CM2.1-5 | Social and Behavioural Determinants of Health — Glossary

A framework explaining health service utilisation through three categories: predisposing factors (beliefs, socio-demographics), enabling factors (income, geography, insurance), and need factors (perceived and evaluated illness severity).

A five-class SES classification based solely on per-capita monthly income, updated periodically with CPI-IW.

A classification of households whose per-capita consumption falls below the official poverty line, making them eligible for subsidised government services; defined by Tendulkar (2009) and revised by Rangarajan (2014) committees.

Consumer Price Index for Industrial Workers — the index used to update income components of Kuppuswamy and B.G. Prasad SES scales to current rupee values.

Resources and structural conditions — income, insurance coverage, transport, facility proximity, provider availability — that make health service use possible or impossible.

Any action undertaken by an individual who perceives themselves to be ill, for the purpose of finding an appropriate remedy; encompasses both formal (professional) and informal (traditional, self-medication) pathways.

Integrated Child Development Services: a government programme delivering nutrition, immunisation, preschool education, and referral services to children under-6 and pregnant/lactating women through anganwadi centres.

Downstream living conditions — housing, income, occupational exposure, healthcare access, social support — through which structural determinants translate into individual health outcomes.

Two or more married couples — typically a parental couple and their married children — sharing a common residence, kitchen, and income pool.

Mahatma Gandhi National Rural Employment Guarantee Act (2005): guarantees 100 days of wage employment per household per year in rural India; a social protection scheme that strengthens economic enabling factors for health.

A validated urban socio-economic scale scoring education (0–7), occupation (1–10), and per-capita monthly income (1–12) of the head of household; total 3–29 classified into five SES classes; income component updated with CPI-IW annually.

A family unit consisting of two parents and their unmarried children living together in one household.

A validated rural SES scale with eight multidimensional domains including education, occupation, land, housing, social participation, farm power, material possessions, and food self-sufficiency.

Pradhan Mantri Jan Arogya Yojana (Ayushman Bharat): government-funded health insurance providing Rs 5 lakh per family per year for secondary and tertiary hospitalisation, targeting the bottom 40% of the Indian population.

The bidirectional reinforcing relationship between poverty and illness: poverty increases disease risk; illness reduces earning capacity and deepens poverty.

Characteristics existing before illness onset — including socio-demographic attributes, social structure, and health beliefs/attitudes — that influence the probability of using health services.

The network of relationships, mutual trust, and reciprocity within a community that functions as a collective resource; high social capital is associated with better health outcomes and greater programme uptake.

The conditions in which people are born, grow, live, work, and age — including education, income, occupation, housing, and social norms — that are the primary drivers of health inequity.

The systematic, stepwise relationship between social position (income, education, occupation) and health outcomes — the lower the social position, the worse the health.

A shared rule or expectation within a group governing what behaviour is typical (descriptive) or expected/approved (injunctive); a major determinant of community health behaviour.

A composite measure of an individual's or family's social standing based on education, occupation, and income, used to stratify health risk and guide resource allocation.

Upstream social forces — governance, macroeconomic policies, education systems, cultural norms — that shape the distribution of resources and produce social gradients in health.

A family in which three generations — grandparents, parents, and children — share the same household.

Village Health, Sanitation and Nutrition Committee: a community-based structure that monitors local health services, identifies health needs, and plans community-level health interventions at the village level.