Chapter 1 – Introduction to Health Assessment

Health Determinants

The Ottawa Charter for Health Promotion from the 1980s remains relevant, but in the 1990s there was a shift to a more expansive understanding of health determinants. See Table 1.6 for some examples of health determinants.

Table 1.6: Health determinants. (adapted from the Canadian Public Health Association, 1996).


Health determinants 


Healthy child development.

Assessment of healthy child development focuses on the physical, cognitive, and emotional development of the child and whether their needs are being met and developmental milestones are being reached.

Lifelong learning.

This type of learning involves the personal and professional pursuit of knowledge. It can involve developing job skills and improving employability, and thus socioeconomic stability. It may also inspire personal development and foster a continual pursuit of knowledge even into older adulthood

Absence of and associated with culture, gender, and sexual orientation.

Discrimination and racism can negatively affect a person’s health and wellbeing. Therefore, you should assess for the presence of these in a client’s life and how it affects them.

A life free of violence.

A life free of violence positively influences health and wellbeing. It is important to be aware of the negative effects of violence on a person’s life and how you can screen and assess for it.

Work opportunities and adequate income.

Access to work opportunities supports an individual’s development over the course of their life and also provides access to adequate income. Limited access to these opportunities can have negative effects on health and wellbeing.

Healthy lifestyles (nutrition, activity/exercise, sleep/rest, coping and stress management, and smoke free).

A range of lifestyle factors can negatively affect health and wellbeing and lead to certain disease processes. Inquiring about these factors is part of many assessments.

Healthy, social relationships.

Healthy, social relationships are positive health determinants throughout all life stages. These can include parenting relationships, friends, work, and intimate partner relationships: all of these can support development and quality of life.

Protection from infectious diseases and environmental hazards.

Living in an environment free from and/or protected from infectious diseases and environmental hazards is important to overall health and wellbeing.


Canadian Public Health Association (1996). Action statement for health promotion in Canada

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