• Factors or events that are capable of bringing about
change in health (PBSCB) i.e physical, biological, social,
cultural and behavioural factors that influence health
• Examples
• Specific biologic agents (e.g., bacteria, viruses, protozoa).
• Chemical agents that may act as carcinogens
• Stress or adverse lifestyle patterns (lack of exercise, or
tobacco consumption or diet high in saturated fat
• Determinants of disease can be intrinsic or extrinsic
, Extrinsic determinants
1) Physical - mechanical injuries/trauma, thermal,
radiation, noise, psychological stress, light, etc.
2) Chemical - organic/inorganic forms, gases
3) Nutritional - metabolic, primary/secondary,
nutritional deficiencies, hormonal imbalances, etc.
4) Biological - all living organisms that cause disease
or infection - bacteria, virus, rickettsia, protozoa,
fungi, etc. Genetic defects are included here
, Dynamics of disease transmission
• Disease results from the interaction of the
host (a person), the agent and the
environment
• Many underlying principles govern
transmission of diseases
• Human susceptibility is determined by genetic,
nutritional and immunological characteristics
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