Diverse Perspectives on Health and Wellness

Introduction to Health

• Health has varying meanings, relative to environment, culture, and personal interpretations.
• Keleher and MacDougall define health as a dynamic concept with multiple meanings dependent on context.
• Ramihar and Rambihar describe health as a complex state or process toward wellbeing, away from disease.
• Davies defines health as the capacity to do what matters most to you.
• Saylor describes health as living well despite illnesses/disabilities.
• Indigenous health includes mental, emotional, spiritual, and physical facets.
• Values supporting wellness: respect, wisdom, responsibility, relationships.
• Interpretations of illness/disease traditionally define health practice boundaries, rather than how people maintain their health.
• Definitions of health have changed, and are open to interpretation.

Objective vs. Subjective Measures of Health

• Objective measures are standardized, typically biological or clinical, based on defined criteria, and more quantitative.
  • They help predict morbidity/mortality and assess medication/treatment needs.
  • Examples: blood pressure, blood sugar, heart rate.
• Subjective measures involve personalized information, context-dependent, and revolves around individualized information.
  • They may help predict quality of life.
  • Examples: functional status, pain level, mental health.

WHO Definition of Health

• Health is a state of complete physical, mental, and social well-being, not merely the absence of disease/infirmity.
• The WHO definition has issues with the idea of completeness.

Problems with the WHO Definition

• The absoluteness of "complete" would result in most individuals being considered unhealthy most of the time.
• It contributes to the medicalization of society.
  • New screening technologies identify abnormalities that might not cause illness.
  • Pharmaceutical companies produce drugs for conditions not previously defined as problems.
• The nature of disease is changing from infectious to chronic diseases.
• Primary risk factors for cancer, cardiovascular disease, and diabetes are behavioral and modifiable.

The Cost of Cancer

• In 1998, the total cost of cancer in Canada was estimated at $14.2 billion, including both direct ($2.5 billion) and indirect costs ($11.7 billion).
• In 2021, cancer-related costs in Canada were $26.2 billion, with 30% borne by patients and families.
• Costs are expected to increase due to infrastructure demands for cancer treatment.
• Accomplishing the goal to lower costs, requires Canadians change their behaviours and manage/change risks.

Ontario Public Health Standards

• Public Health focuses on primary prevention and population health.
• Tertiary prevention involves intensive, individual intervention; secondary prevention involves targeted interventions for those at risk; primary prevention involves system-wide intervention with a broad community focus.
• Downstream focuses on treating existing problems, while upstream focuses on prevention.

History of Ontario Public Health

• 1873: First Public Health Act Passed.
• 1882: First Board of Health Established.
• 1934: First County-Wide Health Units.
• 1945: Public Health Act Amended.
• 1983: Health Protection and Promotion Act (HPPA).
• 1997: Mandatory Health Programs and Services Guidelines.
• 2007: Public Health Ontario Established.
• 2009: New Ontario Public Health Standards (OPHS).
• 2018: Modernized OPHS.

Ministry of Health

• Sets strategic directions and priorities for Ontario's health system.
• Develops/enforces legislation, regulations, standards, policies, and directives.
• Monitors and reports on the health system.
• Provides funding to the health system.

Public Health Ontario

• Provides critical laboratory testing (over 6 million tests annually).
• Monitors the health of Ontario’s population.
• Provides education, professional development to health providers/organizations.
• Conducts public health research.
• Offers advice/support in emergencies or outbreak situations with health implications.

Ontario Public Health Standards (OPHS)

• Identifies minimum expectations for public health services and programs by Ontario's 34 public health units.
• Published by the Ministry of Health.
• All boards of health are accountable for implementing the standards, each having a Medical Officer of Health (MOH).

Authority of the OPHS

• Boards of health must provide programs/services in areas such as community sanitation, safe drinking water, infectious disease control, health promotion, family health, and epidemiological data collection/analysis.
• Boards of health need to be knowledgeable about other Ontario laws such as the Building Code Act, Child Care and Early Years Act, Employment Standards Act, and Immunization of School Pupils Act, etc.

Scope and Accountability of OPHS

• OPHS specifies the responsibilities of Boards of Health, they can't do less but can always do more.
• Boards of Health are held accountable by the province for implementing the standards.
• The concepts of population health and health promotion are embedded in the OPHS.
• The act has concepts of Need, Impact, Capacity, Partnerships & Collaboration.

Food Security for UW students

• Need: Lack of healthy food programs at UW.
• Impact: Negative impacts on academic performance.
• Capacity: Cost of additional programs/healthier ingredients.
• Partnerships & Collaboration: Increased use of breakfast, lunch, and dinner/snack programs.

Foundational Standards of OPHS

• Articulate specific requirements supporting all Program Standards.
• Include Population Health Assessment, Health Equity, Effective Public Health Practice, and Emergency Management.

Population Health Assessment

• Includes measurement, monitoring, analysis, and interpretation of data relating to population health, as public health practice responds effectively to current/evolving conditions, contributing to the public's health/well-being through programs informed by the population’s health status.

Health Equity

• Means all people can reach their full health potential without being disadvantaged due to social position or other circumstances, leading to decreased health inequities.

Effective Public Health Practice Sections

• Program Planning, Evaluation, and Evidence-Informed Decision-Making.
• Research, Knowledge Exchange, and Communication.
• Quality and Transparency.

Evidence-Informed Decision-Making

• Uses best available evidence to inform decisions on developing/delivering public health programs/services, emphasizing continuous quality improvement. Goal: Public health practice is transparent, responsive to current and emerging evidence, and emphasizes continuous quality improvement.

Emergency Management

• Ensures boards of health are ready to cope with and recover from threats to public health, done through coordination with community partners, strengthening the overall resilience of boards of health/the broader health system, enabling consistent/effective management of emergency situations.

Boards of Health in Ontario

• 34 local boards of health (public health units) serve Ontarians across the province, responsible for populations within their geographic borders.
• Can be autonomous (24) or regional (6).

Program Standards of OPHS

• Grouped thematically, addressing Chronic Disease Prevention and Well-Being, Food Safety, Healthy Environments, Healthy Growth and Development, Immunization, etc.
• There are 34 PHUs in Ontario and 10 Regional Board of Health
• Regional is better for resourcing.

Health Promotion

• Green and Kreuter define it as any planned combination of health education and related organizational, political, and economic intervention designed to facilitate behavioral/environmental adaptations to improve health. Based on the Ottawa Charter and Health Promoting Universities and Colleges movement.

Ottawa Charter (1986)

• An international agreement signed at the First International Conference on Health Promotion, organized by the WHO.
  • Launched a series of actions to achieve "health for all".
• Participation and empowerment differentiate health promotion from traditional medicine and public health.
• Requires understanding causes of inequities in health.

Aspects of Health Promotion

• Socioecological approach working upstream.
• Addresses social determinants of health/advocates for health equity.
• Participatory, collaborative, focusing on strengths/assets.
• Systematic approach to planning.
• Comprehensive approach including policy.

Okanagan Charter (2015)

• An International Charter for Health Promoting Universities and Colleges that reflects the latest Health movement concepts, processes and principles
• A framework that reflects the latest concepts, processes and principles relevant to the Health Promoting Universities and Colleges movement

Health Promotion Criticisms

• Health promotion efforts are often referred to as the "Nanny State."
• Often involves telling people how to be healthier.
• Some examples: tobacco/alcohol taxes, smoke-free spaces, seat belts, recycling, and drinking/driving laws.

Challenges to Public Health

• Insufficient capacity.
• Misalignment of health, social, and other services.
• Duplication of effort.
• Inconsistent priority setting.

Tobacco & Vaping

• Prevalence: Snapshot/statistic over a certain time period.
• Incidence: is the # of New cases
• Modifiable: Can be changed over time.

Cigarette Components

• Tar: Sticky, brown substance that collects in the lungs, containing carcinogenic chemicals.
• Carbon Monoxide: Poisonous gas that limits blood's oxygen-carrying capacity.
• Nicotine: Addictive chemical that stimulates the cerebral cortex, increasing heart rate and blood pressure, causes endorphins, and increases dopamine levels.

Smoking Health Effects

• Chemicals in smoke damage DNA, harm the cleaning system in airways, and affect the immune system, causing inflammation.
• Long-Term Effects: Lung and other cancers, COPD, emphysema, chronic bronchitis, and cardiovascular disease.

Conclusions on Smoking

• There is no risk-free level of exposure to tobacco smoke and its exposure increases greatly with lung cancer risks.
• Risk and severity of adverse outcomes are related to exposure duration/level to tobacco smoke.
• Sustained use is due to addictive effects of tobacco products.
• Low-level exposure leads to rapid dysfunction/inflammation, implicated in acute cardiovascular events/thrombosis.
• Insufficient evidence that product modification strategies reduce risk for major adverse health outcomes.

Indigenous vs. Commercial Tobacco

• Indigenous tobacco is used in ritual, ceremony, prayer, and given thanks, considered a sacred plant with spiritual benefits.
• Commercial tobacco and its sacred uses should not be confused with commercial tobacco.
• DID YOU KNOW: 4.3 TRILLION CIGARETTE BUTTS ARE THROWN AWAY WORLD WIDE, CREATING 500,000 TONS OF POLLUTION EVERY YEAR

Environmental Impacts of Tobacco Use

• Deforestation.
• Toxic litter.
• Pollution and pesticides.
• Carbon Dioxide emissions.

Smoking Rates in Canada (2022)

• Approximately 12% of Canadians aged 15 and older currently smoke cigarettes, and 14% of males & 10% of females aged 15 and older currently smoke cigarettes.

Inequalities in Smoking in Canada (2019)

• Smoking was 3.9 times higher for those who did not complete high school versus university graduates.
• 2.6 times higher for unskilled workers than those in professional occupations.
• 1.9 times higher for those in the lowest income group.
• Within Indigenous populations: rates are 2.4x higher among Inuit, 1.9x higher among First Nations living off-reserve, and 1.7x higher among Metis.

Smokeless Tobacco

• Types: chewing tobacco (loose leaf, plug, or twist) and snuff (finely ground tobacco).
• Less than 1% of Canadians age 15+ reported chewing tobacco in last 30 days.
• Health Effects: Gingivitis, white/red patches inside the mouth (leukoplakia).

Second-Hand Smoke (SHS)

• No safe level of exposure, 22 % of Canadians who do not smoke are exposed to second-hand smoke every day.
• Non-smokers living with smokers have a 30% increased risk of lung cancer, heart disease, and stroke.
• Infants/children exposed to SHS have higher risk of respiratory illnesses/ear infections, and can cause more severe asthma attacks.

Smoking Cessation

• Smokers go through predictable phases (stages of change) averaging 30 attempts to quit.
• Motivation can be built using the 5 R's: Relevance, Risks, Rewards, Roadblocks, Repetition.
• Age, Working and Living conditions & Education/Income are all Social Determinants of health effects rates.

Cessation Products

• Pharmacological Support: Champix (Varenicline) reduces nicotine cravings. Zyban (Buproprion) antidepressant that eases withdrawal.
• Nicotine Replacement Therapy (NRT): Gum, patch, inhaler replaces nicotine.
• Helplines: Free confidential service, support and information to assist quitting smoking and tobacco use.

International Tobacco

• The tobacco epidemic is one of the biggest public health threats faced with tobacco killing more than 8 million people each year.
• Over 80% of the world's 1.3 billion tobacco users live in low- and middle-income countries.

Tobacco Use in China

• China has the most cigarette smokers in the world at 291 million (25% of population aged 15+ in 2022).
  • Of that, 47% are men, and 2% are women.
• China National Tobacco Corporation (CNTC) produces 1/3 of the world's cigarettes and is the largest tobacco company in the world.
• Smoking Level and bans have moderate levels of compliance

Smokeless Tobacco in India

• 24% aged 15 years+ (in 2022) were tobacco product users in India which is the 2nd highest globally.
• 21.4% of people (29.6% males and 12.8% females) aged 15+ years were current smokeless tobacco users in India (in 2016-2017), leading to one of the highest oral cancer rates in the world.
• India banned e-cigarettes and Heated Tobacco Products (HTPs) in 2019.

Vaping

• Heating e-liquid into an aerosol containing propylene glycol and/or glycerol and other chemicals.
• Health Canada detected an average of 22 chemicals and roughly nine flavouring chemicals in vaping products
• Further chemicals from aerosolization or contact with parts of the device.

Vaping Conclusions

• Nicotine exposure from e-cigarettes during adolescence can cause addiction and harm the brain: The health is not completely understood. Nicotine can cross the placenta and has known effects on fetal and postnatal development.
• It contains some toxic traits: less then combustible tobacco products.
• E-cigarette aerosol is not harmless “water vapor".
• Ingestion of e-cigarette liquids containing nicotine can cause acute toxicity and death.

Alcohol and Cannabis

Standard Drink Equivalents

• Beer (12 oz, 5% alcohol).
• Wine (5 oz, 12% alcohol).
• Spirits (1.5 oz, 40% alcohol).

Alcohol Consumption

Ethanol's Path Through the Body

• The majority (APPROX 95%) the alcohol consumed is broken down (metabolized) by the liver
• the remaining 5% percent of alcohol consumed leaves through urine, sweat glands, and breathing.
• Liver metabolizes alcohol at approximately one drink per hour but unmetabolized alcohol still continues to circulate in the bloodstream, this is intoxication.
• The only way to remove (metabolize ) alcohol from the body is with time.

Factors Affecting Absorption/Intoxication

• Food in stomach, rate of liver absorption, gender (women get drunk faster), amount, speed of drinking, medications, and marijuana use.

Cirrhosis

• Severe scarring of the liver that inhibits it's function.
• Advanced cirrhosis is life-threatening.

Alcohol and Mental Health

• Alcohol is a risk factor for several mental illnesses like depression, post-traumatic stress disorder, and anxiety.
• Acute intoxication increases risk for suicidal behavior.

Conclusions on Alcohol

• Impact is determined drinking volume and pattern.
• Hazardous drinking and patterns creates significant public health safety and problems.
• High-risk is consumption of 60 or more grams of pure alcohol (~5 drinks/one occasion).
• Long-term use of alcohol in excessive quantities is capable of damaging nearly every organ and system in the body.
• The developing adolescent brain is particularly vulnerable to the toxic effects of alcohol.

Alcohol Regulation in Ontario

• Beer is available in gas stations, Walmart, Costco, and wineries.
• Government-owned retailers includes Liquor Control Board of Ontario (LCBO).
• Private business is in the Beer Store.
• They also have authorized grocery stores and manufacturers offer/on-site retail stories
• The Alcohol and Gaming Commission of Ontario (AGCO) oversees sales, service, and enforces policy

Alcohol Use in Canada (2019)

• 76% (23.7 million) of Canadians reported consumed alcohol in the past year.
• Young adults (aged 20 to 24) and adults (aged 25 years and older) had the highest rates. Alcohol Use can be linked to Socioecomical status
• Patterns of drinking and the types are associated to status

Alcohol and Social Determinants of Health

• Income: Higher income is linked to more drinking, Sex & Gender: Risky drinking is higher among men then women Age: 19-24 year olds have highest rates of binge drinking
• Those over the age of 65+ may be at increased risk of alcohol related harms Housing status: Unstable housing were associated with more alcohol problems
• Indigenous: Indigenous youth more likely to use alcohol.

Canadian Guidance on Alcohol

• Women:

– 2 standard drinks per day – 10 standard drinks per week – 3 standard drinks on special occasions – avoid drinking alcohol on some days

• Men: – 3 standard drinks per day – 15 standard drinks per week – 4 standard drinks on special occasions – avoid drinking alcohol on some days
• Pregnant women: – avoid drinking alcohol
• Youth, with parental consent: – no more than twice weekly – no more than 1 or 2 standard drinks each time

Alcohol-Related Harms in Canada

• Harms include suicide, injuries, liver disease, brain damage, and death.
• 21% of those who reported past-year alcohol use, experienced some harm due to alcohol use in the past year.
• In 2014, usage caused 14,827 deaths and cost $14.6 billion.

Global Impact of Alcohol (WHO)

• Harmful alcohol use results in 3 million deaths every year.
• Alcohol is the world’s third largest risk factor for disease burden

Patterns from Around the World

• Canada = 8.2 litres of pure alcohol per year and 23% of drinkers drink heavily.
• United States = 8.7 litres of pure alcohol per year and 24.5% of drinkers drink heavily.
• United Kingdom = 10.4 litres of pure alcohol per year and 33.4% of drinkers drink heavily.
• Australia = 10.4 litres of pure alcohol per year and 13% of drinkers drink heavily.

Reducing Impaired Driving

• Leading criminal cause of death and injury in Canada. From 2018-19, police-reported incidents of impaired driving increased by 19%:
• alcohol-impaired driving increased by 15%
• drug-impaired driving increased by 43% in this first year since the legalization of cannabis

WHO's Priority Areas for Alcohol

• Leadership, awareness, and commitment.
• Health services’ response.
• Community action.
• Drunk-driving policies and countermeasures.
• Availability of alcohol.
• Marketing of alcoholic beverages.
• Pricing policies.
• Reducing negative consequences of drinking/intoxication.
• Reducing public health impact of illicit/informally produced alcohol and monitoring.

Cannabis Components

• Cannabis contains hundreds of chemical substances (over 100 of these are known as cannabinoids).
• THC is a cannabinoid that effects the way your brain and body respond to cannabis, causing the high and intoxication. THC has some therapeutic effects (pain, nausea), but also has harmful effects (paranoia, delusions)

Cannabis Impacts

• • Short-term effects on your brain include confusion, fatigue and impaired ability to concentrate, pay attention and react quickly
• Risk of addiction: Long-term effects on your brain
• Long-term effects of smoking cannabis (similar to smoking tobacco); bronchitis, lung infections, chronic (long-term) cough & mucus.

Cancer

Define Cancer

• Diseases where abnormal cells divide without control and invade other tissues.
• Cancer cells can spread to other parts of the body through the blood and lymph systems.
• There are more than 200 different types of cancer.

Carcinogenesis

• The process by which a normal cell becomes a cancer cell.

Major Categories of Cancer

• Carcinoma, Sarcoma, Leukemia, Lymphoma, myeloma, and Central nervous system cancers.
• Carcinoma is the most common.

Cancer Disease Types

• Prostate Cancer, Lung Cancer, Colorectal Cancer, Breast Cancer.

Prostate Cancer

• The diagnoses at later stages and failure of therapy are the main key factors.
• PCa is the second most common cancer diagnosis in men and the fifth leading cause of death worldwide, accounting for 1,414,259 new cases.
• This was responsible for 375,304 deaths in 2020.
• Risk Factors: Red/ Processed meats, any unhealthy dietary factors, lack of activeness, environmental and occupational factors. Stress, irregular eating patterns, bad food habits, insufficient physical exercise, and inadequate sleep, which are typical in daily life. Black ethnic groups, blood in urine, and burning sensation when urinating.

Lung Cancer

• Has 13% of new cancer cases and it is the #1 cause of cancer related deaths, with those being 50+ years and older.
• Risk factors: smoking (90-80%), SHS, radon, air pollution, family history, asbestos
• Symptoms include cough, wheezing, blood in cough, chest pain and shortness of breath

Colorectal Cancer

• 10% of all new cancer cases.
• Risk factors include family history, polyps, inactivity, diet, tobacco, and alcohol use.
• Change in bowel movement, fatigue, digestian are all symptoms

Breast Cancer

• Makes up 25 % if new cases of cancer and 14 percent of all cancer deaths in women, or will be 1 in 8 during the average woman's lifetime.
• Risk factors include history of breast cancer, mutations, and taking HRT's
• Symptoms include lumps, swelling and nipple discharge

Cancer Stats in Canada

• Top cause of all deaths on a yearly basis: 2 in 5 Canadians will be diagnosed with cancer in their lifetime/ about 1 in 4 will die from cancer.
• An estimated 247,100 Canadians will be diagnosed with cancer (incidence) and 88,100 will die from cancer (mortality) in 2024.
• Most common diagnoses include Lung, breast, colorectal and prostate cancers (46%).
• Melanoma (skin) cancer continues to rise, but is preventable
• 64% is estimate of current survival rates for all cancers combined (in 2021).

Tumors

• Benign tumors are not cancerous, can often be removed, and do not spread, whereas Malignant tumors are cancerous.
• Cells in these tumors can invade nearby tissues and spread to other parts of the body.
• The spread of cancer from one part of the body to another is called metastasis. Some cancers don't tumors, like leukemia.

Cancer Symtoms

• Unexplained weight loss, Fever, Fatigue, Pain

Cancer Screening

• It can be found before there are any symptoms. Checking for cancer is called screening. Generally, cancer treatment is more effective when the disease is found early.
• There is no screening for all cancers.

Tests

• Biopsy of the tumor
• Blood tests (which look for tumor markers)
• Bone marrow biopsy (for lymphoma or leukemia)
• Chest x-ray
• CT scan
• MRI scan.
• Surgery: Most will have this to remove mass.
• Radiation: Radiation therapy uses damaging DNA to kill the cells.
• Chemotherapy: A treatment that uses drugs to destroy cancer cells.

Human Papillomavirus (HPV)

• HPV infects skin and wet surfaces of the body (vagina, cervix, anus and mouth).
• More than 100 different types of HPV, these types appear up as warts.
• HPV infects the genital areas of males and females.
• Two high-risk types, HPV 16 and HPV 18, cause 70% of cervical cancers worldwide.
• Nearly all people sexually active will get HPV but most will clear on their own. Dramatic increase in oropharynx.

Stress and Cancer

• The research isn't 100% clear, but it is believed there is a relationship: Stress can weaken your immune system, hormone levels & lead to un-healthy behaviours.

Public Health Approaches

• Ontario Screening Programs, HPV Vaccine and STOP Programs
• Older and middle aged adults need to be screened to manage it.
• Testing only occurs once identified - diagnosis needed, then can start treatment.

HPV Vaccine

The Program typically offered in schools in grade 7 (12 years old).

• Public health units plan and organize immunization clinics at schools Parents/guardians must sign a consent form The vaccine is usually given in 2 injections, at least 6 months apart. Not mandatory under Immunization of Schools Pupils Act.
• 10 years after vaccination was introduced, we detected no HPV16/18 infections in 16-18 year olds (0% of n=584)" HPV 16/18 cause ~70% of cervical cancer

STOP Program

Province-wide initiative that delivers smoking cessation treatment and counseling support to eligible Ontario smokers who wish to quit smoking. 26 weeks of free Nicotine Replacement Therapy (NRT) A research study, these individuals are followed for research purposes

Skin Cancer

• Skin cancer is the most common type of cancer in Canada, about one-third of all new cases and can include both squamous cell and basal cell skin cancer
• Melanoma, is the starts and melanocytes

Risk Of Skin Cancer

Basal cell carcinomas (BCC) Most common; present on sun-exposed areas of the skin, especially the face. They rarely metastasize and rarely cause death. They are easily treated with surgery or radiation. Squamous cell carcinomas (SCC) Common, but much less common than basal cell cancers. They metastasize more frequently than BCCs although the metastasis rate is quite low

• Melanomas Least common but most deadly. Frequently metastasize and can potentially cause death once they spread.

Causes of Melanoma

• There is no simple answer, but some factors can increase the risk of UV radiation from the sun or artificial light - tanning beds.
• light skin, eyes or hair Exposure to UV radiation
• Works, places, and excessive workouts will increase
• People who purposefully seek out UV radiation in other forms (tanning beds) areat greater risk – “risk is 75% higher if tanning bed use begins before age of 35”

Skin Cancer Prevention Act (Tanning Beds)

–legislation came into effect on May 1, 2014 prohibits the sale, advertising and marketing of tanning services to youth under 18. – Requires that tanning bed operators request identification from anyone who appears under 25 years old – Public Health Inspectors are required to inspect locations (e.g., tanning salons, spas) whenever there is a complaint or referral from the public.

Physical Activity

Physical Activity

• Any bodily movement produced by skeletal muscles that expends energy, increases heart rate and breathing.
• Discussed in terms of:

1. Type
2. Duration
3. Frequency
4. Intensity

Aspects of Physical Activity

• Type (e.g., strength training, flexibility, aerobic, balance).
• Duration (e.g., in minutes, hours).
• Frequency (e.g., per week).
• Intensity (measured using metabolic equivalents (METs).

Types of Physical Activity

• Improves Breathing and Heart Rate (eg: health of heart, lungs, circulatory diseases and help prevent many types of diseases, dancing, balance.)
• The action of the physical activities are important for you're body and muscle structure (eg: muscle strength, strengthen bones, going to the gym.)

Frequency and Duration of Physical Activity

• Most physical activity guidelines outline recommendations for frequency (how often) and duration (how long)
• More is generally better and a variety is beneficial

Intensity of Physical Activity

• METs: Ratio between working and resting metabolic rate.

Physical Activity Intensities

• Light includes routine tasks during day, walking, house work. light housekeeping, light walking.
• Includes activities such as brisk walks, heavy cleaning, badminton, cycling, baseball, which cause people to sweat a little.
• Vigorous includes Hiking, jogging, fast cycling, soccer, basketball, which causes people to sweat and be ‘out of breath’.
• They have Canada’s Physical Activity Guide:

Health Effects of Physical Activity

Increases chances of living longer, reduce your risk for type 2 diabetes, some cancers. Helps with body composition, cardiovascular disease , strengthen your bones and muscles, prevent falls and improve your mood.

Physical Activity and Mental Health

Reduces stress and anxiety Improves mood Boosts self-esteem Reduces symptoms of depression Enhances cognitive function, grow and protect the cells in the brain

Key Points on Physical Activity

People of all ages, both male and female, benefit from regular physical activity. Significant health benefits can be obtained by including a moderate amount of physical activity on most, if not all, days of the week. additional amount of physical activity adds to the benefits. Physical acitivity is important

• Sedentary behaviour
  • “Sedentary behavior is any waking behavior characterized by an energy expenditure ≤1.5 metabolic equivalents (METs), while in a sitting, reclining or lying posture.”
• Sitting at a desk.

CSEP: 24-Hour Movement Guidelines (2020)

• Follow these Guidelines through the early years is associated with:
• Better growth, cardiorespiratory and musculoskeletal fitness, cognitive development, psychosocial health/emotional regulation, motor development, body composition, quality of life/well-being, as well as reduced injuries
• For those not currently meeting these 24-Hour Movement Guidelines, a progressive adjustment toward them is recommended
• For those not currently meeting these 24-Hour Movement Guidelines, a progressive adjustment toward them is recommended

24 Hour Movement Guidelines

Adult Physical Activity Numbers (2021)

• 12% achieved ≤8 hours of sedentary time per day.
• 7% use active travel (walking/bicycling to travel to work).

Cardiovascular Disease

CVD Definition

Refers to more than one disease of the circulatory system including the heart and the major blood vessels, whether the blood vessels are affecting the lungs, the brain, or other parts of the body.

• Cardiovascular disease is the 2nd leading cause of death in adult Canadian men and women
• CVD has some hereditary factors but is largely related to our lifestyle

CVD System

• Heart:
• Pumps oxygen-poor blood to lungs
• Red blood cells pick up oxygen at the lungs
• Blood delivers oxygen-rich blood to the rest of the body (muscles, organs, brain etc.)
• Blood vessels
• Arteries carry oxygen–rich blood away from the heart to muscles, organs etc.
• Veins carry oxygen-poor blood and return to the heart

Types of CVD

• (atherosclerosis)
• (ischemic heart disease)
• Ischemia - less than normal blood flow to part of your body
• Myocardial Infarction
• (cerebrovascular disease)
• (peripheral vascular disease)
• (heart failure): Congestive heart failure.
• (rheumatic heart disease)
• • Congenital heart disease

What Is Atherosclerosis

• thickening or hardening of the arteries, which cells can become damaged over time
  • Body responds with build up of deposits of fat, cholesterol and other substances called plaque
  • Plaque build-up narrows arteries, which reduces blood flow and can eventually cause complete blockage of a blood clot
  • If a clot becomes trapped, cuts off blood supply and oxygen to tissue or organ (thrombosis) Usually caused by diet high in cholesterol, alcohol, or smoking

Ischemic Heart Disease (coronary heart disease)

• The problem is with the blood to the heart muscle.
• Eventually, heart is weakened by reduced blood flow
• A partial blockage of one or more of the coronary arteries can result in not enough oxygenated blood causing symptoms such as angina (chest pain).
• *A bypass is usually a blood vessel from the groin will re-route that blood vessel tot he heart, double by pass means two of those arteries of blocked and quadruple would be four.

Myocardial Infarction/Heart Attack

Blockage results/ one or more of the coronary arteries, a heart attack results is an injury to that heart muscle.

• Usually comes without warning, but is likely the result of a long disease process
• Average age of first heart attack is 71 yrs old
• Heart attack symptoms: Chest pain (pressure, squeezing, burning) Sweating Upper body discomfort- women may experience this more Nausea Shortness of breath Light headiness
• Symptoms may differ between men and women

Cerebrovascular Disease

• Refers to a problem with the circulation of blood to the brain
  • Atherosclerosis is primary cause of cerebrovascular disease A complete blockage with long- term effects is referred to as a stroke Sometimes, a blood vessel in the brain can burst (Aneurysm)

stroke

If deprived of oxygen (for more than a few minutes) brain cells will die.

• (cerebrovascular accident) occurs when blood supply is cut off to the brain
• Can cause death or disability, stroke survivors often have some level of disability, Paralysis, speech impairment, memory loss, change in behaviour, chronic fatigue.

Peripheral Vascular Disease

The issue is with any disease or disorder outside the brain and heart.

• Atherosclerosis in the leg or arm (caused by build-up of plaque or fatty material within blood vessels)
• Symptoms include: Claudication: aching fatigue in affected leg with movement/physical activity Rest pain: oxygen not able to supply oxygen even when not physically active
• If blood flow not restored quickly, cells and tissue will die
• *Amputation may be required in severe cases

Heart Failure

• heart cannot provide enough blood to the rest of the body as it is needed, the pumping action of the heart cannot provide enough blood the rest of the body.
• Results due to damage to the heart muscle resulting in the heart cannot maintaining regular pumping rate Patients with heart failure usually suffer from shortness of breath, fatigue and swelling of the legs when heart cannot maintain regular pumping rate, fluids can back up – called congestive heart failure e.g. from a heart attack, atherosclerosis, excessive consumption of alcohol, viral infections, birth defects

Congenital Heart Disease

• structure of the heart arising because of a birth defect which is about 1% of population. These anatomical defects can be as simple as a small hole in one of the inside walls of the heart or they can be very complex, affecting the way blood flows through the heart and lungs Often diagnosed through heart sounds

Heredity CVD Risk

Arteries may stiffen with age (i.e., contributing to risk of CVD in older Canadians) CVD varies amongst ethnic groups in Canada: Higher rates: South Asian and African descent, Indigenous people

• High cholesterol and high blood pressure causes more CVD related diseases but can be managed.

smoking CVD Risk

Smoking contributes to the development of blocked arteries, increases the risk of blood clots, reduces oxygen in the blood and increases blood pressure, and smoke increases the risk of a ischemic Heart Disease. Stopping provides immediate and long lasting

Unhealthy Eating CVD Risk

• • Fresh fruits and vegetables can protect the heart and blood vessels, and can prevent the arteries from getting blocked
• Cholesterol buildup can cause major health problems or other main risk to having artery or blood failure

Hypertension CVD Risk

It happens when BP is exerted on blood and the Artery Walls When blood vessel walls damage it can affect fatty plaque from high risks and very high pressure

• BP Is (heart contracts) 120 and relaxes (80): Blood pressure that is consistently more than 135/85 mmHg is considered high risk. Prevention with :
• Smoke-free, reduce sodium intake, maintain healthy weight, be physically active and limiting alcohol

Stress CVD Risk

cause of the stress isn't as important as the individual response to it Learning to cope with stress is very important to the prevention of hypertension, especially if the stressor cannot be eliminated or changed High levels

Explore varied definitions of health, including objective, subjective, and Indigenous perspectives. Understand the dynamic nature of health, its measurement, and the influence of personal interpretation. Examine the role of healthcare providers in improving patient care and the limitations of standardized health definitions.