Community Health Module Quiz: CHP 310

Introduction to Public Health

• Community Health course: CHP 310
• Learning outcomes:
  • Define and differentiate health and disease from individual and community perspectives
  • Analyze determinants of health and disease in communities
  • Identify and analyze dimensions of health related to well-being
  • Recognize, assess, and address inequities in health and disparities in healthcare access

What is Health?

• Holistic definition (WHO, 1948): "a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity."
• Good health is essential for participation in activities like education and employment

Health, Disease, Illness, Sickness, and Wellness

• Health: State of complete physical, mental, and social well-being.
• Illness: Symptoms of abnormality experienced by the patient (e.g., chest pain).
• Sickness: Social and cultural concept or belief for a disease (e.g., heart attack).
• Disease: State of disorder or impairment of normal body functioning (e.g., pericarditis).
• Wellness: A person's overall balance of physical, social, spiritual, emotional, intellectual, environmental, and occupational well-being.

Three Perspectives: Disease, Sickness & Illness

• Disease: Underlying pathology, biologically defined (practitioner's perspective).
• Illness: Subjective experience of symptoms. What the patient brings to the doctor.
• Sickness: Social and cultural perceptions, beliefs and reactions to illness affecting the patient's response. Disorders deemed appropriate for medical treatment

Public Health vs. Community Health vs. Community Medicine vs. Epidemiology

• Public Health/Preventive Health: Science and art of preventing disease, promoting health through organized efforts.
• Community Health: Branch of public health focusing on health within a community.
• Community Medicine/Preventive Medicine: Branch of medical science with disease identification, treatment, prevention, and health promotion.
• Epidemiology: The study of health-related states (distribution and determinants) in populations, applying it to control health problems.

Health-Illness Continuum Model

• Presents health as a spectrum, from pre-mature death to high wellness.
• Includes unrecognized sickness, mild sickness, severe sickness, death.
• Demonstrates varying degrees of wellness and illness.

Medical Conception of Disease

• (Natural history of disease)
  • Preclinical phase: biological onset of the disease.
  • Clinical phase: Symptoms appear; Diagnosis; Therapy begins
  • Outcome: Recovery, disability, death

Agent-Host Environment Model

• Used to describe causes of illness, not promote wellness.
• Identifies risk factors from agent-host-environment interactions

Factors Related to Host, Environment and Agent

• Host: Age, sex, genetic profile, previous diseases, immune status, religion, customs, occupation, marital status, family background
• Environment: Temperature, humidity, altitude, crowding, housing, neighborhood, water, milk, food, radiation, pollution, noise
• Agent: Biological agents (bacteria, viruses, fungi), chemical (poisons, alcohol, smoke), physical (trauma, fire), and nutritional (lack or excess)

Dimensions of Good Health ("Well-being")

• Multidimensional process including:
  • Physical, mental, emotional, social, and spiritual dimensions.
  • Combination of these elements defines good health.

Dimensions of Health

• Physical: Body's health; strength, well-being.
• Mental: Clear thinking; happiness, motivation
• Emotional: Feelings and emotional management.
• Social: Connections and relationships
• Spiritual: Purpose and meaning in life

Physical Dimension of Health

• Perfect functioning of organs at optimal capacity.
• Ability to carry out daily tasks and achieve fitness.
• A normal person: no evident disease; growth is comparable to peers

Social Dimension of Health

• Health practices, beliefs influenced by economic level, lifestyle, family, and culture.
• Low-income groups may be less likely to seek preventive care. High-income groups are more prone to stress-related health issues.

Mental Dimension of Health

• Not merely the absence of mental illness, but the ability to cope with life experiences.
• A state of balance or harmony between the individual and others, and the individual and their environment.
• Being able to interact successfully with others, maintain healthy relationships, and show respect and tolerance.

Other Dimensions

• Spiritual Dimension: Moral principles, values, beliefs, the purpose in life, religion.
• Vocational Dimension: Adaption of work to human goals; roles in promoting health and mental well-being (e.g., job loss).

WHO "World Health Declaration" (1998)

• Signed by all member countries.
• Human rights: Health for all.
• Improvement of health and well-being = aim of social and economic development; Good health is crucial for sustainable economic growth.
• Enjoyment of the highest standard of health is a fundamental human right.

Determinants of Health

• Factors influencing a person's well-being and likelihood of illness.
• Categorized into groups according to the WHO: social and economic environment, the physical environment, and the person's characteristics and behavior

Social Determinants of Health (SDOH)

• The conditions in environments where people live, learn, work, play, worship, and age affect a wide range of health outcomes and risks.
• Can be grouped into five domains: Education, Economic Stability, Health Care, Social and Community Context, and Neighborhood and Built Environment

Socioeconomic Status (SES)

• Socioeconomic factors like income, education, occupation, and wealth are key social determinants of health.
• Lower SES associated with greater chronic diseases, lower life expectancy, and poorer health outcomes.
• Higher SES associated with better health

Economic Determinants of Health

• Employment & Working Conditions: Stable employment, safe working conditions and fair wages=better outcomes; Unemployment, hazardous work, job insecurity=stress, mental health disorders and chronic diseases
• Income & Wealth Inequality: Income inequality= disparities in health outcomes; Lower incomes=higher morbidity and mortality; Limits to access to resources (food, housing, healthcare)
• Access to Education: Education= powerful determinant of health, including health behaviors, health literacy, and socioeconomic opportunities. Higher education levels = better health outcomes, lower chronic diseases, and longer life expectancy
• Housing and Neighborhood Conditions: Access to safe and affordable housing= good outcomes; Insufficient housing, overcrowding, exposure to environmental pollutants= poor health outcomes

Behavioral Determinants of Health

• Behaviors influencing health, including nutrition, personal hygiene, habits, customs, smoking/passive smoking, alcohol, substance abuse, exercise, sleep habits, violence, recreation, compliance with medical treatment, reaction to stress

Environmental Determinants of Health

• Physical Environment: Air, water quality/quantity, waste disposal, housing, climate, temperature, humidity, rainfall, air geography, heat, light, noise, vibration, and radiation.
  • Air Quality: Exposure to air pollution worsened respiratory and cardiovascular problems and even cancer.
  • Water Quality: Contaminated water leads to infectious diseases, diarrhea, other health problems.
  • Waste Management: Improper waste disposal=water/soil contamination, pests and air pollution
  • Climate Change: Rising temps, extreme weather events=heat stress, infectious diseases, respiratory illnesses.
  • Built Environment: Community design, access to green spaces, walkable neighborhoods, safe roads, and quality housing influence physical activity and well-being; safety and exposure to environmental hazards.
  • Chemical Safety: Exposure to harmful chemicals in air, water, soil, consumer products can cause various health effects.
  • Noise Pollution Disrupts sleep, increases stress levels and can lead to hearing loss
• Biological Environment:
  • Genetics: Genes determine susceptibility to diseases. Family history impacts risk.
  • Sex and gender: Biological differences lead to health risk variations
  • Age: Older people's systems are less efficient, more susceptible to diseases.
  • Nutrition: A healthy diet is crucial for good health.
  • **Hormones:**Hormone imbalances impact bodily functions and lead to health problems.
  • Microbiome: The microorganisms in the gut are crucial for digestion, immune function.

Psychosocial Environment

• Habits, customs, ethnicity, cultural values,
• Ethnicity : cultural identity defined by common origin, history, language, or culture.
• Culture : Complex social phenomenon encompassing knowledge, beliefs, goals, values, attitudes, and practices
• Religion/Morals : Education/ health awareness, Employment, Community life, Housing
• Political organization: % GNP on health and resource allocation; availability and accessibility of services

Health Inequities

• The differences in health outcomes and risk factors between countries, sexes, and ethnic groups, impacting life expectancy, infant/maternal mortality; influenced by disparities in education, economics, environments
• Life expectancy: differences exist depending on where people live. For example, people in Japan and Sweden are more likely to live longer than people in African countries.
• Infant morality rate : the risk of a baby dying between birth and one year of age varies between countries. Infants born in Iceland are less at risk of dying than infants born in Mozambique.
• Maternal death rate : the risk of maternal death also varies depending on countries. Women are more likely to die in Afghanistan than in Sweden, during or after pregnancy.
• Gender: disparities in health outcomes between sexes, especially in the Indian Subcontinent, frequently due to neglect or discrimination, linked to issues with nutrition and immunization.

References

• CDC Website
• WHO Website
• Healthy People 2030 Website

Test your understanding of community health concepts with this quiz based on CHP 310. Explore definitions of health, illness, and the models used to conceptualize well-being and disease. Sharpen your knowledge of the crucial distinctions and goals within the field of community health.