GEO 3431B Midterm

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consistency of findings in different populations and in different countries strengthens the inference of causation

amount of time between exposure and onset of disease

the greater the exposure the stronger the effect

established from animal studies

an association is specific when a certain exposure is associated with only one disease

way of presenting probabilities

- sample size
- variability of the characteristics being studies
- degree of confidence required

between the time the infection occurs and the appearance of clinical symptoms

each disease has a particular cause

native or confined to a particular region or people

an endemic disease that affects a small proportion of the population at risk

at an especially high level of continued incidence in a population

number of cases of a specific health disorder occurring within a given pop during a stated period of time

It is the number of all cases of a disease (both old and new) that are identified in a specific population at a given point in time.

incidence = rate at which cases first appear

prevalence = rate at which all cases exist

fundamental task of health research is to investigate causation

requirement that more than one factor be present for disease to develop

each effect has a number of causes and each cause can produce a a number of effects

- co-variation
- temporal precedence

X and Y are associated over space and time

X comes first in time, before Y

- there may be a true causal relationship
- the association may occur simply by chance
- X may co-vary with Y because of some third variable Z

disease causation is biologically specific

demonstrated that diseases could be produced by the intro of single specific factors

disease is a temporary or permanent impairment in the functioning of any single component, or of the relationship between the components making the individual

- disease as a deviation from normal biological functioning
- the doctrine of specific etiology
- diseases are generic: universal to human species
- scientific neutrality and rationality
- medical fashion is thought to develop and progress in a linear fashion

- concentration on individual
- focus on component parts of the body

The very notion of health is socially constructed and variable across populations and across time.

- positivist
- social constructionist - humanistic
- structuralist
- structurationist
- post-structuralist

seeks to establish testable hypotheses like natural sciences
- observable
- measurable
- generalizable

address human beliefs, values, meanings, intentions

Study how the subjective definitions of social reality are constructed and how this reality is experienced and described by the social actors

focuses on how underlying causes of disease and illness are embedded in political and economic systems

all knowledge is rooted in social, material, and historical context

one set of alternatives to positivist explanation gives greater weight to the lives of real people "human agency"

a general framework that explains how people use rules and resources to interact in a social system

perspectives are concerned with how knowledge and experience are constructed in the context of power relations

Diffuse defined as "to disperse or be dispersed from a centre; to spread widely, disseminate

process whereby a phenomenon of interest spreads from one place to another

a spatial spread process, but the items being diffused leave the area where they originated as they move to new areas

Hierarchical, contagious, and stimulus.

depends on direct contact

involves transmission through an ordered sequence of classes or places

- primary stage
- diffusion stage
- condensing stage
- saturation stage

marks the beginning of the diffusion process

signals the start of the actual spread process

relative increase in the numbers accepting an item is equal in all locations, regardless of their distance from the original

marked by a slowing and eventual cessation of the diffusion process, which produces a further flattening of the acceptance curve

- propagated epidemic
- common-vehicle epidemic

one that results from the chain transmission of some infectious agent

results from dissemination of a causative agent

- virological
-epidemiological
- clinical
- statistical
- geographical
- mathematical
- humanitarian

measles has been referred to as the simplest of all the infectious disease by WHO

measles exhibits very distinctive wavelike behaviour

disease can be ready identified with its distinctive rash and the presence of Koplik spots with the mouth

high rate of incidence leads to a very large number of cases over a short period of time to give a distinct epidemic event

disease is as widespread as a human population itself is in the early 21st century

despite major falls in mortality over this century, it still remains a major killer

Hamer-Soper model

relationship between the input and output components in the wave generating model has shown to be critical

approximates that of the normal curve

occupies an intermediate position and is included to emphasize that the changing waveforms are examples from a continuum

generated when the susceptible population is well above the threshold value

1. can we identify what is happening and why?
2. what will happen in future?
3. what will happen in future if we intervene in some specified way?

Basic reproductive ratio for a finite period of time of the pathogen in the host pop when resources (hosts) are not limiting

average number of 2degree cases per primary case after pathogen is established

- incidence endemic
- regular basis epidemic

The resistance of a group to an attack by a disease to which a large proportion of the members of the group are immune

- biomedical
- ecological
- psychosocial
- holistic

takes a holistic view of health, one of multidimensionality

- intrapersonal
- interpersonal
- extrapersonal
- metapersonal

- Gave us broader understanding of health promotion
- Shift in focus from individual risk factors to addressing context and meaning of health actions (determinants)
- Primary healthcare (where health promotion/disease prevention occur)
- Inputs to outcomes (Government held accountable)
- The process of enabling people to increase control over and to improve they own health

popular middle-class american phenomenon

- Lalonde reports
- beyond health care
- the mandala of health
- epp report

importance of lifestyle and environmental factors

Conference in toronto which shifted canadian and international public health thinking towards the idea of health as a collective concept

A model of the human ecosystem; attempt to better understand the determinants of health.

Achieving Health for All: A Framework for Health Promotion

Many People expect our health system to improve everybody's health, and in the long run reduce morbidity and costs

- technical
- medicalization
- demographic
- enviropathic
- administrative

Detection vs treatment: we can detect more than we can successfully treat

Iatrogenesis -over- and misapplication of biomedicine: when applied to problems it cannot solve, it can create morbidity

Increased life expectancy related to the epidemiologic transition - tremendous burden of chronic care

Belief in environmental causes of illness can create emotional impacts

Haven't measured the performance of the system well. Getting better at it

does not adequately explain health phenomena experienced by our society