Health Determinants


After this unit, students should be able to:
1. To define determinants of health.
2. To understand the bio-psycho-social relationship in the health-disease process.
3. To know the effect of socio-structural and intermediary factors, social and community networks and macro socio-economic, cultural and general environmental conditions in the health status of populations.
4. To understand the relationship of health systems and the health status of people.
5. To describe specific features of biophysical and psychosocial environment with relevant effect on the health of individuals and communities (water, sanitation, housing, nutrition).

General characterization





Responsible teacher

Cláudia Conceição


Weekly - 8

Total - 36

Teaching language

English and Portuguese


Attendance of 2/3 of classes is mandatory


• Göran Dahlgren and Margaret Whitehead. Policies and strategies to promote social equity in health. Background document to WHO – Strategy paper for Europe.
• WHO, The determinants of health
• Water Sanitation and Hygiene 2015–2020. A Global Strategy for accelerating and sustaining progress on Neglected Tropical Diseases.
• Nolte E, McKee M. Does healthcare save lives? Avoidable mortality revisited. London: The Nuffield Trust, 2004.
• Commission on Social Determinants of Health Final Report. Closing the gap in a generation: Health equity through action on the social determinants of health. Geneva: WHO, 2008.

Teaching method

Theoretical and theory/practical classes, with debate, in which the basic concepts to teach, will be transmitted with audio-visual support. Interpretation of problems and information taking into account the knowledge acquired in theoretical and theoretical-practical classes.

Evaluation method

The students, with a minimum of 2/3 of frequency, will be evaluated based on two parameters: evaluation of participation in a seminar and a written exam.

Subject matter

I. Concepts and technical terms. Interaction between social and biological disease production.
II. Socio-structural and intermediary determinants: biological (age, gender, genetic factors), social and economic (poverty, employment, social exclusion, socio-economic status), environmental factors (social environment, habitat, air and water quality), lifestyles (diet, physical activity, addictive behaviours, sexual behaviour), access to services (education, health, social services, transport, leisure).
III. Health system as a determinant: contribution to health status of populations.
IV. Health in the proto-cities and displaced populations.
V. Water: quality characteristics; health risks; treatment of drinking water. Diseases transmitted from excreta; forms of wastewater treatment. Access to improved water sources and sanitation.
VI. Food: unsanitary food, contaminants and sanitation of food, nutrition and health.


Programs where the course is taught: