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March 2005, Vol 95, No. 3 | American Journal of Public Health 389-392
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2003.033324

POLICY, BIOLOGY, AND HEALTH

Biological Basis of Determinants of Health

Walter M. Bortz, MD

Walter M. Bortz. MD, is with the Stanford University School of Medicine, Portola Valley, Calif.

Correspondence: Requests for reprints should be sent to Walter M. Bortz, MD, Stanford University School of Medicine, 167 Bolivar Lane, Portola Valley, CA, 94028 (e-mail: drwbortz{at}aol.com).

Clinical medicine and health policy planning find common cause as they seek to define the determinants of health. There is substantial recent interest in the social ecology in which health is embedded. However, biology is where these contributing environmental factors are translated.

I provide a new conceptual framework for the biological determinants of health. The old public health rubric of host, agent, and environment as the features that define the root elements of health is an impoverished scheme, because it does not represent our new appreciation of genetic and aging contributions to phenotypic health. I propose genes, external agency, internal agency, and aging as more operationally helpful determinants that effectively describe the biological experience of the organism.

This scheme has the advantage of differentiating those agencies that are practically approachable, and therefore deserving of increased attention and investment, and those that are currently intractable.






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Copyright © 2005 by the American Public Health Association