Table 1.
Conceptual framework for health determinants at different levels in relation to health outcomes with potential links to urbanisation
| Determinant level | WHO DPSEEA modela framework level (14) | WHO Burden of disease framework level (15) | Our selected variables |
|---|---|---|---|
| High level (socio-economic) | Driving forces and Pressures behind different health risks | Distal socio-economic causes | 1a. Socio-economic measures (education; employment; income) |
| 1b. Housing conditions (renting; amenities in home; rubbish and odours in neighbourhood) | |||
| 1c. Household possessions (modern home appliances; motorcycle; car) | |||
| Mid level (environmental) | State of the living/working environment and related conditions | Proximal causes | 2a. Physical environment (pollution; agrochemicals or pesticides in neighbourhood; workplace hazards) |
| 2b. Social conditions (engagement in social activities; social support; trust) | |||
| 2c. Working conditions (shift work; working extended hours; job security) | |||
| Proximate level (behavioural) | Exposures to specific hazards | Physiological and pathophysiological cause | 3a. Diet (fried foods; junk food; fruit and vegetables) |
| 3b. Physical activity and inactivity (exercise; housework; sedentary past-times) | |||
| 3c. Health-damaging practices (smoking; alcohol; use of seatbelt/helmet) | |||
| Health outcomes | Effects on health and well-being | Outcomes and sequelae | 4a. Metabolic health states (obesity; high blood pressure; diabetes) |
| 4b. General and mental health (overall health; psychological distress; emotional limitations) | |||
| 4c. Injuries (traffic injury; injury in the home; workplace injury) |
aDPSEEA model = ‘Driving forces–Pressures–State–Exposure–Effects–Actions’ model.