DPH 1st Lecture PDF

DENTAL PUBLIC HEALTH DE LA SALLE MEDICAL AND HEALTH SCIENCES INSTITUTE COLLEGE OF DENTISTRY DAVID PABLO S. FERNANDEZ JR.,DMD  Class rules 2 hours time allotment for lecture 15mins grace period for tardiness Beyond 15 mins = absent Ab...

DENTAL PUBLIC HEALTH DE LA SALLE MEDICAL AND HEALTH SCIENCES INSTITUTE COLLEGE OF DENTISTRY DAVID PABLO S. FERNANDEZ JR.,DMD  Class rules 2 hours time allotment for lecture 15mins grace period for tardiness Beyond 15 mins = absent Absences of >20% of total number of class hours = dropped Readings will be uploaded on iLS  Class rules Student representative for the class 1 ller notebook for quizzes 1 clear book for portfolio ( nal course output) Raise your hand if you wish to recite and participate in class You are free to attend to your comfort necessities, without the need for permission fi fi Course Introduction  Health “Health is a state of complete physical, mental, and social wellbeing and not merely the absence of disease or in rmity” (WHO) A community’s own concept of health as part of their customs and traditions fi  Health In the last few decades, it has been perceived as a basic right and a worldwide goal Essential to the satisfaction of basic human needs To improve the quality of life  Changing concepts in health Biomedical concept Ecological concept Psychological concept Holistic concept  Biomedical concept Health means the “absence of disease” The human body is a machine and disease is an outcome of the breakdown of that machine The doctor’s task is to repair the machine  Ecological concept Health is viewed as a dynamic equilibrium between man and his environment Disease is a maladjustment of the human organism to the environment Ex Availability of food and population explosion  Psychosocial concept Health is in uenced by social, psychological, cultural, economic and political factors of people concerned Thus, health is a physical and social phenomenon fl  Holistic concept Recognizes the strength of social, economic, political and environmental in uences on health Uni ed or multidimensional process involving the wellbeing of the person as a whole Emphasis on the promotion and protection of health fi fl Holistic concept  De nitions of Health Broad sense, health is a condition or quality of human expressing the adequate functioning of organism in given conditions, genetic or individual In a narrow sense,(1) there is no obvious evidence of disease (2) several organs of the body are functioning adequately themselves in relation to one another Implying equilibrium fi Dimensions of Health  Dimensions of health Physical - concept of perfect functioning of the body A state in which every cell and every organ are functioning at optimum capacity  Dimensions of health Mental dimension The ability to respond to many varied experiences of life “A state of balance between individual and surrounding world”  Social dimension Implies harmony and integration with the individual between each individual and other members of society Between individuals and the world in which they live “The quantity and the quality of an individual’s interpersonal ties and the extent of involvement with the community”  Spiritual dimension The part of the individual which reaches out and strives for meaning and purpose in life It is the intangible “something” that transcends physiology and psychology  Emotional dimension Relates to the “feeling” The dimension re ects emotional aspect of humanness fl  Vocational dimension Work plays a role in promoting both physical and mental health health Physical work is often associated with “wellbeing:” of an individual or group of individuals  Wellbeing Subjective Referred to as the “Quality of life” Objective Relates to the “standard of living”  Standard of living Income, occupation and standards of housing Sanitation and nutrition Level of provision of health Education and recreational and other services Used individually as measures of socioeconomic status  Quality of life The condition of life resulting from combination of the e ects of the complete range of factors determining health, happiness, education, social and intellectual attainments Freedom of action, justice and freedom of expression ff Theories of Disease causation 1st quiz  1. The human body is a machine and disease is an outcome of the breakdown of that machine 2.“______ is a state of complete physical, mental, and social wellbeing and not merely the absence of disease or in rmity” fi  3. The dimension of health re ects emotional aspect of humanness 4. A state in which every cell and every organ are functioning at optimum capacity 5.The concept that ecognizes the strength of social, economic, political and environmental in uences on health fl fl  True or False 6.Work plays a role in promoting both physical and mental health health 7. A person’s objective wellbeing is often referred to the quality of life 8. Physical work is often associated with “wellbeing” of an individual or group of individuals  True of false 9. The standard of living is the condition of life resulting from combination of the e ects of the complete range of factors determining health, happiness, education, social and intellectual attainments 10. income, socioeconomic status, education, health. etc a ff  Germ theory “Mono causal” Disease is caused by transmissible agents A speci c agent is responsible for one disease only Work of Koch and Pasteur (1860 Isolation of bacillus causing tuberculosis (1880-1900) fi  Epidemiological triad An organism or other noxious agent is necessary but it isnt enough to cause disease It is the result of a host, an agent and the environment  Web of causation Considers all the predisposing factors of any type and their complex interrelationships with each other Ideally suited for study of chronic diseases where the causative agent is unknown The removal or elimination of even one factor may sometimes be su cient to control a disease ffi  The theory of general susceptibility Emerged in the last 25 years Not concerned with identifying multiple or single risk factors for disorders Seeks to understand why some social groups are more susceptible to disease and death in general  The socioeconomic approach Risk conditions produced by such an environment a ect health directly through the physical, behavioral, and psychosocial risk factors that they create Improving health requires modi cation of these environments fi ff  Prevention of disease The action to stop ill health before it begins  Levels or categories of prevention Primordial prevention Primary prevention Secondary prevention Tertiary prevention  Primordial prevention The prevention of emergence or development of risk factors in countries or population group in which they have not yet appeared  Primary prevention Action taken prior to the onset of disease Removing the possibility of disease occurrence Carrie out on healthy individuals/populations Maintenance of disease free environment  Secondary prevention Actions which halts the progress of disease at its incipient stage and prevents complications Carried out on targeted populations identi ed by their being exposed to factors that place them “at risk” fi  Tertiary prevention Provides cure at an early stage in disease process Containing a disease or its e ects on a long term basis Seeks to prevent recurrence of the disease All measures available to reduce or limit impairments and disabilities ff  Tertiary prevention The individual or population is aware of the disease and can see its e ects and requires rehabilitation ff Modes of intervention  Primary prevention Services that prevent the initiation of disease (a)Health promotion - process of enabling people to increase control over and to improve health Health education - instructions, demonstration Environmental modi cation - safe water, control of insects and rodents Nutritional intervention - improvement in viable groups fi  Primary prevention (b)Speci c protection Methods of decreasing susceptibility of the host by establishing barrier Immunization, speci c nutrition, avoidance of allergens Protection from carcinogens Ingestion of optimally uoridated water Application of PFS fi fi fl  Secondary prevention Services that intervene or prevent the progression and recurrence of disease (a) early diagnosis WHO - detection of disturbances of homeostatic and compensatory mechanism while biochemical, morphological and functional changes are still reversible  Secondary prevention Screening for subclinical disease Case nding fi  Secondary prevention (b) prompt treatment Attempt to arrest the disease process Restore health by seeking out unrecognized disease Treating disease before irreversible pathological changes take place Reverse communicability of infectious disease  Tertiary prevention Actions taken when disease process has advanced beyond its early stages All measures available to reduce or limit impairments and disabilities Promote patient’s adjustment to irremediable conditions Disability limitation and rehabilitation Prevent death  Tertiary prevention (a) Disability limitation Objective is to prevent or stop the transition of disease process from impairment to handicap Tertiary prevention  Tertiary prevention (b) rehabilitation The combined and coordinated use of medical, social, educational, and vocational measures for training and retraining the individual to the highest possible level of functional ability  Tertiary prevention (b) rehabilitation It is the measure to train the disable individual to reach the highest level of functional ability by using combined coordinated medical, social, vocational, psychological and educational measures  Tertiary prevention Special schools for blind pupils Provision of aids for crippled Reconstructive surgery Modi cation of life for tuberculosis or cardiac patients fi  Barriers to preventive strategies Diversity of population Inherent beliefs/mores Advertising Pressure groups Access Resources