upstream determinant

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A determinant of disease that has an indirect but obvious effect on risk factor(s) for disease. For example, poverty is an upstream determinant of childhood malnutrition; affluence is an upstream determinant of coronary heart disease because it tends to be associated with risk factors such as diets rich in lipids, but it may also be an upstream determinant of reduced risk if it is associated with knowledge of risk and protective factors and the capacity to maximize benefit from these. See proximal and distal risk factor.

Subjects: Public Health and Epidemiology.

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