conditioning? How does conditioning affect your thought process and as a result your happiness? The different determinants of happiness in your life.What positive psychology says about long-lasting happiness. And then you
men really need their jobs and they need job success the top determinant of whether a man is psychologically fit and is not suffering from stress disorders is not his relationship with his job it is actually his relationship with his
And then, the embarrassing fact, the embarrassing reality of this is, what is the strong-- after satiety, after surviving, what is the strongest determinant of food selection? It's proximity, literally what's in the kitchen, what's sitting in front of me, what did someone serve me.
And she wanted to share her pride with other people in the community. is the most important determinant about whether someone stays on Scratch.
And basically the summation of his experience was that he could tell essentially in just a short conversation with somebody if they were going to survive in the concentration camp. The most important determinant of that was that they had meaning and a purpose. OK? But the other thing he talked about was this idea of stimulus and response.
And they limit our opportunities to thrive. Key among these determinants , as you can see from your slide, are the social determinants of health, the structural conditions in which all of us are born into, we live in, and we die in that affect all aspects of health.
Well, as a result, we're missing the link between the social determinants of health and their policy roots. For every social determinants of health that you heard me mention, there was a preceding legislative, regulatory, legal, or other policy decision that resulted in the structural conditions we find ourselves in.
Others are located in more lush parts of the river and benefit because of such specific decisions made on their behalf. These are the political determinants of health. Somewhere upstream, decisions were made to divert the river to benefit certain people and harm others.
Because in the United States, as well as in other countries of the world, we must understand the disquieting and harsh truth that the political determinants of health inequities have rarely, rarely been addressed, unless their reduction or elimination served other purposes. You see the success of any advocacy effort depends on how palatable they are to commercial interests
So gradually, we moved away from diseases, or very early on, and started to look at some of those the social determinants of health. And that's where our focus has been.
So I'm going to move on to the other four determinants . The middle three determinants -- I refer to them with a mnemonic. I'm from the business school, the McCombs School of Business in University of Texas at Austin.
But here the MBA is not what you think it is. Which of these five determinants that you've talked about-- the basic needs, an MBA, and then abundance mindset-- is the most important?
added to this list of determinants of child health and well-being, and that is adversity and trauma, the exposures of children to these toxic stressors that are important determinants of health in young children. And these include all of these things that we think of as adverse childhood experiences-- physical, emotional, and sexual maltreatment
to 30% of that pie. The majority of the determinants of health are behavioral, social, and environmental factors. And yet in the past we focused far less attention-- and by "we" I hold ourselves in academic medicine very much accountable for this--
Okay, once you know to what extent people differ, you can try to get a look at the determinants . In thinking about the determinants , this scheme which I showed you, this conceptual scheme, makes sense because you can say, "Well how happy people are will depend on the livability of their environment and also on their life-ability." And in doing so, you think actually the way
In fact, I think there's more evidence for the diverse direction of causality. That happiness is a more reliable determinant of success than is success a determinant of happiness. In fact, success can often undermine your happiness for a variety of reasons.
to have an assortment of what are known as low-correlation assets. and your contributions are the single biggest determinant of market performance.
diabetes today we spend 13 B ion Dollar on drugs for type 2 diabetes again weight obesity being the key determinant in susceptible individuals to the onset and ideology of type two diabetes so we start I started thinking about okay
And it's mostly sort of cultural -- microcultural. So the good news is, When dads are actively involved, they get dramatically better results for kids, even in two-parent families. Active fathers are seen as the driving determinant of things like better grades, more self-confidence, better behavior -- more so even than moms. And part of the reason for this again, gets to this massive difference in the way men behave.
these factors significantly contribute to our society's health inequities. It shows the compounding effect of political determinants over personal responsibility, because no matter how much many vulnerable and marginalized groups try to act responsibly, there are always structural institutional, interpersonal-- yes, even interpersonal-- obstacles hindering them.
It would take 75 years later before the political stars would align and we would get another opportunity to advance a major health policy that was intended to address these social determinants of health. The same arguments that have been raised 75 years earlier to provide health services, education, food and clothing, security, were also raised.
Care Act, or Obamacare Well, let me close by talking about how we can leverage the political determinants of health. We talked about the political determinants of health. And I really want to provide my definition of this and my ensuing model to help us understand the levers that have been pushed and pulled over time to hinder health equity
or to advance this goal. So I defined the political determinants of health as involving the systematic process of, one, structuring relationships. We talked earlier about redlining in America through the Home Owners Loan Corporation Act, but there were additional laws.
And I think the first might be that-- you and I recently co-authored a piece that we published about the tale of two health when working on the political determinants of health, near and long-term trade offs?" Yeah.
But what has been missing from this list for all of the years of studying child health and wellness, but has recently, in the last, I would say, 12 to 15 years, been added to this list of determinants of child health and well-being, and that is adversity and trauma, the exposures of children to these toxic stressors that are important determinants of health in young children.
It's called the Rainbow Diagram. They're talking about the determinants of health. And these are all the things which affect health-- lifestyle factors, social and community networks, general socioeconomic environmental conditions,
is that there are two most important determinants of happiness; the two most important determinants of well-being are close connections to other people, a network of meaningful and close
10 11 food price spikes food price inflation was a major determinant around inflation was a major determinant around the world of civil unrest and riots and
we live in, and we die in that affect all aspects of health. Well, these social determinants of health do play an incredible role in these human-made pre-existing inequities, but underlying each one is a political determinant that we can no longer ignore.
in order to be healthy is the biggest determinant of whether we're educated or not, healthy or not, work outside the home
does it enhance or enobble human life? how it becomes uh you know one of the determinants of human evolution because you know when you're happy you function best you will work at your optimal best so how to keep you happy all the time
And I think the first might be that-- you and I recently co-authored a piece that we published about the tale of two health So there are a host of these social determinants that, again, we must link to that policy decision or those upstream factors that created the results downstream.
And I think the first might be that-- you and I recently co-authored a piece that we published about the tale of two health disparities, social determinants , and political determinants all intersect, but we have a lot of questions coming in.
The second thing that's very, very important-- you all look like your basic needs are more than covered. So I'm going to move on to the other four determinants . The middle three determinants -- I refer to them with a mnemonic.
data filtering, data quality is the number one determinant of the model quality.
It was the social interactions that these investigators commented on that were a major determinant in how successful this diet was in enhancing well-being.
That is the key metric, the key biofeedback determinant .
But right through adolescence, it's the dominant determinant of weight in an obese environment.
to act responsibly, there are always structural institutional, interpersonal-- yes, even interpersonal-- obstacles hindering them. Beneath these communities notice, have been political determinants that have pulled and continue to pull strings that prevent them from achieving their optimal health and full potential. The inequities that pre-date COVID didn't suddenly appear.
not only around COVID-related deaths and cases or inequities, but also the underlying health conditions that strike disproportionately among marginalized and under-resourced communities and then to overlay that with the social determinants of health, as well as the political determinants of health, to basically track which policies have been mitigating inequities and which ones have been exacerbating inequities.
Fourth principle. To change health, we have to change behavior. You know, when we look at the determinants of health, of wellness and well-being-- yes, there is medical care and there's genomics. But if we look at health and well-being as being a pie, then genomics and medical care represent maybe 25%
This is obviously-- now that we think that diversity is one of the main determinants for gut health, and probably also health, in general.
And then, a lot of the training code is the determinant on how long it takes to train and how fast your experimentation is.
And the course is based on the belief that the ability to develop functional and robust relationships is a key determinant of success--
Another thing we found is that the way parents reacts to kids' mistakes is this big determinant
These upstream decisions have downstream impacts. You see, this pandemic demonstrates the inconvenient and harsh truth about the impact of social determinants of health and how collectively these factors significantly contribute to our society's health inequities.
Minorities, people with disabilities, and other vulnerable communities still contend with neighborhoods that are largely devoid of necessary health-protective and health-sustaining resources. And they're still contending with the political determinants or drivers that created, perpetuated, and exacerbated many of the health inequities we observe or experience today.
We know it's owing to them breathing in the most polluted air. And, yes, through the social determinants of health research, we've been able to pinpoint that to these infrastructure, to the highways, the bus depot, the train tracks, et cetera, but we must take it one step further.
and around the world to overcome them. Unless we do these things, we will continue to make little progress in keeping the social determinants of health in check. And so one of the solutions that we've come up with in partnership with Google has been the creation of the nation's
You have to care about eliminating health inequities. But caring is not enough, because we must educate ourselves on the determinants and the drivers of these inequities. And so we must know enough.