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Both access to health services and the quality of health services can impact health. Healthy People directly addresses access to health services as a topic area and incorporates quality of health services throughout a number of topic areas.

Determinants of Health

For example, when individuals do not have health insurance, they are less likely to participate in preventive care and are more likely to delay medical treatment. Barriers to accessing health services include:. Individual behavior also plays a role in health outcomes. For example, if an individual quits smoking, his or her risk of developing heart disease is greatly reduced. Many public health and health care interventions focus on changing individual behaviors such as substance abuse, diet, and physical activity.

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Positive changes in individual behavior can reduce the rates of chronic disease in this country. Some biological and genetic factors affect specific populations more than others. For example, older adults are biologically prone to being in poorer health than adolescents due to the physical and cognitive effects of aging. Sickle cell disease is a common example of a genetic determinant of health.

Sickle cell is a condition that people inherit when both parents carry the gene for sickle cell. Examples of biological and genetic social determinants of health include:. Achievements in public health, — motor-vehicle safety: A 20th century public health achievement [Internet]. MMWR Weekly. National healthcare disparities report, Rockville MD : U. Pub no. Commission on Social Determinants of Health. Closing the gap in a generation: Health equity through action on the social determinants of health [Internet]. Geneva: World Health Organization; [cited May 10].

Background information on national indicators for social determinants of health.

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Institute of Medicine. Unequal treatment: Confronting racial and ethnic disparities in health. Department of Health and Human Services. Wilkinson R, Marmot M, editors. In most cases Physiopedia articles are a secondary source and so should not be used as references.

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Physiopedia articles are best used to find the original sources of information see the references list at the bottom of the article. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement.

Cite article. Most people will live to experience ageing. Age-related deterioration is affecting an ever-growing number of people.

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There are many theories about the mechanisms of age related changes, and they are mutually exclusive, no one theory is sufficiently able to explain the process of ageing, and they often contradict one another. Modern biological theories of ageing in humans currently fall into two main categories: programmed and damage or error theories. The programmed theories imply that ageing follows a biological timetable regulated by changes in gene expression that affect the systems responsible for maintenance, repair and defense responses , and the damage or error theories emphasise environmental assaults to living organisms that induce cumulative damage at various levels as the cause of ageing [2].

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Curve 2: Modern programmed aging theories — There is an evolutionary cost associated with surviving beyond a species-specific age. Goldsmith's review of modern programmed adaptive theories of biological ageing investigates how organisms have evolved mechanisms that purposely limit their lifespans in order to obtain an evolutionary benefit.

In his review of the modern theories of ageing, Jin [2] highlights three sub-categories of the programmed theory, and four sub-categories of the damage or error theory, and also relates some to how these might be observed in ageing populations.

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Trindade et al [5] provide a different viewpoint again, stating that to understand the evolution of ageing, we have to understand the environment-dependent balance between the advantages and disadvantages of extended lifespan in the process of spreading genes. These researchers have developed a fitness-based framework in which they categorise existing theories into four basic types: secondary beneficial , maladaptive neutral , assisted death detrimental , and senemorphic aging varying between beneficial to detrimental.

Some of the more commonly discussed theories and their relation to ageing are summarised below:.