Social Determinants of Health

Social Determinants of Health

• Economic stability includes employment status, income level and access to financial resources.
• Education access and quality includes literacy levels, educational attainment and access to health education.
• Healthcare access and quality includes insurance coverage, availability of healthcare providers and quality of medical care.
• Neighborhood and built environment encompasses safe housing, environmental conditions and access to nutritious foods.
• Social and community context includes support systems, discrimination, and cultural beliefs.

Obstacles to Care

• Lack of reliable transportation prevents access to medical facilities.
• Physical disabilities limit access to healthcare settings.
• Miscommunication between patients and providers occurs form language differences.
• Some medical treatments may conflict with religious practices.
• Lack of insurance leads to delayed or avoided medical care.

Cost of Care

• Direct costs include hospital stays, medications, diagnostic tests, and surgeries.
• Indirect costs include lost wages, travel expenses, childcare, and time off work.

Age-Related vs. Age-Dependent Diseases

• Age-related diseases are more common with age, but not inevitable, such as osteoporosis and atherosclerosis.
• Age-dependent diseases are directly caused by aging, such as presbyopia and menopause.

Diagnostics & Patient Assessment

• Provider questions about symptoms, duration, previous medical conditions, substance use, family history, recent travel or exposure to sick individuals.
• Percussion is a physical examination technique involving tapping body parts to assess underlying structures.
• Palpation is a physical examination technique involving feeling body structures for abnormalities.
• Normal blood pressure ~120/80 mmHg, high blood pressure is >130/80 mmHg.
• Normal pulse ~60-100 bpm; variations may indicate cardiovascular issues.
• Typical findings: regular heart rate, normal reflexes, normal respiration.
• Atypical findings: irregular heart rhythm, abnormal lung sounds, jaundice, swelling.

Complete Blood Count (CBC)

• Neutrophils indicate bacterial infections.
• Lymphocytes indicate viral infections.
• Monocytes indicate chronic inflammation.
• Eosinophils indicate allergic reactions and parasites.
• Basophils indicate allergic reactions and histamine release.
• Low blood cell count may indicate anemia, leukemia, or bone marrow suppression.

Imaging Techniques

• CT scan: cross-sectional images, used for detecting tumors, fractures, and internal bleeding.
• MRI: high-resolution imaging for soft tissues including the brain, spinal cord, and joints.

Inflammation & Immune Response

• Classical Pathway: activated by antibodies binding to pathogens.
• Lectin Pathway: detects pathogen-specific sugars.
• Alternative Pathway: directly attacks pathogens.
• Regeneration involves tissue fully restored to normal function like liver regeneration.
• Repair results in the formation of scar tissue such as skin healing with a scar.
• Histamine increases blood flow, causes swelling, and redness.
• Prostaglandins mediate pain and fever.
• Cytokines are signaling molecules that regulate immune response.
• Cardinal signs of inflammation are redness, heat, swelling, pain, and loss of function.

Blood Clotting & Vascular System

• Process: platelets adhere to injury site, fibrin clot forms to stop bleeding and coagulation cascade stabilizes clot.

Specific Diseases

• Genetic blood disorder causing misshapen red blood cells, leading to pain crises and organ damage
• Congestive Heart Failure: Heart cannot pump efficiently, causing fluid buildup.
• Atherosclerosis: Plaque buildup in arteries, reducing blood flow.
• Hypertrophy: Thickening of heart muscle due to increased workload.
• Myocardial Infarction (Heart Attack): Blocked coronary artery leads to tissue death.

Types of Tissue Death (Necrosis)

• Coagulative Necrosis: Common in the heart due to ischemic injury.
• Liquefactive Necrosis: Common in the brain from infections, strokes.
• Caseous Necrosis: Associated with tuberculosis.
• Fat Necrosis: Seen in pancreas and breast tissue.

Kidney & Bladder Diseases

• Symptoms of Kidney Disease: Blood in urine, swelling, high blood pressure.
• Renal Calculi (Kidney Stones): Hard mineral deposits causing severe pain.
• Treatment: Lithotripsy is shock wave therapy to break up kidney stones.

Lung Conditions & Necrosis

• Various forms of necrosis affecting lung tissue, commonly due to infections or trauma

Erythroblastosis Fetalis

• Occurs when an Rh-negative mother carries an Rh-positive baby.
• Trauma or blood mixing can trigger an immune response against the fetal blood cells, potentially leading to fetal death.

Medical Terminology & Definitions

• Presbyopia: Age-related loss of near vision.
• Hypoxia: Reduced oxygen supply to tissues.
• Hematochezia: Presence of blood in stool.

Autopsies

• Helps identify new diseases.
• Provides insight into disease progression.
• Confirms cause of death.

Cell Death Mechanisms

• Necrosis involves uncontrolled cell death due to injury or infection.
• Apoptosis is programmed cell death, a normal part of tissue regulation.

Organ Transplantation

• The most common organ transplanted is the kidney.