2222 Final Exam Review PDF

2222 - Final Exam Review Social and economic determinants of health Social Determinants of Health → a set factor that act together to influence the health of individual and communities (negative or positive) - Increase income = better health - Decrease income = poorer health 1. Income and...

2222 - Final Exam Review Social and economic determinants of health Social Determinants of Health → a set factor that act together to influence the health of individual and communities (negative or positive) - Increase income = better health - Decrease income = poorer health 1. Income and income distribution (most important determinant of health) - Increase income = longer life = decrease rate of suicide - Decrease income = increase rate of CVD, diabetes, respiratory disease and infant mortality Income inequality → extent to which income is distributed unevenly in a country - Results in a weaker economy and poorer health for everyone - Rich getting richer and the poor are getting poorer - More equal societies → life expectancy, child wellbeing, literacy and trust are all better - More equal societies → infant mortality, obesity, teenage pregnancy and mental health issues are lower More seniors going bankrupt than before (lack financial literacy) - Living longer, returning with debt, giving money to family member, healthcare expenses and losing money in the stock market 2. Education (higher education = better health) - Increase one’s overall literacy and increase one’s ability to improve health thought individual action - Provides more opportunities for individuals if their employment situation suddenly changes 3. Unemployment and job security Employment → provides income, a sense of identity and helps to structure day-to-day life Unemployment → leads to material and social deprivation, psychological stress and the adoption of health-threatening coping behaviors Job insecurity (part-time, temporary) - Non-standard working hours (difficult to manage and separate from life) - Only paid for direct care time (travel time is not paid) 4. Employment and working conditions - Most vulnerable to poor health outcomes experience adverse working conditions  - Factors that shape health outcomes: employment security, physical work conditions, pace and stress, working hours and opportunities for self-expression 5. Early childhood development (90% brain developed before age 5 and 10% after age 5) Latency effect → early childhood experience predispose children to either good or poor health (regardless of later life circumstances) Cumulative effect → longer children live under conditions of material and social deprivation, the more likely they are to show adverse health and developmental outcomes - Children development health requires a holistic understanding - Strongly and consistently associated with increase likelihood of positive outcome later in life (educational achievement, professional success and better health) - Decrease likelihood of negative outcomes (unemployment, criminal behaviors and early mortality) Dependent on 2 enabling conditions: - Universally accessible community services → high quality education, child care and health programs/services - Family time and resources → time to care personally for children, adequate income and educated parenting skills 6. Food insecurity (in canada rate of food insecurity is 12.4%) - Inadequate or insecure access to food due to financial constraints - Creates conditions that are harder to tray than presenting food security in the first place Paradox of hunger and obesity → hunger and obesity can exist in the same families and same individuals - Need to maximize caloric intake, food quantity and quality and overeating Quantitative → Not enough food Qualitative → inexpensive non-nutritious food Psychological → stress associated with trying to meet daily needs Social → getting food in socially unacceptable ways Food banks - Helpful → given poverty a public profile and satisfies present and urgent need - Harmful → acceptance of poverty, government inaction and food banks have become institutionalized Community food security → all community resident obtain a safe, personally acceptable, nutritious diet thought a sustainable food system that maximizes healthy choices, community self-reliance and equal access for all 7. Housing - Poor quality housing leads to increase risk of many health problems  - High housing cost = less money for food (creates stress and unhealthy means of coping) - Early death among homeless individuals is 8-10x greater than among Canadian population (>2200 homeless in London) 8. Social exclusion - ex. Indigenous canadians, low income, women and people with disabilities - More likely to be unemployed, earn lower wages, have less access to health and social services, and lack the means to further their education - ex. Lack of access to emergency childcare, seniors living alone, don’t fit in, do not speak english and can’t practice profession 9. Social safety net - A wide range of programs and supports that protect citizens during life changes that can affect their health - Normative life changes (growing a family) and non-normative (accidents, divorce) 10. Health services - Poor and less educated have more health problems and die earlier than those with money and education - Many people do not have health insurance through their employer and must pay out of pocket 11. Geography - Influences health though; air, food, water, environmental pollution and access to healthcare - Death rates higher for people living in rural and remote areas - Toxic waste sites, landfills and incinerators are often close to; communities of colour and or poor neighborhoods 12. Disability - People with disabilities are less likely to be employed and earn less (more likely to live in poverty) - Must rely on social assistance (benefits are very low and do not even bring people to the poverty line) 13. Indigenous ancestry - Distal SDOH → Colonialism, racism, self-determination - Intermediate SDOH → Healthcare system, education system, community, environmental stewardship, cultural continuity - Proximal SDOH → Health behaviours, physical environments, SES Colonialism (Residential School System)  - Children were forcibly taken from their families and verbally, emotionally and physically abused - Critically affected their health throughout their life course - Intergenerational trauma (poor health, loss of cultural identity, low SES and lack of competencies) 14. Gender - Women: experience more adverse SDOH than men (carry more responsibility for raising children, employed in lower-paying occupations, more workplace discrimination) - Men: suicide rate 4x higher than that of women, more likely to be perpetrators and victims of robbery, 95% prison population, prone to anti-social behaviours and criminal offences - Other genders: experience discrimination that leads to stress and adverse health effects 15. Immigration - Immigration is an important course of economic growth and sociocultural diversity - Immigrants have better health than Canadian-born counterparts (but health deteriorates after than due to social exclusion and racialization of poverty) 16. Race - Since the 1960s >¾ of immigrants to Canada belong to visible minority groups - Institutionalized racism → policing, bank lending procedures, school funding based on property taxes - Personally-mediated racism → Lack of respect, suspicion, name calling, scapegoating, hate crimes, dehumanization - Internalized racism → people who are stigmatized accept these messages, which lead to loss of self-esteem, resignation, helplessness 17. Globalization - Nations, businesses and people are becoming more connected and interdependent vis increased economic integration and communication exchange, cultural diffusion and travel - Negative aspects: deregulate global finance, reduction of social protection programs and environmental devastation - Positive aspects: sharing of health knowledge, global treaties on human rights, tobacco control and global food trade Stress and Illness - Physiological (chronic stress → more vulnerability to CVD, immune system diseases, Type 2 diabetes) - Psychological (poor living conditions → feeling of shame, anxiety, hopelessness, worthlessness and the adoption of unhealthy coping behaviours) Suicude in Canada - Millions of people around the world are affected by suicide (directly or indirectly) - 4500 Canadinas die by suicide every year (1 person every 2 hours) Proposed Solutions Upstream thinking → focusing on the causes of illness, poor quality of life and premature death Downstream thinking → dealing with the outcomes of poor social determinants of health (1) Focus on sources of problems - Promoting health and reducing illness requires a focus on the sources of problems rather than dealing with symptoms - Improving the living and working conditions people experience reduces material and social deprivation, as well as the physiological and psychological stress that leads to illness Health equality → everyone has a fair and just opportunity to be as healthy as possible - Removing obstacles to health such as poverty, discrimination and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments and health care - Process of reducing disparities in health and its determinants (2) Invest in Social Services - Government should spend less on “healthcare” and more on social programs - If 1 cent more were spent on social services for every 1 dollar spent of health (life expectancy would increase 5% and avoidable mortality would decrease 3%) (3) Basic Minimum Income - Benefit that governments provide to citizens instead of various targeted social benefits - Providing almost all Candaians with a basic income for six months could cost about $98 billion - Decrease rate of hospitalization, increase mental health and increase number of children completing high school (4) Financial Literacy  - Being educated about everyday personal finances enables people to make smarter money management decisions that lead to a financially secure future - Earnings and income, goal setting and budgeting - The way to achieve financial security was to know about savings and investment - Financial literacy theory proposes that controlling one’s spending (first) is imperative for being able to save and invest Financial stability → changes over time - Being able to deal with imbalances before they become a threat Financial security → means not being worried about achieving financial goals (5) Healthcare Patient level - Ask about social history in a sensitive and culturally acceptable way - Treat patients with dignity and respect and create safe spaces for disclosure - Refer patients and help them access benefits and support services Practice level - Improve access and quality of care for hard-to-reach patient groups - Integrate patients social support navigators into the primary care team Community level - Partner with community groups, public health and local leaders - Use clinical experience and research evidence to advocate for social change - Get involved in community situational assessments and health planning Ecological determinants of health (1) Sustainable development → meeting present needs without compromising future generations ability to meet their needs - Interacting with ecosystems in easy that allow them to maintain sufficient functional integrity - Health society gives equal attention to social justice, economic development and environmental sustainability because they are all mutually reinforcing - Beach sand mining → used for the global urbanization boom (concrete, asphalt, glass) (2) Microplastics and nanoplastics Problem 1: Hundreds of thousands of tons of plastic in our oceans - REDUCE overall use of plastic - REUSE if possible - RECYCLE which helps to keep plastic out of landfills, but it is not cost-effective - Advocate for biodegradable plastics Problem 2: Many chemicals are added to plastics - Plastics in the oceans can have higher concentration of pollutants than the water from which they were collected - Solutions: use BPA-free products, cut back on cans, avoid heat, use alternatives and advocate for biodegradable plastics Problem 3: Health effects of plastics in marine food chain - Addition to chemical added to plastics, plastics also absorb other toxic substances - Marine organisms consume these plastic which then bioaccumulates up the food chain - Researchers are investigating the human health effects of marin plastic The problem with plastic - Within 3 min of heating, come containers released 4.2M microplastic particles and 2.1B nanoplastic particles from only 1 sq cm of plastic area Proposed solution: Biodegradable plastics - 88% of cannabis is waste - Must be treated before disposal to make it unfair for human consumption: mix it 1:1 with kitty litter, burn it or grind it into compost (costly and damages enviro)  - Effective behaviours change campaigns should Be customizable (segment by target audience) Use positive norms and language Convey benefits Catalyze commitment (inspire people to pressure gov/businesses to legislate/offert plastic free options) Specific action ex: say no to avoidable, harmful and unnecessary plastic, shift to reusable products, sort waste, ensure plastic packing is reused, recycled and composted, purchase package-free foods, transition from liquid to soil products Microfibers → synthetic fibers