Queensland Stay On Your Feet® - Social determinants
There is an increasing recognition that many modern health problems have multiple causes, which result from a complex interaction of social, economic, environmental, behavioural, and genetic determinants over the course of a personâ€™s life.
These determinants can be broadly divided into the following three categories:
upstream determinants including education, employment, income, living and working conditions 
midstream determinants including health behaviours and psychosocial factors 
downstream determinants, which includes physiological and biological factors .
These determinants can influence the communityâ€™s behaviour, and subsequent health, in positive and negative ways. The earlier a person is exposed to positive or negative conditions during a personâ€™s work, home or play strongly impacts on their quality and length of life [25, 51].
A safe environment, adequate income, meaningful roles in society, secure housing, increased education and social support within communities are all associated with better health and wellbeing.
A personâ€™s social circumstances affect their health throughout life. Most diseases and injuries are more common in groups which are socially disadvantaged and the social gap has been widening over the past few decades.
Given that no one agency can address the social determinants of health alone, there is a need for shared responsibility, based on partnerships, to address a range of factors, including:
structural factors such as education, housing, transport, policy and legislation
community factors such as social cohesion, and the capacity of individuals and communities to adopt positive health practices.
The social determinants of health necessitate the implementation of a broad range of educational, motivational, organisational, economic, legislative, political and technological strategies, which is best achieved by using an ecological model.
A useful tool to help address the social determinants of health and wellbeing is Queensland Healthâ€™s framework of the social determinants of health and wellbeing.
Health Determinants Queensland 2004
Queensland Healthâ€™s Health Determinants Queensland 2004 report provides a summary of the most important factors influencing the health status of Queenslanders. It highlights the areas of potential gain and the key responses needed to address them.
The report also identifies major health indicators including behavioural, social, economic, and environmental determinants of health and their recent trends in Queensland.
The report provides valuable guidance to government, non-government agencies, and the community for improving health and reducing the burden of disease now and in the future.
Chapter 4 of this report deals specifically with the determinants of health for older people.
For more information
Queensland Health has developed a range of fact sheets that use a social determinants approach. You might find it useful to read a couple of these fact sheets to see how social determinants can help give a new perspective to falls prevention in older people:
Available fact sheets include: