Defining the Personal Determinants of Health for Older Adults

Abstract

Social Determinants of Health (SDOH) are defined as the broad community-scale conditions and factors shaping daily life. Meanwhile, less is known about the personal, individual-level characteristics impacting health outcomes. These have not been defined as a construct, leaving a gap in overall understanding of the resources that shape healthy and successful aging. Our primary purpose is to propose and define a new construct encompassing critical personal resources to be known as the Personal Determinants of Health (PDOH), built on resilience as a key strength later in life and supported by factors that buffer challenges and declining health. A literature search was conducted to streamline the scope of this review, with key terms determined to identify relevant publications; common databases and resources were utilized. Search strategies failed to identify a standard definition for Personal Determinants of Health as a construct, nor does this term exist regarding applied initiatives with older adults. Thus, a clear opportunity exists to establish PDOH as a unique construct. Despite evidence that individual characteristics impact late-life health outcomes, these key personal resources have not been established as a separate construct. Thus, we propose to define PDOH with a foundation of resilience supported by selected personal resources. Establishing this new construct will be critical in designing initiatives to support older adults and improve their health outcomes.

The Impact of COVID-19 on Informal Caregivers in the US

“…Notably, high resilience may be accessed by female caregivers as a buffer to severe stress during times of crisis, potentially explaining why they have reported lower increases in caregiver burden as compared to their male counterparts [1,27] . Resilience is highlighted as the core of an emerging concept described as personal determinants of health (PDOH), a collection of personal resources that buffer challenges in life and support optimal health outcomes [47] . Even prior to COVID-19, growing perspectives on health outcomes began to shift from a sole focus on negative risk factors to encompass the positive resources within an individual's control [48] .…”

“…Recent research demonstrates that older adults with a combination of at least one of these attributes tend to have better health outcomes than those who do not [48] . The most influential of these resources include not only resilience, but also purpose in life, optimism, and social connections, all of which have been compromised by the pandemic [47] . The abrupt absence of strong support systems, roles, and activities; growing anxiety and stress; and the intensifying role of informal caregiving arguably amount to accumulating impacts on these factors [47] .…”

“…The most influential of these resources include not only resilience, but also purpose in life, optimism, and social connections, all of which have been compromised by the pandemic [47] . The abrupt absence of strong support systems, roles, and activities; growing anxiety and stress; and the intensifying role of informal caregiving arguably amount to accumulating impacts on these factors [47] . Notably, as policy and practice directions for caregiver support shift as a result of COVID-19, initiatives to focus on boosting the key PDOH during times of crisis could be worthwhile.…”

Loneliness, Social Isolation, and All-Cause Mortality in a Large Sample of Older Adults

“…Across both urban and rural areas, these new protocols impacted all aspects of life, with devastating effects touching not only physical and mental health but also important social and personal health indicators. Personal determinants of health (PDOH) are considered the individual-level resources that can help to support positive health outcomes; the key PDOH include resilience, optimism, purpose in life, and social connectedness ( MacLeod et al, 2021 ). Even prior to the pandemic, these PDOH—including social connectedness—were already critical to positive health outcomes later in life.…”