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continuum
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more than the absence of a disease
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triangle of human ecology
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population, habitat, behavior
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what is health and medical geography
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discipline that uses concepts and methodologies from geography
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holistic viewpoint
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cultural systems and biosphere
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what does ecology mean to medical geographers
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multivariate factors that produce health and healthcare at multi scale
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ecology fallacy
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associations statistically identified at one scale of analysis are valid at or can be generated to either larger or smaller scales
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Leonhard Ludwig Finke (1792-95)
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the first person to use the term medical geography
- built on the holistic Hippocrates tradition to chart meaningful argument
- built on the holistic Hippocrates tradition to chart meaningful argument
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August Hirsch (1883- 86)
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- discovery of microbes invade human bodies and cause alterations
- led to development of vaccinations, antibiotics, chlorination of water, treatment of sewages
- led to development of vaccinations, antibiotics, chlorination of water, treatment of sewages
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political covariates+ social covariates+ physical covariates=
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positive/ adverse health outcomes
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health geo adopts ecological approach to examine
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- diffusion of disease
- spatiotemporal distribution/ patterns of disease
- social factorial analysis of disease patterns and distribution
- spatiotemporal distribution/ patterns of disease
- social factorial analysis of disease patterns and distribution
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what happened at the end of WWII
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there were vast production in antibiotics and powerful insecticides, such as DDT for eliminating vectors
- it was thought that the world will be free from infectious diseases
- knowledge of degenerative diseases such as heart diseases, stroke, cancer, liver and kidney failure and respiratory obstruction increased
- it was thought that the world will be free from infectious diseases
- knowledge of degenerative diseases such as heart diseases, stroke, cancer, liver and kidney failure and respiratory obstruction increased
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etiology
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the cause, set of causes, or manner of causation of a disease or condition.
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Jacques may
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- realized that the local and social- cultural- environmental conditions shaped the health of his patients
- published the map showing the distribution and species of helminths and microbes and ticks and mosquitoes
- published the map showing the distribution and species of helminths and microbes and ticks and mosquitoes
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def of health
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"health is a state of complete physical, mental and social well- being and not merely the absence of disease or infirmity"
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pathogens
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disease causing agents
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examples of stimuli (chemical)
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chemical:
- carbon monoxide
- drugs
- benzene
- formaldhyde
- calcium deficiency
- lead
- oxygen deprivation
- carbon monoxide
- drugs
- benzene
- formaldhyde
- calcium deficiency
- lead
- oxygen deprivation
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examples of stimuli (physical)
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physical:
- trauma
- radiation
- light
- noise
- electricity
- air pressure
- trauma
- radiation
- light
- noise
- electricity
- air pressure
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examples of stimuli (infectious/ biological)
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- prions
- viruses
- rickettsia
- bacteria
- protozoan
- helminths
- viruses
- rickettsia
- bacteria
- protozoan
- helminths
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examples of stimuli (psychosocial)
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- love
- anxiety
- crowds
- danger/ safety
- isolation
- abuse/ neglect
- community
- anxiety
- crowds
- danger/ safety
- isolation
- abuse/ neglect
- community
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risks/ insults vary by
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time and location
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exposure to risks depend on
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ambient environment (wind speed, number of cars, crime)
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congenital health conditions
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health conditions or diseases that are present at birth
- may be genetical in origin: hemophilia, diabetes, etc
- may be acquired in the womb as a chemical induced deformity: HIV, coronavirus, malaria
- may be genetical in origin: hemophilia, diabetes, etc
- may be acquired in the womb as a chemical induced deformity: HIV, coronavirus, malaria
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acute health conditions
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symptoms are severe and the course is short
- can be deadly in extreme cases
- some may be treatable and may not have a cure at all
- can be deadly in extreme cases
- some may be treatable and may not have a cure at all
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chronic health conditions
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when the present of reoccur over a long period of time: more than 6 months
- may be genetical in origin: hemophilia, diabetes
- may be acquired ion the job as a chemical induced deformity: HIV, Coronavirus, malaria
- acquired during birth process: inflammation of the eye caused by gonorrhea infection via birth canal
- may be genetical in origin: hemophilia, diabetes
- may be acquired ion the job as a chemical induced deformity: HIV, Coronavirus, malaria
- acquired during birth process: inflammation of the eye caused by gonorrhea infection via birth canal
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degenerative diseases
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diseases that are mostly age related
- deterioration or impairment of an organ
- deterioration or impairment of an organ
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infectious diseases
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- result from the activities of living creatures
- microorganisms that invade the body
- transmissible from one person to another
- microorganisms that invade the body
- transmissible from one person to another
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clinical vs subclinical
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clinical disease are detectable
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contagion
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- transmission of infectious diseases agent between people
- may be direct through person- to- person contact
- indirect through the bites of insect vectors or via fomites
- may be direct through person- to- person contact
- indirect through the bites of insect vectors or via fomites
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fomites
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objects or materials that are likely to carry infection, such as contaminated air, blankets, surfaces, money or water (vehicles)
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endemic disease
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disease constantly present in a population
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epidemic disease
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turns epidemic when it is transmitted beyond the normal rate and derived from a common or propagated source
- may include an outbreak spreading through a population
- may include an outbreak spreading through a population
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pandemic disease
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similar to epidemic, but it affects multiple countries or regions of the world
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incidence vs prevalence
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incidence: number of new cases of a disease diagnosed/ reported in a particular time, usually a year
prevalence: number of people who are reportedly sick in a particular time
prevalence: number of people who are reportedly sick in a particular time
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4 prerequisites for understanding the Human Ecology of Disease (HED)
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- population genetics
- physiology
- immunological status
- nutritional status
- physiology
- immunological status
- nutritional status
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cultural ecology
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more specific and refers to behaviors and belief systems within a particular culture
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landscape and its formation can help understand ecology due to
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- mobility and composition of population
- the determinants of economic activity and its location
- the diffusion of things, ideas and technology
- the determinants of economic activity and its location
- the diffusion of things, ideas and technology
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what is landscape (for health and disease)
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the landscape is composed of insects, medical herbs and hospitals
- also includes the topography, vegetation, animals, water resources, house types and neighborhoods
- also includes the topography, vegetation, animals, water resources, house types and neighborhoods
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why is mobility important n health geography
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mobility is important in exposure to an transmission of diseases, culture, and health beliefs
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population in the triangle refers to
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- human as the biological organism and
- human as the potential hosts of a disease
- human as the potential hosts of a disease
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the ability of a population to cope with insults of all kinds depends on
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- the genetic susceptibility or resistance- sets the limits of our possible responses
- nutritional status
- immunological status
- physiological status
- nutritional status
- immunological status
- physiological status
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age in the triangle refers to
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- life experiences that impact health
- diseases related to aging have become the interest of geriatrists
- diseases related to aging have become the interest of geriatrists
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genetics in the triangle refers to
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determines the limits of possible responses to : social, biological and physical experiences
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dna is the
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sum total of all genetic information
- can be altered, deleted, switched, overridden or repeated
- can be altered, deleted, switched, overridden or repeated
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ethnicity and race
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can be used to indicate the overall genetic distance of closeness of population to establish research framework
- ethnicity recently replaced the use of race in science
- ethnicity recently replaced the use of race in science
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habitat in the triangle
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part of the environment within which people live
- natural, built and social
where you live is one of the most significant components of overall health outcomes and life expectancy
- natural, built and social
where you live is one of the most significant components of overall health outcomes and life expectancy
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built environment
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where you physically lived and have lived pretty much affects your health
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social environment
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consists of the groups, relations and societies within which people live and interact with each other
- schools, churches, restaurants, low/middle/high class
- cultural groups
- schools, churches, restaurants, low/middle/high class
- cultural groups
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behavior on the triangle
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the observable aspect of culture
-education for example
- education involves behavioral exposure to opportunity in the habitat
-education for example
- education involves behavioral exposure to opportunity in the habitat
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place vulnerability thesis
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the graphic concentration of vulnerable peoples creates an environment of heightened vulnerability to disease, and vulnerable places attract vulnerable people
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infection disease causative organism
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is the AGENT of disease
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agent
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virus, protozoan, bacterium or a worm
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prions
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- these are mysterious molecules within the continuum of infectious disease
- they have no life, no nucleus of control or container
- characterize several fatal and transmissible neurodegenerative diseases in humans and many other animals
- can change behavior of DNA
- they can make bacteria virulent or cause the destruction of brain cells
- they have no life, no nucleus of control or container
- characterize several fatal and transmissible neurodegenerative diseases in humans and many other animals
- can change behavior of DNA
- they can make bacteria virulent or cause the destruction of brain cells
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viruses
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- most common agent of disease known to general population
- outside living tissue, they cannot reproduce
- pharmaceutical drugs have little effect on them
- vaccines are the best weapon against viruses
- outside living tissue, they cannot reproduce
- pharmaceutical drugs have little effect on them
- vaccines are the best weapon against viruses
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infectious agent
answer
- cannot live outside cells
- usually hosted in arthropods
- can be easily combated by mass treatment
- usually hosted in arthropods
- can be easily combated by mass treatment
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host
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organism infected by a disease
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zoonosis
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when animals are the primary hosts
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anthropo- zoonosis
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diseases that affect both human and animals
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reservoir
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when the host serves as continuing source of infection
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enzootic
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disease endemic to animal population
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epizootic
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when disease is spreading or epidemic
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biological vector
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organism that transmits a disease agent between hosts, arthropods
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intermediate hosts
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organisms that are necessary to some stage of an agents life cycle
- attain maturity
- complete sexual life
- attain maturity
- complete sexual life
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transmission: physical contact
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- transmission through physical contact or air
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transmission: contamination
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- some diseases agents can be spread from person- to- person through food/ water contamination
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transmission: animal to human
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some incidental contacts may also result to infection not known in a population
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landscape epidemiology
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examines how the temporal dynamics of host, vector, and pathogen population interact partially within a permissive environment to enable transmission of diseases
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4 types of regions:
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- biome
- realm of evolution
- cultural realm
- natal nidus
- realm of evolution
- cultural realm
- natal nidus
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biome
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climate, altitude, and latitude combines to create broad biotic regions, biomes, with predictable locations
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realm of evolution
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because oceans, deserts and great mountain ranges formed barriers to the exchange of genetic info as the continents drifted apart, complexes of plants and animals followed separate paths of evolution
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cultural realm
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broad cultural area delimited by the extent of particular cultural practices and believes that largely originated in the primary culture hearths
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natural nidus
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a microscale region constituded of a living community (among the members of which a disease agent continually circulates) and the habitat conditions (necessary to maintain that circulation in the disease system)
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vector ecology
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the study of disease vector that transmit pathogens, focusing on their interaction with (vertebrate) hosts or with the disease- causing parasitic organisms and their habitats
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landscape epidemiology approach
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"landscape epidemiology is a graphic delimitation of the territory of a transmitted disease in order to identify cultural pathways for disease control"
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downstream and upstream forces both
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forge to create individual health and disease ecology
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political ecology believes that health is
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socially produced and historically determined
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structure
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the social political and economic contest that constrain (or enable) an individuals ability to act on his or her own choices
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human agency
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the ability to act in any given environment
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eight americas
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1) asians
2) northland
2) northland
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disability- adjusted life years (DALY)
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an indicator used to estimate and represent burden of diseases
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some things women are exposed to
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women are more likely to be exposed to insults emanating from cleaning agents
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pre industrial stage
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high death and birth rates
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transitional stage
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death rates fall due to rising food production and better medical care; birth rates remain high so population surges
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industrial stage
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birth rates fall, as women are employed and as children become less economically useful in an urban setting; population growth rate declines
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post- industrial stage
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birth and death rates remain low and stable; society enjoys fruits of industrialization without threat of runaway population growth
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demographic transition
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illustrates population growth in terms of discrepancies and changes in two crude vital rates-mortality and fertility
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crude death rate
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(# of death in a calendar year/ mid- year population)* 100,000
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crude birth rate
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(#births in a calendar year/ mid- year population)* 100,000
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rate of natural increase
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CBR-CDR
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demographic transition
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difference between countries in less developed world than countries in more economically developed world
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epidemiological transition
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a long- term shift occurs in mortality and disease patterns whereby pandemics of infection are replaced by degenerative and man- made diseases
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stages in the epidemiological transition
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- pretransition: pestilence and famine
- early transition: receding pandemics
- late transition: degenerative and man- made diseases
- post transition: delayed degenerative diseases and emerging infections
- early transition: receding pandemics
- late transition: degenerative and man- made diseases
- post transition: delayed degenerative diseases and emerging infections
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quarantine
answer
restriction of movement
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