The need to discover effective methods to prevent chronic and debilitating illness, combined with increasing life expectancy, was paramount. There was a growing recognition of the importance of social, economic and cultural inequalities in health. .
Many social, cultural and economic factors affect health but those determinants that have been shown in a variety of settings to have the greatest influence appear to be income and poverty, employment and occupation, education, housing, population based services (for example electricity for heating and refrigeration, water and sewerage), social cohesion and culture and ethnicity. .
2. Determinants of Health .
2.1 Income .
A report from the National Health Committee of New Zealand (1998) states, "income is the single most important determinant of health. There is a persistent correlation world wide between low income and poor health. With few exceptions, the financially worst off experience the highest rates of illness and death". Therefore, it could be said, that a sufficient income is a requirement for a number of other determinants of health, such as suitable housing, a balanced diet and access to educational opportunities. Falkingham (1999, Social policy & welfare, p 115) refers to T. McKinley's work in the 1990s on two complimentary measures of poverty: .
• Income poverty - covering the ability to purchase food, clothing and shelter.
And more interestingly.
• Capability poverty- covering the ability, or lack of, to live a healthy life, free of avoidable disease; having adequate nourishment; being informed and knowledgeable; being capable of reproducing; being personally secure; and being able to actively participate in society.
Poverty has long been recognised as an important determinant of ill health (Calman 1997). It is widely understood that people who are poor have worse self-reported health, higher rates of disability, and higher rates of death, disease and injury.