HHN Module 2 PDF

**Chapter 1; Health and Wellness** **P&P Canadian Fundamental of Nursing (70-137)** **Disease** - **objective state of ill health**, the pathological process of which can be **detected by medical science** **Illness** - **subjective** experience of loss of health **Health** - **obje...

**Chapter 1; Health and Wellness** **P&P Canadian Fundamental of Nursing (70-137)** **Disease** - **objective state of ill health**, the pathological process of which can be **detected by medical science** **Illness** - **subjective** experience of loss of health **Health** - **objective process** characterized by functional stability, balance, and integrity - Old English word hoelth, meaning whole of body. - WHO definition - **a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.** **Wellness** - subjective experience **CONCEPTUALIZATION OF HEALTH** **Card (2017)** - health as the experience of physical and psychological well-being **Jones and Meleis (1993)** - health as empowerment **Labonte (1993)** - focus and reflect the essence of health promotion - categorized the major determinants of health in a socioenvironmental approach as 1. psychosocial risk factors- complex psychological experiences 2. socioenvironmental risk conditions- social and environmental living conditions **Rootman and Raeburn (1994)** - health as a quality enhanced by a sensible lifestyle and equitable access to resources that promote the individual and collective initiative to maintain or improve well-being. **Historical Approaches to Health in Canada In modern** **Medical Approach** - emphasizes the notion that medical intervention restores health. - Health problems are defined primarily as physiological risk factors---physiologically defined characteristics that are precursors to or risk factors for disease - **downstream thinking** **approach** - focuses on individual health concerns, treatment, and cure. **Behavioural Approach** **Lalonde Report** - traditional medical approach to health care was inadequate and that "further improvements in the environment, reductions in self imposed risks, and a greater knowledge of human biology" were necessary to improve the health status of Canadians - first modern government document- acknowledge-inadequacy of biomedical health care system - defined health determinants as lifestyle, environment, human biology, and the organization of health care - behavioural risk factors- smoking, substance use, lack of exercise, and an unhealthy diet **Socioenvironmental Approach** - **health is closely tied to social structures** - **upstream thinking approach --focused on policy interventions that benefit the whole population** **Ottawa Charter** - **prerequisites for health as peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice, and equity.** - **focus on social justice and equity also incorporated the concept of empowerment** - **outlined five major strategies to promote health:** 1. **building healthy public policy** 2. **creating supportive environments** 3. **strengthening community action** 4. **developing personal skills** 5. **reorienting health services** **Epp's (1986)** - **identified three major health challenges:** 1. **reducing inequities** 2. **increasing prevention** 3. **enhancing coping mechanisms** - **acknowledged disparities in health, particularly between low- and high-income people** **Population Health Approach** - **"the entire range of known individual and collective factors and conditions that determine population health status, and the interactions among them, are taken into account in planning action to improve health"** - **list of 14 social determinants of health** 1. **Income and income distribution** 2. **Education** 3. **Unemployment and job security** 4. **Employment and working conditions** 5. **Early childhood development** 6. **Food insecurity** 7. **Housing** 8. **Social exclusion** 9. **Social safety network** 10. **Health services** 11. **Indigenous status** 12. **Gender** 13. **Race** 14. **Disability** **Jakarta Declaration** - **declared poverty to be the greatest threat to health** 1. **identified the following priorities for action: promoting social responsibility for health in the public and private sectors** 2. **increasing investments for health in all sectors** 3. **consolidating and expanding partnerships for health to all levels of government and the private sector** 4. **increasing community capacity and empowering the individual** 5. **securing adequate infrastructure for health promotion.** **Bangkok Charter** - **affirmed health as a human right and emphasized mental and spiritual well-being as important elements.** - **emphasized** 1. **strong political action and sustained advocacy** 2. **empowering communities with adequate resources** 3. **corporate sector commitment to healthy workplaces and ethical business practices** **Toronto Charter** - **identified the following social determinants as particularly important for health:** 1. **Indigenous status** 2. **early life** 3. **education** 4. **employment and working conditions** 5. **food security** 6. **gender** 7. **health care services** 8. **housing** 9. **income and its distribution** 10. **social safety net** 11. **social exclusion** 12. **unemployment and employment security** **Health Inequalities - differences in the health status of individuals and groups** **Health equity - absence of unfair systems and policies that cause health inequalities** **Health disparities- health differences closely** **linked to social, economic, and/or environmental disadvantages that adversely affect groups that have systematically experienced greater obstacles to health** **Social Determinants of Health** 1. **Income and Income Distribution** - **influence most other social determinants of health** - **food insecurity (a state of being without reliable access to a sufficient quantity of affordable and nutritious food)** 2. **Education** - **closely linked with socioeconomic status** - **equip people with the knowledge and skills for employment, income security, job satisfaction, problem-solving skills, and a sense of control and mastery over life circumstances.** - **Health literacy "describes the skills that enable individuals to obtain, understand, and use information to make decisions, and take actions that will have an impact on health status** 3. **Unemployment and Job Security** - Unemployment is linked to material and social deprivation, adoption of health-threatening coping behaviours, psychological stress, and physical and mental health challenges 4. **Employment and Working Conditions** - Healthy workplaces include job and employment security, safe physical conditions, reasonable work pace, low stress, opportunities for self-expression and individual development, participation, and work--life balance 5. **Early Childhood Development** - While all health determinants influence child development, early child development is a separate determinant because of its importance to healthy lifelong outcomes. 6. **Food Insecurity** - The limited or uncertain availability of nutritious foods (i.e., food insecurity) is a growing public health concern in Canada because it is connected to the health and well-being of children and families 7. **Environment** - Physical environment includes environmental quality. Contaminants in the air, water, food, and soil can cause adverse health effects, including cancer, respiratory and gastrointestinal illness, and birth defects. 8. **Housing** - Lack of affordable, suitable, and adequate housing is a concern, as inadequate and insecure housing can affect health directly (e.g., presence of lead, asbestos, poor heating systems, overcrowding, dampness) and indirectly through its influence on other determinants 9. **Social Exclusion** - Social isolation, social exclusion, and lack of supportive relationships directly increase stress and vulnerability to disease, and indirectly increase risk behaviours such as smoking, substance use, and overeating 10. **Social Safety Network** - Social support has been linked to positive health outcomes. Social safety networks and inclusion are associated with healthy aging through practical, emotional, informational, and affirmational support. 11. **Health Services** - Health care services account for only 25% of a population's health status; other contributing factors include child benefits, housing, gender equality, equity, reconciliation, and climate change 12. **Indigenous Status** - Indigenous peoples in Canada are more likely to experience health inequities and the burden of disease because of racism and the historical and contemporary discrimination they have experienced as a result of colonization 13. Gender - Many health issues are a function of gender-based social roles, and gender can influence health status, behaviours, and care - Culture, Race, and Racism 14. Culture, Race and Racism - Cultural and ethnic factors influence people's interactions with the health care system, their participation in prevention and health promotion programs, their access to health information, their health-related lifestyle choices, and their understanding of health and illness - Racism, though often subtle, is "an ideology that either directly or indirectly asserts that one group is inherently superior to others" - **Systemic racism**--- racism that is embedded in the laws, regulations, policies, and practices of a society or an organization - Racialization occurs when the dominant group or groups in society construct races as being real, different, and unequal in ways that matter to economic, political, and social life, thus forcing people to seek explanations for racial disparities in health. - Racialization and racism adversely affect health by limiting access to health resources, creating fewer socioeconomic opportunities, and fostering unhealthy coping behaviours **Health Promotion - "directed toward increasing the level of well-being and self-actualization"** **Disease Prevention (specifically primary prevention) is "action to avoid or forestall illness/disease"** **Three levels of disease prevention correspond to the natural history of disease:** 1. **Primary prevention activities** - **protect against a disease before signs and symptoms occur** - **e.g. immunization, reduction of risk factors** 2. **Secondary prevention** - **promote early detection of disease once pathogenesis has occurred** - **e.g. preventive screening for cancer, bp screening, blood glucose screening** 3. **Tertiary prevention** - **initiated in the convalescence stage of disease and are directed toward minimizing residual disability and helping people to live productively with limitations.** - **E.g. cardiac rehabilitation program** 1. **Build Healthy Public Policy** 2. **Create Supportive Environments** 3. **Strengthen Community Action** 4. **Develop Personal Skills** 5. **Reorient Health Services**