Te Kete Ipurangi Navigation:

Te Kete Ipurangi

Te Kete Ipurangi user options:

You are here:

Determinants of Health

Intended outcomes

Students will:

  • demonstrate their understanding of the wider social factors (determinants) that affect people's well-being (7A4, 7C2, 7D1)
  • establish priorities for policies to raise standards of health across the population (7D2, 7D3)
  • identify and examine ways in which determinants of health are interrelated (7A4, 7C2, 7D1)

Links to NCEA Achievement Standards

This foundation unit will help prepare students for assessment against all NCEA level 2 and 3 achievement standards in health education.

Key areas of learning

  • Mental health
  • Sexuality education
  • Food and nutrition

Key concept

Socio-ecological perspective: Analysing how determinants of health and their interrelationships affect people's well-being.

Background information

The activities in this section are essential for health education at this level. (They may also be used in physical education and home economics.) They are designed to help students identify and understand the factors that affect the well-being of people in society generally, and they provide students with opportunities to think critically as they learn to look at health issues from a socio-ecological perspective.

The three activities on pages 38–41 are intended to be combined as a unit of work that provides students with background information about determinants of health and related concepts. Students can then draw on this knowledge in a range of situations and learning contexts. It is recommended that this unit of work be implemented early in year 12 programmes.

For each activity, allow sufficient time for in-depth discussion that includes analysis and synthesis of new concepts introduced and students' ideas.

A complete version of the activity on pages 46–47, with teaching materials, can be found in Social Issues: Alcohol (Tasker and Hipkins, 2002).


Below are three possible learning activities provided for this learning experience.

Activity 1: A picture of health

Share the learning goals (intended outcomes) with your students and establish success criteria.

Students work in small groups. Give each group a photo and ask them to discuss the following questions in relation to their photo.

  • What do you think is happening, or what could have happened, in the photo?
  • What can you tell about the person?
  • Does the person look healthy?
  • Explain all the factors (determinants) that could be affecting their well-being

Print out and enlarge the  Health determinants: Key terms and sentences (PDF, 7 KB) handout (if necessary) and cut it into separate terms with their sentences. Place them in random order on a surface where the students can view them all. Students examine these and, as a group, select a term and sentence(s) that they think could match their photo.

Display the photographs with their matching statements around the room for students to share and discuss. This process will help them to identify social determinants of health.

Then provide each student with a list of determinants. Either in discussion or in writing, students go on to demonstrate their understanding of determinants that affect people's well-being.

Teachers' notes

This first activity helps students to identify some social determinants of health. Because students may initially have difficulty with some concepts, you may need to explain these fully.

Gather a set of photographs of people, such as those in the web-based document Social Determinants of Health: The Solid Facts (WHO, 1998). 

Alternatively, teachers could gather photographs that feature an aspect of health from newspapers or news/current affairs magazines, such as National Geographic magazine.

Print out and enlarge the following handout (if necessary) and cut it into separate terms with their sentences. Place them in random order on a surface where the students can view them all. Students examine these and, as a group, select a term and sentence(s) that they think could match their photo.

Activity 2: Factors affecting well-being

Make up a set of cards, each of which contains information about a particular determinant of health. You could make up a set based on the example below, including additional details from Social Determinants of Health: The Solid Facts (WHO, 1998) or from Social Issues: Alcohol (Tasker and Hipkins, 2002), pages 103–124.

The cultural determinant:

Give each group of students a Cultural determinant card (PDF, 26 KB) . Each group discusses their responses to the following questions and instructions (in relation to the determinant on their card) and then presents their conclusions to the whole class.

  • What determinant of health is on your card?
  • What impact does it have on people's well-being?
  • What might need to be changed to bring about more positive health outcomes in relation to this determinant?
  • All determinants of health are interrelated. Explain how the effects of other determinants may compound the effects of your determinant on people's well-being.
  • Referring to the information provided on your card, suggest one or more laws, policies, or practices that could raise standards of health across the population in relation to this determinant. You may need to consider other laws, policies, or practices that could compound its effects.
  • As a class, discuss and agree on priorities for these policies.

Teachers' notes

Activity 3: The deal of life

Students work in groups of about five. Give each group of students a set of cards. (See Teachers' notes on this page.) One student deals out the cards, face down, to the other group members. One at a time, each student turns over one of their cards and reads out the statement on it. As each card is turned, the group responds to question 1 below so that each group gradually builds up a profile of a person's health.

If the statements on different cards appear to contradict each other, students can discard one card, but in general they should try to build up a profile that accommodates apparent discrepancies.

Building a profile

  • Question 1: What would you expect this person's health to be like? Explain your answer.
    Once they have built up the profile of their person, each group considers the following questions and then shares their conclusions with the whole class.
  • Question 2: Do you think that this person is healthy?
  • Question 3: Considering the profile of this person and the ways their health is affected by social determinants of health, how long do you think they might live?
  • Question 4: How might these social determinants be changed to enhance the health of this person?
  • Question 5: How likely is it that these determinants will be changed? Explain your answer.
  • Question 6: What other determinants of health might affect the well-being of this person?

The profile could include personal determinants, such as genetic factors, age, and gender, lifestyle determinants, and cultural, political, and environmental determinants.

Engage students in an in-depth discussion of the interrelationships among the various determinants of health. Go on to examine how the effects of any determinant may be compounded or mitigated by the effects of other determinants.


Students each select one determinant of health. They research existing national or local legislation, policies, and practices that are designed to mitigate the negative effects of this determinant (or to enhance its positive effects) in order to achieve equitable outcomes for all groups in the community or to help disadvantaged groups. Local websites may have sections that provide relevant regional information.

Students then present a brief report on their findings. They could consider the policies already in place and decide on the next priority for policy in this area.

Teachers' notes

This third activity enables students to analyse some of the complex interrelationships between determinants of health.

Make up different sets of ten cards – one for each social determinant of health. Each card contains a statement that relates to one social determinant of health.

  • One card has a statement about work, such as: "High level of job control – high satisfaction rate – can make choices about tasks".
  • Another has one about food, such as: "Balanced diet with very little processed food".
  • Another is about social support, such as: "High level of social support from family and community", and so on).

For a source of six such statements for each social determinant of health, refer to Social Issues: Alcohol (Tasker and Hipkins, 2002).

The statements in each set contribute to the profile of an individual.

Further activities focusing on determinants of health within the context of health education at years 11-13 can be found in 'Determinants of health and changing states of health' and 'Applying knowledge of determinants of health'.