Population Health Determinants – EXAM ONE

receive same treatments versus equal treatments/fairness

health behaviors or environment factors or specific susceptibilities

individual level model of health and disease

built on distinction between the individual who has various attributes that increases or decreases his/her susceptibility, resilience, vulnerability, and a set of factors that interact with that individual characterized as potential threats/risks

about cells, whole body, diet, and exercise; personal health status

Focuses on health measurements at a population level; effective regulation ensuring the safety of food and water, public services, and environmental protection

what are the variants of the risk factor model?

what are host characteristics?

used to asses the health of a person, but not a powerful predictor; substantial variation at all ages, potential of healthy living, and in life expectancy

continuum and non-binary: two men or women can be very different; confounded with gender; may shape behavior

social expectations placed on a person and roles that person adapts

environmental and social condition modify behavior and genetic expression; very few unambiguous genetic disorders

study of gene expression

study of the social determination of health behavior

found that it's extremely difficult to change people's habits; focused on exercise, diet, smoking, and the redundancy of blood pressure and cholesterol

"s state of complete physical, social, and mental wellness and not merely absence of disease or infirmity"

-discovered "cause" of cholera
-tracked causes and developed maps to place disease incidence
-focused on environment

-published "The Condition of the working class in England"
-showed death rates of the poor in urban areas were higher than the poor in rural areas

-"father" of modern pathology and developed what remains to this day
-"Report in the Typhus outbreak in Upper Silesia" = ground breaking analysis
-additional med care and drugs DONT improve population health

-father of sociology and developed concept of "social facts"
-social facts = human artifacts arise from group interactions and have capacity to act as determinants of human behavior
-analysis suicide rates among communities

study of how birth and death rates in human populations

as social and economic development occur, disease becomes prominent

what are the three pillars of population health?

population/community based prevention perspective utilizing interventions targeting populations or communities as well as defined high-risk groups

includes the delivery of services to individuals on a one-on-one basis.

range from improving housing, education, transportation, or economic development to providing opportunities for work, also to expand and improve Medicare, Medicaid, and other health programs.

examines the components of population health, the determinants of health and disease, how we measure the course of disease in a population

describe an individual including symptoms and risks for disease

describe a population including determinants

called the "cause of causes"

actions that increase exposures to factors that produce disease or protect from disease

often the direct cause of disease

role in development and outcome of disease

geographic location influence frequency and presence of disease

"natural" physical world with natural disasters

access to and quality of care

education, income, occupational status

Studies how social position and context influence human health

-characteristics DONT equal absolute
-"normal" is socially constructed; no absolute standard
-scale and pattern of disease
-important health attributes (health, weight, blood pressure)

The cut off for "high" is a judgement call, not a feature of the distribution

predicts average values and how they fall in their tail distribution; shifts

where does most disease occur?

treating high-risk populations will NOT do much improvement of overall health of the population

- Small portion of incidence
- Band aid approach
- Behaviorally inadequate
- Errors about cause and effect

Two cohorts of British government workers
Results:
Employees in more higher paid, higher status jobs enjoyed better health
Risk factors accounted for only a small fraction of differences
The lion's share of differences was attributes directly to
-employment grade
-Salary
-Education level
-Working conditions

Working Group on Inequalities in Health
Showed the gap in health between social classes
Showed that the gap was growing

Examined health disparities in 32 OECD countries

Strong correlation between life expectancy and the proportion of income received by the lower 50% of the income distribution

Unequal societies = unhealthy societies

expressed in differences in income or education (depends on parent's education and home environment)

Level of resources at the individual level
*Income
*Education
*Social network

Research shows consistent relationship between resources available at the individual level and health outcomes

The status of the person plays a central role

The size of the gap between the rich and the poor is what matters most

Focuses on the position of individuals in social hierarchy

Feeling of stress => deterioration in health

provide the foundation for population health sciences, including analysis of complex health problems and the identification of health problems

a way of structuring our thinking about health problems looking for effective ways to address these problems, and measuring the success of our inventions

What are the steps in system-thinking? (6)

represents the 3rd foundational framework of population health and build upon and grow out of population health/systems framework

3 basic strategies used to improve population health

5 tools of population health

exploding field; electronic communications

extension of tradition product marketing; key tool

being able to capture meaning in a few words

getting and holding people's attention

easily visualizable

can be reinforced by trustworthy courses of information

connect to emotional assists in gaining attention and remebering

short personalized stories are easily recalled

asses readiness for change; social marketing aimed at specific groups

actively thinking about the benefits and barriers to change; information on hazards

developing a plan of action to make change

change in behavior is taking place; remove connections

new behavior becomes permanent; continued reinforcement

What are two important population health approaches to health policies?

the use of tests on individuals who don't have symptoms for a disease

What basic strategies of population health are illustrated in the HIV/AIDS case?

What of the five tools of population health are illustrated in the HIV/AIDS case?

the relationship between income and health persists

an empirical cross-sectional relationship between life expectancy and real income

What does a higher population typically signify?

What is the problem of collinearity?

Country's GDP correlates strongly with life expectancy in poorer countries but very weakly with life expectancy in richer ones.

At some point (around $10,000 per capita), the relationship between income and life expectancy virtually disappears.

Each addition to GDP is less important in more affluent countries.

Total income and average income matter most in poor places, but the distribution of available income matters in rich countries.

important to social mobility; integrated communities have better

social change is creating chaos; creates stress and there's a need to feel unitied

the study of living nonhuman primates as well as primate fossils to better understand human evolution and early human behavior

What are the problems of the inequality hypothesis under Assaults'?

key factor in health
the amount depends on taxes and transfers
should be adjusted for household size

different taxation system = ??

A measure of income inequality within a population, ranging from zero for complete equality, to one if one person has all the income.

the push to reduce government intervention in business and/or individual lives

Link between household income and health
Income is linked to education, living conditions, and health
supports processive taxes and redistributive public programs

importance of material conditions distribution of wealth in society

focus on perception of our status and personal security; DONT square well with the available evidence

Psychosocial Model

what are the differences in health status linked to?

what does the gradient health link income wiht?

Inequality in Canada and US in recent years