Our health is not just determined by eating healthy or regular check-ups or even taking the right vaccinations at the right time. The conditions which we live in also affect our health. That is why, health has been defined as “not just the absence of disease, but a state of complete physical, mental and social well-being (WHO).

The conditions of day to day life are called social determinants of health or the causes of the causes. An interplay of all these factors also determine health.

Stress is one of the 10 social determinants of health as listed by the WHO, the others being: Social gradient, early life, social exclusion, work, unemployment, social support, addiction, food and transport.

Stress, as we know, is the reaction of the body and mind to the interpretation of a known situation. It is always due to a known person, place or situation. The same situation or beliefs may or may not cause stress unless it is interpreted in such a way that it is uncomfortable to the person and he/she is unable to cope with these challenges of everyday life. Exposure to the same set of conditions every day compounds the level of stress resulting in chronic stress, which can be harmful to health.

Chronic stress manifests as physical ailments such as diabetes, heart disease, obesity and addictions to smoking, alcohol or substance abuse.

This is where the role of social determinants of health comes in. Identifying the stressors and changing the condition/s that originally caused the stress can reduce the stress.

But, removing the known situation may not be possible all the time. For example, if it is your workplace conditions that are causing stress, resigning from the job may not be feasible option always. The answer therefore is to change one’s interpretation of the said situation. For this, one should start thinking positively and differently and then choose the option that does not hurt the heart. Practicing pranayam, relaxation, meditation, regular physical activity also prepares the body so that the stress does not affect the mind and the body.

Similar is the case with a patient of depression. Treating the patient for depression, but sending the patient back to the same living conditions like social isolation, loneliness will only worsen the disease.

Treating the disease alone will not yield the desired health outcomes. It is also important to treat the person as a whole in context of his social circumstances. In addition to the clinical factors, the social determinants of health are equally important.

Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAO

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA