Health Determinants and The Lalonde Report

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Questions and Answers

What was the primary focus of the Lalonde Report?

Emphasis on lifestyle and environmental factors in health (correct)

Proposed new medical technologies

The importance of hospital facilities

Increased funding for healthcare programs

Which of the following is considered a physical determinant of health?

Dietary choices

Family history of disease

Cherished beliefs and values

Access to healthcare services (correct)

According to the Preston Curve, what happens to life expectancy as GDP per capita increases?

It remains constant regardless of GDP changes

It increases at a constant rate

It decreases steadily with no limit

It increases but the effect diminishes at higher levels (correct)

How does the built environment affect public health?

It significantly influences physical activity levels Signup and view all the answers

Which of the following elements is NOT categorized as a determinant of health?

Cultural beliefs Signup and view all the answers

What role do communities play in health management?

They provide safe spaces for healthy behaviors Signup and view all the answers

What is the term for the volume of air the lungs can hold when fully inflated?

Total Lung Capacity (TLC) Signup and view all the answers

Which pulmonary volume is typically impacted by respiratory diseases such as asthma or COPD?

Total Lung Capacity (TLC) Signup and view all the answers

Which statement best describes the relationship between lifestyle choices and health according to the Lalonde Report?

Lifestyle choices are critical in shaping individual health outcomes Signup and view all the answers

Which factor is NOT associated with lung capacity variability?

Age of the individual Signup and view all the answers

Which factor is most likely to improve health and longevity according to economic conditions?

Higher wealth levels Signup and view all the answers

What characterizes obstructive airway diseases?

Inability to exhale fully Signup and view all the answers

Which of the following is an example of a restrictive lung disease?

Pulmonary Fibrosis Signup and view all the answers

What is the primary consequence of a pulmonary embolism?

Blockage of blood flow in the lungs Signup and view all the answers

Which volume represents the amount of air inhaled or exhaled during normal relaxed breathing?

Tidal Volume (TV) Signup and view all the answers

What is a common risk factor that can lead to Deep Vein Thrombosis (DVT)?

Prolonged immobility due to surgery Signup and view all the answers

How does body size generally affect lung capacity?

Larger individuals tend to have greater lung capacity. Signup and view all the answers

Which of the following is NOT a symptom of Deep Vein Thrombosis (DVT)?

Wheezing Signup and view all the answers

What is a primary treatment option for managing pulmonary fibrosis symptoms?

Oxygen therapy Signup and view all the answers

Which of the following is a physiological change associated with asthma?

Constriction of smooth muscle surrounding airways Signup and view all the answers

Which treatment is categorized as a 'reliever' for asthma symptoms?

Quick-acting bronchodilators Signup and view all the answers

What is a potential consequence of untreated severe asthma episodes?

Bluish lips and severe anxiety Signup and view all the answers

Which of the following is NOT a cause of pulmonary fibrosis?

Regular aerobic exercise Signup and view all the answers

What is a primary focus of treatment for pulmonary fibrosis?

Managing and alleviating symptoms Signup and view all the answers

Which test is specifically used to assess anaerobic fitness?

Wingate Test Signup and view all the answers

What does BFOR stand for in a workplace context?

Bona Fide Occupational Requirement Signup and view all the answers

What was the main issue in the Meiorin case regarding fitness standards?

The aerobic standard discriminated against women. Signup and view all the answers

In what types of occupations are BFORs particularly applicable?

Physically demanding occupations Signup and view all the answers

Which of the following is NOT a test commonly associated with muscular fitness?

Wingate Test Signup and view all the answers

What is the total high-intensity time in the 4X4 Approach?

16 minutes Signup and view all the answers

Which of the following is a negative of HIIT?

It can lead to increased adverse event risk. Signup and view all the answers

What is the recommended frequency for training each major muscle group?

2-3 times per week Signup and view all the answers

What is the correct formula for calculating the One Repetition Maximum (1RM)?

1RM = Weight Lifted / (%1RM value / 100) Signup and view all the answers

What intensity is recommended for novice and intermediate individuals during resistance training?

60-70% 1RM Signup and view all the answers

Which component of a training program helps to enhance the range of motion?

Flexibility Signup and view all the answers

How long is the recommended rest period between sets during resistance training?

1-3 minutes Signup and view all the answers

What is one of the benefits of HIIT training?

It improves anaerobic thresholds. Signup and view all the answers

Study Notes

The Lalonde Report (1974)

Published by Marc Lalonde, Canada's Minister of National Health and Welfare
Transformed the way the world thinks about health, emphasizing factors beyond medical care
Remains a foundational document in the field of health promotion
Key Insight: Health is influenced by both internal and external factors. Lifestyle choices and environmental factors play significant roles in determining health.

Determinants of Health (World Health Organization)

Physical Determinants of Health: Health is affected by factors such as where people live, quality of their environment, genetics, income, education level, and relationships with friends and family.
Determinants are often categorized into social, economic, environmental, and behavioral factors.

Life Expectancy and Wealth (Preston Curves)

The Preston Curve shows the relationship between wealth (GDP per capita) and life expectancy
As wealth increases, life expectancy tends to increase, but the effect diminishes at higher levels of wealth.
Economic conditions play a significant role in improving health and longevity

Built Environment and Community Health

Built Environment: Physical surroundings such as buildings, parks, and transportation systems.
It significantly influences physical activity and, thereby, public health.
York University is an example of how institutions can create a supportive built environment to promote health and well-being.
Role of Communities: Communities are crucial in promoting and sustaining physical activity by providing safe spaces like parks and gyms for people to engage in healthy behaviors.

Importance of Pulmonary Volume Measures

They help evaluate lung health and capacity, which is crucial for assessing exercise performance and diagnosing chronic respiratory diseases such as bronchitis, asthma, COPD, and emphysema.
Key Pulmonary Volume Measures: Total Lung Capacity (TLC), Vital Capacity (VC), Tidal Volume (TV), Inspiratory Reserve Volume (IRV), Expiratory Reserve Volume (ERV), and Residual Volume (RV).
Factors Affecting Pulmonary Volumes: Body Size, Sex, Fitness Level, Function of Ventilatory Muscles, Airway Obstructions/Restrictions.

Main Types of Respiratory Diseases

Pulmonary Circulation Diseases: Issues with blood flow between the heart and lungs, such as pulmonary embolism.
Restrictive Lung Diseases: Conditions that limit lung expansion, affecting lung structure and making it difficult to take a deep breath. Examples include Pulmonary fibrosis, sarcoidosis, and severe obesity. Effects include increased work of breathing, increased oxygen demand, reduced tidal volumes, and shallow breathing. Fibrosis also impairs gas transfer at the alveolar-capillary surface.
Obstructive Airway Diseases: Conditions where airway obstruction makes it hard to exhale all the air in the lungs. Examples include Asthma, chronic bronchitis, and emphysema.

Pulmonary Embolism (PE)

Occurs when a blood clot (often originating from a deep vein thrombosis, DVT) travels to the pulmonary arteries, blocking blood flow in the lungs.
Risk Factors: Cancer, injury, or surgery that leads to prolonged immobility. Deep Vein Thrombosis (DVT): Clots usually develop in the lower extremities and can travel to the lungs.
Symptoms: Sudden shortness of breath, Chest pain that worsens with breathing or coughing, Cough (sometimes with blood), Rapid pulse and lightheadedness.
Treatment: Anticoagulants (blood thinners) to prevent clot growth, Oxygen therapy to alleviate respiratory symptoms, Surgical removal or filtering of clots in severe cases.

Restrictive Lung Diseases

Pulmonary Fibrosis: A chronic disease characterized by scarring and thickening of lung tissue, making it stiffer and harder to expand. Causes include infections, environmental agents like asbestos, and chronic inflammation. Symptoms include increased work of breathing, reduced tidal volume, increased lung oxygen demand, and impaired gas exchange. There is no cure, but treatments focus on managing symptoms. Options include medications to reduce inflammation and in some cases, lung transplantation.

Asthma

Definition: A chronic condition in which the airways become inflamed and narrowed, making breathing difficult.
Cause and Risk Factors: Triggered by environmental factors (e.g., cold weather, chemicals, pollen), Family history and other respiratory infections can also increase risk, Allergies, obesity, and exposure to irritants like tobacco smoke are common risk factors.
Physiological Changes: Inflammation of the airways, increased mucus production, and bronchospasm (constriction of the smooth muscle surrounding the airways).
Symptoms: Wheezing, breathlessness, tight chest, and coughing. Emergency Symptoms: Bluish lips, severe anxiety, rapid pulse, and extreme difficulty breathing.
Treatment: Preventers: Inhaled corticosteroids to reduce inflammation, Controllers: Long-acting anti-inflammatory medications, Relievers: Quick-acting bronchodilators for immediate symptom relief.
Physical Activity: Individuals with asthma may avoid physical activity due to symptoms, but regular aerobic exercise improves lung function and reduces symptom severity.

High Intensity Interval Training (HIIT)

A method of training that alternates between short periods of intense exercise and periods of recovery.
Shorter Duration Approaches (Tabata Protocol): Four minutes with 20 seconds of high-intensity exercise followed by 10 seconds of rest.
Longer Duration Approaches: The 4X4 Approach involves 4 bouts of 4 minutes at high intensity (85-95% HRmax). Each bout is followed by 3 minutes of rest. Total high-intensity time is 16 minutes; total workout time is about 25 minutes.
Benefits of HIIT: Enjoyment and the intensity achieved, Health and fitness outcomes, such as increased cardiorespiratory fitness (CRF) and improved anaerobic thresholds. It is well-tolerated by many individuals and is time efficient.
Negatives of HIIT: Increased adverse event risk, High perceived intensity and difficulty may discourage some participants, HIIT is more labor-intensive due to the need for intensity monitoring and precise timing.

Components of a Training Program

Warm-Up: Prepares the body for exercise by increasing temperature and blood flow to the muscles.
Aerobic Exercise: Activities that increase heart rate and improve cardiovascular fitness.
Resistance/Strength Training: Exercises aimed at improving muscular strength and endurance.
Flexibility: Stretching exercises to enhance the range of motion.
Cool-Down: Gradually returns the body to resting state and prevents injury.

ACSM Guidelines for Resistance Training

Frequency: Each major muscle group should be worked 2-3 times per week.
Intensity: 60-70% 1RM for novice and intermediate exercisers, >80% 1RM for advanced strength trainers, 40-50% 1RM for elderly or previously sedentary individuals.
Type: Exercises should target major muscle groups and can include a variety of equipment, including body weight, isometric, and isotonic exercises.
Volume (Sets/Reps): 8-20 reps, depending on training goals and fitness level, 2-4 sets; ≤2 sets for novice or elderly individuals. Rest Periods: 1-3 minutes between sets; at least 48 hours between training the same muscle group.

Determining Resistance Intensity: One Repetition Maximum (1RM)

1RM Calculation: 1RM represents the maximum weight a person can lift for one repetition of a given exercise. To determine 1RM: Use the formula: 1RM = Weight Lifted / (%1RM value from table / 100).

Fitness Testing

Muscular Fitness: Tests include grip strength, push-pull exercises, sit and reach, push-ups, curl-ups, vertical jump, bench press, and others.
Anaerobic Fitness: Evaluated using the Wingate Test.
Aerobic Fitness: Assessed via a VO₂max test. Interview: Includes a personal interview to assess various aspects of the athlete beyond physical capabilities.

Bona Fide Occupational Requirement (BFOR)

       - Definition: A qualification or requirement that is essential for carrying out a specific job, particularly in physically demanding occupations.
       - BFORs may include specific fitness standards that must be met to ensure that the employee can safely and effectively perform the duties of their job.
       - Key Considerations for BFORs: Applicable to any physically demanding occupations where failure to perform the job effectively could result in the loss of life or property. Employers must demonstrate that the fitness standards are necessary for the job's purpose and that it would be impossible to accommodate the worker without undue hardship.

The Meiorin Decision (1999, Supreme Court of Canada)

Case Overview: Tawney Meiorin was dismissed from her firefighter job for failing a minimum fitness standard (a running test). Ms. Meiorin argued that the aerobic standard discriminated against women under the Canadian Charter of Rights and Freedoms.
The Supreme Court of Canada established a three-part test to determine if a BFOR is justified :
- the standard is rationally connected to the job requirements;
- the standard is adopted in good faith to achieve its purpose;
- it cannot be imposed without undue hardship.
Key Outcome: The Meiorin decision established the principle that employers must accommodate employees to the point of undue hardship. It shifted the burden of proof onto employers to justify their BFORs and demonstrated that a fitness standard is discriminatory if it does not meet the three-part test.

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Description

Explore the transformative insights of The Lalonde Report and its impact on global health perspectives. This quiz delves into the various determinants of health identified by the World Health Organization and examines the relationship between wealth and life expectancy through the Preston Curve.