Dimensions Of Wellness

Systematic approaches to evaluate the effect of policies on children of this sort are the exception, rather than the rule, and few other systematic attempts can be identified. Health insurance of any type cannot facilitate access to health care services when the necessary resources are not present.

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The resulting behaviors are both manifestations of their health and have significant implications for it. At each new exposure, the child may respond in a variety of ways that in turn unleash a variety of reactions in his or her caregiver and in others around him. A body of recent research suggests how these behaviors develop and describes the role of family, peers, and social environment, including media, in shaping this developmental process . While behaviors like smoking, drinking, and exercise are known to affect later health, it is not clear how these behaviors develop in childhood . Children’s health is determined by the interaction of a multitude of influences, reflecting complex processes.

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The structural determinants cause and operate through intermediary determinants of health—housing, physical work environment, social support, stress, nutrition and physical activity—to shape health outcomes. A broad range of social, environmental, psychological, and genetic factors have been associated with tobacco use, including gender, race and ethnicity, age, income level, educational attainment, geographic location, and disability. Motivation to begin and to continue smoking is strongly influenced by the social environment, although genetic factors are also known to play a role. Smoke-free protections, tobacco prices and taxes, and the implementation of effective tobacco prevention programs all influence tobacco use.

We divide these influences into biological, behavioral, and environmental even though our model of children’s health views their effects as highly intertwined and difficult to isolate. This chapter provides a summary of published literature and a framework for understanding those influences. Dr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness.

• Chemicals in the environment move into the body across such biological barriers as skin, lungs, and the gastrointestinal system.
• For this reason, exposures need to be tracked as highs and lows on a daily basis rather than as monthly averages.
• However, a daily peak may exceed a threshold of concern and still be within the regulatory limit.
• Exposure is considered to be contact of the agent with the biological barrier; following exposure, the agent crosses the barrier and is found inside the body .

Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management. The authors make a critical distinction between the structural determinants of health inequities and the intermediary determinants of health. The structural determinants include “all social and political mechanisms that generate … stratification and social class divisions in society and that define individual socioeconomic position within hierarchies of power, prestige and access to resources” (p. 5).

Evidence on the likely effects of welfare reforms comes both from random-assignment experiments and from longitudinal survey studies . A key finding from the experiments is that effects on the achievement and behavior of younger children were consistently more positive in programs that provided financial and in-kind supports for work than in those that did not. The packages of work supports were quite diverse, ranging from generous earnings supplements provided alone to more comprehensive packages of earnings supplements, child care assistance, health insurance, and even temporary community service jobs.

In sum, all these psychological factors, whether a child’s perceptions of peer norms, self-efficacy beliefs, attitudes about health and health care, or level of motivation to pursue specific health care behaviors, contribute to health-related choices and behaviors. With increasing age, children’s behaviors, such as substance use, academic performance, violence, suicide, and auto accidents, constitute a major influence on future health. The hallmark of childhood is the constant exposure to new developmental challenges. As children acquire new physical and cognitive skills and experiences, their behaviors change. They explore, practice, and experiment and as a result they change and are changed.

The effect of social factors on health, and the possibility of their remediation, does not detract from the importance of health services, at least in part because one of the correlates of social factors is differential access to and appropriate use of health and other services. Documentation of the overall effect of services specifically on children’s health is more limited. A 1985 publication on the importance of health services on the incidence, prevalence, and severity of 16 important conditions in childhood illustrated the importance of access to health services.

However, this study provided no quantitative estimates of the total magnitude of effect of health services on the child population, and it predated numerous new vaccines and other general environmental improvements that have further reduced morbidity and mortality. It was also based on a model of health that was more disease-oriented than the multifaceted conceptualization of health proposed in this report. Although exposures of the ovum or the sperm prior to conception may have herpes genital profound health effects on a child, including development of an abnormal fetus,1 in this section we focus on prenatal influences. Exposures of the mother during pregnancy can come from many sources; common sources include maternal occupation, substance use, diet and water consumption, and paraoccupation . The strongest workplace exposure associations are lead, mercury, organic solvents, ethylene oxide, and ionizing radiation and poor reproductive outcome, including birth defects (Agency for Toxic Substance and Disease Registry, 1993; Schardein, 2000).