Americans See Environmental, Social Factors as Determinants of Health

A majority of U.S. adults are concerned about their future health, which they see as being affected by a broad range of environmental and social factors, including childhood experiences, a report from National Public Radio, the Robert Wood Johnson Foundation, and the T.H. Chan School of Public Health at Harvard University finds.

Based on a survey of nearly twenty-five hundred Americans age 18 and older, the report, What Shapes Health (46 pages, PDF), found that 62 percent of respondents said they were "very concerned" (31 percent) or "somewhat concerned" (31 percent) about their health in the future. Among those most likely to be very concerned were respondents who described their current health status as fair or poor (52 percent), African Americans (47 percent), Latinos (44 percent), people between the ages of 50 and 64 (40 percent), and those with annual household incomes of less than $25,000 a year (39 percent).

When asked the importance of fourteen factors as determinants of health, respondents listed as "extremely important" lack of access to high-quality medical care (42 percent), personal behavior (40 percent), viruses or bacteria (40 percent), high stress (37 percent), and exposure to air, water, or chemical pollution (35 percent). The survey also found variations among racial/ethnic groups, with African Americans more likely than whites to perceive lack of access to high-quality medical care, God's will, low income, and not having enough education as extremely important causes of ill health, while Latinos were more likely than non-Latino whites to say that bad working conditions were extremely important. In addition, those with annual household incomes of less than $25,000 were more likely than those with incomes of at least $75,000 to believe poor neighborhoods and housing conditions and bad working conditions were extremely important.

Asked to assess specific factors in a person's childhood experience that can cause health problems later in life, 54 percent of respondents rated being abused or neglected as "extremely important," followed by living in a polluted area (44 percent), eating a poor diet (44 percent), and not receiving vaccinations (43 percent). The report also notes that African Americans were more likely than whites to believe a poor diet, lack of vaccinations, poverty, not graduating from high school, and being born premature or underweight were extremely important causes of ill health later in life, while low-income respondents were more likely to say abuse or neglect, a polluted environment, poor diet, poverty, and premature or underweight birth were extremely important.

"This very important poll illustrates the dire socioeconomic factors faced every day by too many people in this country," said RWJF president and CEO Risa Lavizzo-Mourey. "These factors can have as much, or more, impact on their health as disease — and they know it. Here at the foundation, we have expanded our mission to address these factors, in order to ensure that everyone in America can attain the healthiest life possible."

"Poll Finds U.S. Public Sees Ill Health as Resulting From a Broad Range of Causes." Robert Wood Johnson Foundation Press Release 03/02/2015.