Many Factors Impact Health
Understanding and measuring our health extends beyond just how long we live or the presence of specific health conditions. While these outcomes are important, they don’t tell the whole story of what contributes to or creates barriers to the health of individuals and communities.
To better tell the whole story of health, the Whatcom Community Health Insights (WCHI) data platform uses the Population Health Framework, adapted from the Robert Wood Johnson County Health Rankings population health model. The framework illustrates how many factors, or “determinants,” influence health outcomes – the length and quality of people’s lives. These “health determinants” fall into four categories:
- Social and economic conditions;
- Physical environment;
- Health behaviors;
- Health care.
Within and across these categories, there can be complex interactions among the determinants; for example, economic conditions can impact health care, and the physical environment can impact health behaviors.
The WCHI data platform is organized based on the this framework, with indicators (also called “measures”) for each of the health determinants or “health topics.”
Organizing the WCHI within this framework presents some limitations and challenges. First, some data don’t fit neatly into any category or could fit into more than one. For example, Children Eligible for School Lunch Programs could be an indicator of “Income and Poverty” or of “Nutrition and Physical Activity.” Secondly, and very importantly, the framework does not highlight the significant impacts that systemic racism and other forms of discrimination have on all the health determinants. We know that at the population level, different groups have very different experiences with housing, employment, and other determinants of health – and therefore have disparate health outcomes.
Despite these limitations, the Population Health Framework is a useful organizing structure that helps us recognize that many factors contribute to our health and well-being.
This platform also includes Healthy People 2030 national targets as reference points when the WCHI indicators are the same as in Healthy People. Healthy People 2030 is produced by the US Office of Disease Prevention and Health Promotion and provides 10-year national public health objectives. Healthy People 2030 also gives targets of what is considered healthy or ideal. Whatcom County Health and Community Services (WCHCS) has not adopted these as targets; however, they are useful for understanding benchmarks set at the national level.
