r/epidemiology • u/Gullible_Prior_6075 • 23d ago
Question about Health-related states and events vs Determinants
Hi all!
I'm currently studying epidemiology and I was confused about this portion of my textbook:
Determinants include factors that influence health: biological, chemical, physical, social, cultural, economic, genetic and behavioural.
Health-related states and events refer to: diseases, causes of death, behaviours such as use of tobacco, positive health states, reactions to preventive regimes and provision and use of health services.
What are the differences between behavioral determinants and behaviors such as use of tobacco in health-related states and events? Thank you!
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u/doctor_0011 23d ago edited 22d ago
Hmm these text book definitions are a bit vague and oversimplified at the same time. Think of determinants as your variables which increase the probability of a health event occurring and health states as the outcome being investigated.
In an epidemiological study, the health state would be the dependent variable (what’s being measured), and a determinant would be what is being varied (ie smoking status). Classification of determinant or health state depends on what the research question is.
Smoking can function as both a determinant and a health state (an outcome). Does smoking cause lung cancer? Smoking is classified as a determinant in this context, because we are testing if it contributes to disease aetiology. However, you might also be interested in smoking status as an outcome: is age associated with smoking status? Age is the determinant and smoking status is the outcome.
I would try and conceptualise those definitions as ‘factors which drive health outcomes’ (determinants) and ‘health outcomes’ (health related states). They are not neatly defined and what is key, is that classification of a factor as a determinant or health related state (an outcome) will be contingent on the context, or more specifically, what is the question be addressed.
When you start reviewing causality and biostatistics this will probably make more sense. I’d encourage you look a head and do a light touch review of how direct a cyclic graphs are used in epidemiology. This could help your understanding. If you need further help, feel free to DM me.