Wider Determinants of Health

The health and well-being of individual people and local communities is affected by a wide range of factors.  These factors, described as ‘the causes of the causes’, can be outside of our control: such as gender or genetic make-up.  Other factors exist which although are generally beyond the individuals control, can be improved upon with support from organisations such as the Government, Local Authorities and the NHS.  These factors concern the environment, the economy, society and health as a whole and are generally interconnected with one another as shown in the model below.


Dahlgren and Whitehead 1991

These factors, or determinants of health, include:

Socioeconomic Status: The link between socioeconomic status and an individual’s health is a clear one – lower social position and associated socio-economic deprivation results in poor health.

Education: The availability of high quality education is key in enabling our residents to maximise opportunities.  Educational attainment can determine future employment and income as well as lowering the risk of alcohol and drug misuse and teenage pregnancy.

Physical Environment: Environmental themes can play a significant role in affecting our quality of life and health.  Those living in areas with safe water supplies, clean air, a healthy working environment and comfortable housing are more likely to be in good health than those lacking such conditions.

Social Environment: Having support from family, friends and the local community is important for preventing isolation and loneliness, contributing to good mental wellbeing and therefore improving overall health.

What We Do

It is important for us to ensure that the health impacts of these determinants are explicitly considered when making decisions about them.  One way we do this is by carrying out Health Impact Assessments (HIAs).

HIAs consider the proposed change, this could be anything from a new housing development or new policies, and assesses what the likely positive and negative consequences for health and wellbeing will be.  Recommendations are then made on how to enhance the positive consequences and reduce the negatives.


  • All public sector organisations in Warwickshire commit to carrying out Health Impact Assessments on all new major plans and policies to ensure that the maximum health gain is achieved.
  • Health and wellbeing should be included as core considerations in every planning and transport policy in Warwickshire and as part of the District and Borough Councils Core Strategies and Neighbourhood Plans.
  • Some funding from Community Infrastructure Levies on new developments is used to address local health and wellbeing issues and where necessary carry out more in depth HIAs.
  • The Warwickshire Health and Wellbeing Board champion the use of HIAs as a way of addressing the social determinants of health and reducing health inequalities.

There are small changes we can make to our lifestyles which can influence these determinants and help us to become more healthy. Check our Key Health Messages page for our 12 Top Tips.