causes of death. Elsevier.
The top 10 causes of death, (2018). WHO. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
