GLPH 171 – Module 1

state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

biological or physical malady affecting the body

perception of dysfunction by the afflicted individual

social acknowledgment of impairment of affliction

disease without illness (hypertension)

illness without disease
(hypochondriac)

illness without sickness
(headache)

- germs
- genetics
- lifestyle
- multifactorial disease causation (epigenetic or environmental factors)

- germs present intones w disease and absent in those without
- germs can be isolated/cultured from those w disease
- germs cause diseases when introduced into healthy host
- German can be re-isolated from newly-diseased host

ignores social context and genetic origins of diseases

- sepsis caused by dust contaminating surgical wounds
- antiseptic conditions should prevent wound infections

- germ theory of disease
- principles of microbial fermentation and sterilization
- heat treatment for milk and wine

responsibility of disease is bc of genetics and environment

behaviourally driven

having a specific gene raises risk of disease but not completely deterministic (environmental trigger needed)

- learning
- financial security
- social participation
- work
- leisure
- housing
- health
- security
- environment
- family life

group of individual with shared characteristics (can be geographically or politically defined, but doesn't need to be)

the health outcomes of a group of individuals, including the distribution of such outcomes within the group

The study of the distribution and determinants of disease in populations

distribution: descriptive epidemiology, how specific health outcomes are dispersed/patterned across a population (essential for developing hypotheses abt etiology of disease)

determinants: focus of analytical epidemiology, anything that influences state of health in indiv or distribution of health in population

- diseases distribute in relation to factors that determine health for individuals in population
- factors that determine health status can be identified by studying distribution of health outcome in populations

the range of personal, social, economic, and environmental factors that influence health status

- income and social status
- education and literacy
- gender
- culture
- access to health services
- healthy behaviours
- childhood experiences
- etc.

1. age, sex and constitutional factors
2. individual lifestyle factors
3. social and community networks
4. living and working conditions
5. general socio-economic, cultural and environmental conditions

factors closest to person (personal and biological features)
- sex and genes can contribute to susceptibility to specific disease

factors associated with individual's health practices and behaviours
- not always associated w individual's freedom (can be influenced by family, community or more)

how much social support individual receives from peer, family members and other in community
- stronger support = better health
- being able to express one's culture is important for individual health

education system, work environment, housing/health care services and access to water, sanitation services and for production

broad/distal factors that influence health in direct/indirect ways
- climate change
- poverty level

specific group of social and economic factors within broader determinant of health that influence health outcomes

factors in the physical environment which affect health risk and health outcomes

- psychosocial
- biological
- environmental
- health policy effects
- individual behaviours

root causes, underlying causes, proximal causes

broader factors in natural environment, macro-environment and population level inequalities

aspects of built environment and social context that might influence health as medium range

factors that are closer to individual

increases individuals risk of negative health outcome
- intrinsic (biological, non-modifiable)
- disease-related
- behavioural
- physical environment
- social environment

- high blood pressure
- smoking
- air pollution
- high blood sugar
- obesity

traditional risks
- undernutrition, indoor air pollution, water sanitation and hygiene

modern risks
- tobacco
- obesity and physical inactivity
- urban air quality, road traffic safety, occupational risks

specific ways to measure health status

1. determine causes of illness, disability, and death
2. carry out disease surveillance
3. make comparisons about health within and across countries

- life expectancy at birth
- neonatal mortality rate (under 28 days)
- infant mortality ratem (under 1 year)
- under-5 mortality rate
- maternal mortality rate (during pregnancy/childbirth)

vital statistics (births and deaths) and mortality

a type of difference in health that is closely linked w social or economic disadvantage

- income
- variation in health indicators

a difference or disparity in health outcomes that is systematic, avoidable, and unjust

inequality = equal shares (doesn't address health differences bc everyone has different starting points)

inequity = fair shares (more or less depending on needs)