What determines our health?
This week I want to discuss what determines our health and I honestly can’t think of a better time.
COVID is raging and folks are exhausted in every way possible.
Teachers and healthcare workers are being worked to the bone after 2 years of already brutal circumstances.
Parents have to decide whether to send their kids to daycare/school and potentially be infected or not go to work.
Folks are struggling to keep their mental health afloat with all of this worry, decision fatigue and isolation.
It’s been a lot.
And I’m here to remind you… it’s not all up to you.
We only have control over so much.
I know, that can sting a little bit.
We like to be in control, don’t we? This shows up in all areas of our lives, but definitely with our health. Let’s discuss.
What determines a person's health?
We’ve been taught that it’s all about how we eat and how we move. If we’re doing those correctly, then we’re healthy, right?
Sure, these behaviors are a piece of the puzzle. But just one piece. And it’s not even the biggest piece.
If you Google “determinants of health” you’ll find oodles of pie charts that visually show how much weight different aspects of our lives, well, determine our health!
Let’s break all of these down a bit.
Social & Economic Factors (40%)
Do you have a safe home?
Access to healthy and fresh food?
Do you face oppression in the form of racism, weight stigma, transphobia or ableism?
Have you been living paycheck to paycheck? Or with even less means?
Health Behaviors (30%)
These are the things we typically think about when we think about health.
Are you exercising?
Are you eating a variety of fresh foods?
Do you meditate?
Do you go to acupuncture, a chiropractor or a massage therapist?
Are you sleeping 7-9 hours a night?
Physical Environment (10%)
What is the quality of your drinking water?
Is there mold, asbestos, or other toxic substances in your house?
Sound pollution in your neighborhood?
PFAS contamination in your soil?
Clinical Care (10%)
Do you have insurance?
Do you feel cared for and seen by your healthcare provider?
Are you treated differently or not taken seriously because of your body size, skin color, gender expression or disability?
Genetics (10%)
Our genes and biology are determined before we’re even born. There’s more and more research about gene expression and how our environment, actions and thoughts can determine how our genes behave… but again, that comes down to these same health determinants.
As you can see, our "lifestyle choices" only contribute to 30% of our overall health! That leaves so much out of our control.
Now that might feel like a relief, or that might feel terrifying. Maybe both.
So yes, we do have some control over our health. But I will argue strongly that we don’t have nearly as much control over our health as we’ve been led to believe.
Does this mean we just throw up our hands and stop caring for ourselves? Of course not.
“Yes, our diets, beliefs, exercise habits, time spent in nature, meditation, etc., all tremendously influence health and well-being, but health is the sum total of factors that begin before we are born and that are bigger than solely our individual choices. Genetics, socioeconomics, racism, trauma, and many other factors play a dramatic role in our health. Even the mode of our birth can impact our health vis-à-vis its influence on the formation of our microbiome. It’s why it’s so important to not blame yourself even if you’ve been doing ‘all the right things’– and you still have symptoms or a medical condition."
-Dr. Aviva Romm
Of course movement and nutrition matter. They just don’t matter more than racism or fatphobia. They don’t matter if you are living with food scarcity. They don’t matter if your doctor ignores your requests because you're Black, fat, queer or disabled.
We all have a responsibility to dismantle the systems of oppression that are keeping people from being well.
If you're curious to see how this plays out with our current COVID pandemic, I encourage you to read this newsletter by Virginia Sole Smith and this Instagram thread by Caroline J Sumlin. And remember that even if you do everything right, you might get COVID during this surge and that's not your fault.
Your morality doesn’t lie in your health. Your health does not make up your worthiness.
We are living in a tumultuous time and we’re all just doing the best we can.
Keep going. ❤
