HSCI 130 Final

1. Normality; illness as deviation
2. Balance
3. Adaptation to environment
4. Function: Able to fulfill daily tasks
5. Fitness/Being fit
6. Complete well-being: "A state of physical. mental and social wellbeing, not just absence of disease" (WHO)
7. Absence of disease
8. A resource for living

present health of individual

characteristic of being healthy/unhealthy; longer term
attribute

Illness defined as perception of ill health, based on a person's response to particular symptoms (e.g. pain, nausea) that cannot be directly observed

- diagnosed or diagnosable pathologies;
- abnormal functioning that may or may not produce discomfort or distress

1. Scientific knowledge changes
2. Diseases change
3. The distribution of disease in a population changes
4. New ideas about health are built on other existing ideas
5. Cultures and societies change and cultures and societies influence health illness and disease
6. Moral frameworks are imposed on health, illness and disease

- Ancient symbol among many indigenous Peoples of 'NorthAmerica'; represents 'sacredness of four'
- Four parts of person: mental, physical, spiritual, emotional
- not used by Inuit

- residential school experience
- loss of traditional cultures
- loss of traditional lands

1. Colonization
2. Globalization
3. Migration
4. Cultural continuity
5. Access
6. Territory
7. Poverty
8. Self-determination

- Body is a microcosm of the world
- Elements of natural world (earth, air, fire and water) linked to the elements or humours of the body (black bile, blood, bile, phlegm).
- Four primary qualities (hot, dry, cold, wet) also linked to four humours.
- Humours (and combinations of humours) have own diseases and remedies are humour specific.

- set of behavioural expectations about how a sick person is to behave built into our social system
- sickness is SOCIAL
- people learn from culture how to behave in response to health and illness

- exemption form responsibility for illness
- temporary exemption from regular role responsibilities

- duty to try and get well and resume responsibilities
- duty to seek technical competent help and cooperate in the process of getting well

1) structural functionalism
2) conflict
3) symbolic interactionist
4) feminist
5) sociology of the body
6) indigenous

Past experiences and their timing shape aspects of our current and future lives such as health status

1. communicable (infectious) disease
2. Chronic (non-communicable) disease
3. Adjacent and injuries

1. sexually transmitted
2. food-borne
3. water-borne
4. vector-borne
5. vaccine preventable
6. bio-terrorism
7. zoonotic
8. emerging infections

1. cardiovascular disease
2. cancer
3. diabetes
4. chronic respiratory infections

1. Pneumonia
2. Tuberculosis
3. Diarrhea
4. Diseases of the Heart
5. Intracranial lesions of vascular origin

cancer

preventing the initial development of a disease eg. immunization

early detection of existing disease to reduce severity and complications eg. screening for cancer

reducing the impact of the disease (clinical phase) eg. rehab for stroke

- 1974
- emphasis on lifestyle and personal responsibility

- individual lifestyle approach is blaming the victim
- health inequalities not being addressed or reduced

- peace
- shelter
- education
- food
- income
- stable ecosystem
- sustainable resources
- social justice
- equity

Health promotion is the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions

1. build healthy public policy
2. create supportive environments
3. strengthen community action
4. develop personal skills
5. reorient health system

Make the healthiest choices easiest

- Legislation, Fiscal measures, Taxation, Organizational change
- smoke free work places
- reduced tax on low alc beer
- sun hats as school uniform
- alcohol tax
- compulsory seat belt wearing

encourage reciprocal maintenance

- work-safe initiatives
- Quitline (support smokers quitting) (social environment)
- shade in school playgrounds (physical environment)
- recycling programs

empowerment of communities

create community health centres with boards of local members

Individuals need support to change health

- Classes to teach healthy cooking
- Anger management programs
- Health education initiatives in schools

shift emphasis in health care towards health promotion

- "Collective patterns of health-related behaviour based on choices (agency) from options available to people according to their life chances (structure)."
- agency always constrained by structural conditions

- Studying cholera outbreaks in london
- 2 theories about cholera
Miasma: bad vapours in the air
Germ theory: small organisms responsible
- Grand experiment- Documents source of drinking water for those dying

- nutritive agents
- chemical agents
- physical agents
- infectious agents

occurrence of cases by time, place, person

- causes/risk factors
- physical, biological, social, cultural, behavioural factors

- diagnosis of a specific disease or cause of death
- health-related behaviour (smoking, prenatal vitamins)

- measurable group
- denied by location, time, demographics, etc

1.7 million

160, 000

98, 000

38.4 million

1.5 million

650, 000

- the proportion of individuals in a population with the disease at a given point in time
- # of cases/total population

proportion of individuals in a population with the disease at a given point in time

the proportion of individuals in a population with the disease at any time during a specific time period

- find how many people are infected
- estimate probability that someone will have the disease
- project health care/policy needs/issues
- estimate cost associated with disease

- how long people have had disease
- cause

- proportion of people who become diseased during a specific time period
- # new cases in specific time period/# people in pop at risk at beginning of period

- people with the disease
- people who can't get disease
- to avoid underestimating risk

- estimate probability a person will get disease
- research on causes, prevention, treatment

- measure of the rate of development of a disease in a population (how quickly people are developing disease)
- # new cases during a time period/# of person time people were at risk (during observation)

research on causes, prevention, treatment

factor(s) that will inevitably produce disease

factors that contribute towards causation but cannot cause on its own

agent (or component cause) required for development of disease

- necessary cause found in all cases
- component cause needed in some cases
- sufficient case- combination of necessary and contributing causes

- infectious agents
- behaviours
- intrinsic characteristics of individuals
- social/environmental factors

- researcher does not intervene
- measure occurrence of disease or health outcome
- identify associated risk factors

- investigator changes something and measures effect on disease outcome
- clinical trials, preventative trials

research that describes the occurrence of disease and/or exposure

evaluate association between an exposure or characteristic and the development of a disease

compare the prevalence of exposures and disease occurrence in popultions

study group chosen to represent a subgroup of society/cross-section of population

compare odds of exposure between individuals with disease or outcome of interest (cases) and group without disease (controls)

follow-up studies: follow people over time to see what happens

10.4 million

1.8 million

400,000

- how well does the test classify people with the disease as diseased
- true positive/# with disease (A/A+C)
- decreasing false negatives will increase proportion of true positives

- how well does the test classify people without the disease as not diseased
- true negatives/# without disease (D/B+D)
- decreasing false positives will increase proportion of true negatives

John Snow

the proportion of people who become diseased during a specific time period

false negatives

randomized controlled trials

formula for IR

healthy immigrant effect

risk-taking hypothesis

differential exposure hypothesis

lack of democracy

symbolic interactionism

iatrogenesis

vertical structures

Salutogenic model of health

Bono

HIV infects and kills these cells, thus rendering the entire immune system dysfunctional

antibodies

Saskatchewan

1971/1972

chronic pain

physician services

percentage of the BC budget spent on health care

CUPPA- comprehensiveness, universality, public administration, portability, accessibility

228 billian dollars

the region that has the highest per capita incidence of TB

1984

the type of study that helped epidemiologists discover that TSS was caused by tampons

"women are sicker, but men die quicker"

1. role-accumulation hypothesis
2. role-strain hypothesis
3. social acceptability hypothesis
4. risk-taking hypothesis

- Lifestyle and personal responsibility
- Determinants of health are outside the health care system

outbreak of a disease in a localized group of people, spread by 1. vectors 2. carriers 3. sudden intro of new pathogen; more cases than usually expected

Seyle's concept that the body responds to stress with alarm, resistance and exhaustion

the non-specific response of the body to any demand

that which produces stress

How social influences affect disease
Lower grade of employment = higher risk of heart disease/other major causes of death

1. Role-accumulation hypothesis
2. Role-strain hypothesis
3. Social acceptability hypothesis
4. Risk-taking hypothesis

- Health care delivery is the responsibility of the provinces
- Privately delivered and publicly financed
- Private providers and public not-for-profit hospitals
- Free-for-service funding and global budgets
- Choice of practitioner
- Universal coverage applies to less than ½ of total health care expenditures

1. Income and social status
2. Social support networks
3. Education and literacy
4. employment/working conditions
5. Social environment
6. Physical environment
7. Personal health practices and coping
8. Skills
9. Healthy child development
10. Biology and genetic endowment
11. Health services gender
12. culture

- materialist explanations
- cultural behavioural explanations
- psychosocial explanations

Aspects of social structure are powerful determinants of health

Health is also affected by the level of funding invested in social infrastructure

typhus

- lack of democracy leads to poor living conditions, poor diet, poor hygiene (Led to epidemic of typhus)
- discovered cell theory (cells divide from other living cells)

relatively stable differences between individuals and groups of people in the distribution of power and privilege

unfair, avoidable differences arising from poor governance, corruption, social exclusion, discrimination, etc. social unjustice

a graded association between the indicator of socioeconomic status and population health

social and economic factors that influence what position individuals and groups hold in the social structure of a society

occupation, income, education, wealth

the conditions in which people are born, grow, live, work and age, shaped by the distribution of money, power and resources

- guide for identifying and understanding salutary factors that make populations healthy
- improved understanding of the origins of good health and social conditions that facilitate health-protective behaviours.

Ideas and perspectives people use to make sense of and find meaning in their everyday life experiences, such as health and illness.

1. have a direct impact on health of individuals and populations
2. are the best predictors of individual and population health
3. structure lifestyle choices
4. interact with each other to produce health.

physiological attributes of the person

socio-cultural expression of sex in terms of personal identity

20.6%

- Aboriginal peoples have poorer health outcomes because of social exclusion and racism
- There is a "healthy immigrant effect" that deteriorates over time
- There are ethnic differences in perception and understanding of symptoms
- There are ethnic differences in health-care behaviour
- There are ethnic differences in the social determinants of health.

1. exclusion from civil society
2. exclusion from social goods
3. exclusion from social production
4. economic exclusion

- Converging lifestyles
- Resettlement stress
- Differential access to health care

- clinical
- social
- cultural

immediate factors that shape health and well-being (family environment, workplace)

macro-level factors that indirectly influence
health and well-being (social, political, and economic policies)