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Determinants
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Things that may affect our health
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1. Behavioral factors
2. Natural environment
3. Genetic determinants
4. Social determminants
5. Population dynamics
6. Political and cultural factors
7. Globalization
8. Climate change
9. Urbanization
2. Natural environment
3. Genetic determinants
4. Social determminants
5. Population dynamics
6. Political and cultural factors
7. Globalization
8. Climate change
9. Urbanization
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9 Determinants of health
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- Dynamism
- Multiscale
- Cross-boundary
- State changes
- Multiscale
- Cross-boundary
- State changes
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Complicating features of determinants
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Dynamism
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Dynamic and changing character of determinants
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Multiscale
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Determinants operate at various scales
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Molecular to global
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Various scales of multiscale
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Cross-boundary
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Public health threats transcend international boarders
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State changes
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Large, abrupt changes at societal or planetary levels can drive patterns of health and illness for generations
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- Society
- Culture
- Social pathology
- Culture
- Social pathology
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The society and health
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Society
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Organized by group of individuals following a given way of life
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Culture
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Learned behavior that is socially acquired
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Culture
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A product of human societies
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Culture
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Customs, beliefs, values, and religion
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Social pathology
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Study of human disease in relation to social conditions and disease process outside the human body
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Social pathology
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Social problems, social conditions, and social circumstances
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1. Poverty and destitution
2. Illiteracy and ignorance
3. Migration
4. Lower status of women
5. Child neglect and abuse
6. Child labor
7. Drug abuse
8. Juvenile delinquency
2. Illiteracy and ignorance
3. Migration
4. Lower status of women
5. Child neglect and abuse
6. Child labor
7. Drug abuse
8. Juvenile delinquency
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8 Social problems
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1. Housing
2. Environmental sanitation
3. Crime and corruption
4. Stress
5. Suicide
2. Environmental sanitation
3. Crime and corruption
4. Stress
5. Suicide
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5 Social conditions
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1. Social sigma
2. Social isolation
3. Vulnerable population
2. Social isolation
3. Vulnerable population
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3 Social circumstances
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Social environment
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All that rise from social relationships susch as customs, traditions, social conduct, rituals, diet, way of life, economic status
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1. Social security
2. Fair distribution of food and other life amenities
3. Facilities for exercise and leisure
4. Facilities for education for all
5. Propagation of healthy customs, freedom of expression and thought
6. Protection of property, life and honor
7. Safe workplace
2. Fair distribution of food and other life amenities
3. Facilities for exercise and leisure
4. Facilities for education for all
5. Propagation of healthy customs, freedom of expression and thought
6. Protection of property, life and honor
7. Safe workplace
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7 Social environment
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Medical model and WHO model
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Health models
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Medical model
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Lack of disease
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WHO model
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Complete physical, mental, and social well-being
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- Region
- Religious and spiritual factors
- Age
- Access to technology
- Religious and spiritual factors
- Age
- Access to technology
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What are the health in different contexts
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- Affects disease susceptibility
- Can promote health protection
- Influences population health and well-being
- Can promote health protection
- Influences population health and well-being
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Cultural practices
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Affects disease susceptibility
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Wiping of infant's umbilical cord and risk of tetanus
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Affects disease susceptibility
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Use of lead-containing pigments in cosmetics and medicament and risk of anemia, nerve damage
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Can promote health protection
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Breastfeeding and risk diarrhea and infant death
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Influences population health and well-being
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Tobacco use and restriction and smoking behavior
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socio-econimic status
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Most important preditor of health
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Socio-economic status
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Income, education, occupational status
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Socio-economic ststus
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Stratification by social calss, gender, race/ethnicity
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socio-economic status
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Lowest SES = highest mortality rates
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Socio-economic status
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Nutrition, access to medical care, psychological stress
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poverty
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Higher burden of disease
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Poverty
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Persistence of poverty
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Poverty
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Inability to provide for necessities of life
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- Absolute poverty
- Medical poverty
- Medical poverty
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2 types of poverty
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Absolute poverty
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Lack of a minimum income necessary for simple survival based upon the price of a basket of 'essentials' goods and services
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Medical poverty
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Catastrophic illness forces people to sell assests and exhaust savings
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Cultural/behavioral
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Poorer people make unhealthy choices
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Cultural/behavioral
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Social contexts and disease burden should be considered
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Natural or social selection
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Healthier people become wealthier
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Natural or social selection
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People are poor, they are unhealthy
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Materialist or structural
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Material conditions and circumstances of poverty affect health
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Materialist or structural
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Related to psychological risk and factors
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1. Major determinants of health
2. Better hosuing
3. Reducing crowding
4. Improved water and food quality
5. Reduced dangerous working conditions
6. Reduced rates of diseases
2. Better hosuing
3. Reducing crowding
4. Improved water and food quality
5. Reduced dangerous working conditions
6. Reduced rates of diseases
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6 economic determinants
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Wealthier nations and poorer nations
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2 types of economic determinants of health
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Wealthier nations
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Abundancce of processed foods
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Wealthier nations
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Epidemics of obesity, diabetes, chronic diseases
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Poorer nations
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Unhealthy housing
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Poorer nations
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Deficient infrastructure
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Poorer nations
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Malnutrition
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Poorer nations
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Dangerous sweatshop working conditions
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Educational strategies
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Informs and educates public
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Educational strategies
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Issues of concern
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Automatic protective strategies
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Controls environment variables
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Automatic protective strategies
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Minimizes need for individual decisions
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Automatic protective strategies
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Limited freedom of choice
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Coercive strategies
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Legal and formal sanctions
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Education is the most influential socio-economic status
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Education's influence on behavior
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Education
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It strongly associates with most health-behavior measures, among the SES indicators
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Contagion theory
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Direct and indirect contact with sick people or animals might transmit diseases
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Miasma theory
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Dirty living environments, unclean drinking water, and poor ventilation due to overcrowding might cause various diseases
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Koch's psotulates
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One-to-one relationship between cause and disease
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Koch's postulates
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Less applicable to chronic diseases
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Hill's criteria
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Strength, dose-response relation, temporality, specificity, and biological plausibility of the association between risk factor and diseases
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Environment and health
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Trend from infectious to chronic non-communicable diseases
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Education and health
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Lifestyle habits, dietary intakes, environment pollution in development of chronic diseases
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Education and health
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Multiple risk factors in pathogenesis of chronic diseases
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education and health
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Environmental pollutants in chronic diseases of multiple organ
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Education and health
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Systems
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Education and health
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Effects of long-term exposure to industrial waste develop insidiously
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Education and health
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Air pollution increases risk of pulmonary diseases
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Education and health
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Workplace environment substantial to occupational diseases
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Environmental health
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All aspects of the natural and built environmnet that may affect human health
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Environmental health
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Aspects of human health and disease that are determined by factors in the environment (WHO)
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Environmental health
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Assessing and controlling factors in the environment that can affect human health
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Direct and indirect
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Types of environmental health
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- chemicals
- radiation
- biological agents
- radiation
- biological agents
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3 types of direct
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- housing
- urban development
- land use
- transport
- imbalance among the many elements that make a person
- urban development
- land use
- transport
- imbalance among the many elements that make a person
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5 types of indirect
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1. Air quality
2. Climate change and its effect on health
3. Disaster preparedness and response
4. Noise pollution control
5. Food safety
6. Land use planning
2. Climate change and its effect on health
3. Disaster preparedness and response
4. Noise pollution control
5. Food safety
6. Land use planning
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6 examples of environment health
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