ENVIRONMENTAL DETERMINANTS
The Environmental Determinants of Occupation
Open this drawer when the determinants for occupational performance involve access, accommodation, attitudes, barriers, built environment, disability supports, ecology, environmental adaptation, expectations, micro-, meso- & macro- environment, services, systems & policy, stigma, social support, tools & technology.
TOOLS FOR THINKING
BASIC CONCEPTUAL MODELS
Understanding humans and their environment in which they live and work (knowledge of Geography, art, architecture, economics, politics, anthropology, and many more).
BASIC MODELS OF PRACTICE
Aim to change the environment through urban and social planning, advocacy, organizational tactics or other structural changes.
OCCUPATIONAL CONCEPTUAL MODELS
Helps us to understand the influence of environment or factors that are external to an individual or occupation. Could be built or natural environment, social environment or policies, institutions or services.
OCCUPATIONAL MODELS OF PRACTICE
Assessments and interventions include environmental audits for safety, accessibility, attitudes toward disability.
The Environmental Determinants of Occupation include both physical and social environment. They can either impede or facilitate occupation and are seen at 3 levels:
Micro: home and proximal surroundings
Meso: workplace, community, and neighborhood
Macro: society in which one participates, also include institutions such as government or healthcare system
The environment has physical, social, cultural, economic and political components. Occupational dysfunction arising from environmental determinant could be due to inadequate, less accommodative, overly controlling, hostile or an indifferent environment.
BIG "T" THEORY
The International Classification of Functioning, Disability, and Health (ICF)
The ICF was developed to reflect important aspects of the physical, social, and attitudinal environment in which people live and conduct their lives. This classification has three important principles:
universal application (all people can have their experience of a health condition described)
an integrative approach that acknowledges the impact of both individual features as well as social factors as important to consider in the understanding of disability as well as focusing on interventions
an interactive approach
World Health Organization. (2001). International classification of functioning, disability and health : ICF. World Health Organization.http://www.who.int/iris/handle/10665/42407
5 COMPONENTS OF THE ENVIRONMENT
Products and technology: the natural or human-made products or systems of products, equipment and technology in an individual’s immediate environment, that are gathered, created, produced or manufactured.
Natural environment and human made changes to environment: animate and inanimate elements of the natural or physical environment, and components of that environment that have been modified by people as well as characteristics of the population in that environment.
Support and relationships: people or animals that provide practical physical or emotional support, nurturing, protection and assistance, and relationships to other persons in the home, place of work, school or at play or in other aspects of their daily activities.
Attitudes: the attitudes that are the observable consequences of customs, practices, ideologies, values, norms, factual beliefs and religious beliefs. The attitudes classified are those of people external to the person whose situation is being described, not of the person themselves.
Services, systems and policies: services comprise structured programs, operations and services, public, private or voluntary, established at a local, community, regional, national or international level by employers, associations, organizations, agencies or government in order to meet the needs of individuals, and includes the persons who provide these services. Systems and policies respectively comprise the administrative control and monitoring mechanisms, and rules, regulations and standards established by local, regional, national and international government or other recognized authorities, which organize services, programs and other infrastructural activities in various sectors of society.
Schneidert, M., Hurst, R., Miller, J., & Üstün, B. (2003). The role of environment in the International Classification of Functioning, Disability and Health (ICF). Disability and rehabilitation, 25(11-12), 588-595.