Kin 223 Midterm 2 PDF

Definitions of Health: - WHO (comprehensive definition): a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity - Jadad: the ability to adapt and self manage in the face of social, physical and emotional challenges - Rat...

Definitions of Health: - WHO (comprehensive definition): a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity - Jadad: the ability to adapt and self manage in the face of social, physical and emotional challenges - Rattan: a state of adequate physical and mental independence in activities of daily life - Biomedical: a state characterized by anatomic, physiologic, and psychological integrity. Dominate due to its focus on disease and medical technology development - Wellness: the ability to realize aspirations, to satisfy needs, and to change or cope with the environment - Salutogenic: looks at the complex factors that support health and wellbeing. His model includes biophysical, social, environmental and psychological factors - First Nations: holistic vision of wellness, individual, balance, values, ties, environment, people - Biosocial: consider biological aspects and social conditions related to illness Definition of Wellbeing - WHO: a positive state experience by individuals and societies, is a resource for daily life and is determined by social, economic and environmental conditions Field of health: Biology Lifestyle Environment Health Care Systems Prerequisites to Health: Ottawa Charter - Peace - Shelter - Food - Equity - Income Determinants of Health: The range of personal, social, economic and environmental factors that determine the healthy life expectancy of individuals and populations - Ex. income and social status, gender, race, childhood experiences, education Social Determinants of Health: the social, cultural, political, economic and environmental conditions in which people are born, grow up, live, work and age, and their access to power, decision-making, money and resources that give rise to these conditions of daily life - Ex. income, education, food insecurity, housing, working conditions - Rainbow model: Age, sex and constitutional factors > Individual lifestyle factors > Social and community networks > Living and working conditions > General socio-economic, cultural and environmental conditions Healthy inequity: health inequalities that are unfair and unjust and modifiable Physical Activity: any bodily movement produced by skeletal muscles that requires energy expenditure. Exercise is structured, Sports are regulated and competitive - Lower income countries show higher levels of PA - Moderate to vigorous PA reduce risks of mortality - Policies and interventions need to: - Set clear target groups, expected outcomes, realistic perspectives and duration - Integrate peers and local facilitators - Holistic approach - Monitor distribution effects Global Health: focuses on improving health and achieving health equity - International health: the challenges that affect low and middle-income countries - Public health: Promotes and protects the health of people and the communities where they live, learn, work and play - Population health: the health outcomes of a group of individuals. Focus on improving the health of the entire population & to reduce health inequities Functions of Global Health: 1. Generate new knowledge and theories 2. Distribute the knowledge 3. Solve global health problems - Globalization: the increased interaction and interdependence of people across the globe - Global Burden of Disease: the total, cumulative consequences of a defined disease Built environment: the human-made design and layout of the communities in which people live, work and play. - Green and blue space: natural and semi-natural areas within a city or urban area - Active transportation: the movement of people or goods powered by human activity - Active transportation infrastructure: physical structures and the built environment that support active transport - Themes: connectivity, safety and security, convenience, land use and growth, maintenance and accessibility, education and awareness Non-communicable diseases: long duration (chronic) diseases and are the result of a combination of genetic, physiological, environmental and behavioral factors - Behavioral risk factors: tobacco, unhealthy diet, alcohol intake, physical inactivity - Metabolic risk factors: raised blood pressure, overweight/obesity - Environmental risk factors: air pollution - Mortality due to non-communicable disease are lower in high income countries, and mens mortality rates are higher - Cancer: abnormal and uncontrollable cell growth - Cardiovascular disease: group of disorders of the heart and blood vessels  Diabetes: a chronic, metabolic disease characterized by elevated levels of blood glucose which over time leads to serious damage of the heart, blood vessels, eyes, kidneys and nerves - Prevalent in low and middle income countries - Insulin: hormone that controls the levels of sugar in the bloodstream - Type 1 DM: - When there is an insufficient insulin production, the body destroys it - Generally develops in childhood or adolescence - 10% of diabetes cases - Patient is insulin-dependent - Type 2 DM: - Where the body cannot make enough insulin or does not properly use insulin - Related to behavioral and metabolic risk factors - Can lead to insulin-dependence - Gestational DM: - Develops during pregnancy where glucose levels are higher than normal - Secondary DM: - Develops as a consequence of other diseases - Symptoms: - Unusual thirst and frequent urination - Weight change - Tiredness or lack of energy - Blurred vision - Infections - Cuts and bruises are slow the heal Chronic respiratory diseases: affect the airways and other structures of the lungs - Risk factors: tobacco, air pollution, chemicals, dust - Asthma - Recurrent attacks of breathlessness and wheezing due to airway narrowing - The most common chronic disease among children - The airway obstruction is reversible with inhaled medications - Most asthma deaths occur in low to low-middle income countries - COPD - Fixed (non reversible) airway narrowing - 3rd leading cause of death - Only affects adults and is a degenerative illness - Symptoms: breathlessness, sputum production, chronic cough - Caused mainly by smoking - Chronic bronchitis: airways become swollen and filled with mucus - Emphysema: air sacs (alveoli) are damaged Mental Health - Determinants of mental health: genetics, emotional skills, substance use, poverty, violence, inequality, economic crisis, disease outbreak, forced displacement - Protective factors: emotionals skills, positive social interaction, quality education, decent work, safe neighborhood, community cohesion - Promotion and prevention: education, advocacy, multisectoral collaboration - Women and gender diverse people are most affected - Mental health condition: mental disorders, psychological disabilities, other mental states - Mental Health Disorder: clinical significant disturbance in an individual’s cognition, emotional regulation, or behavior - Psychosocial Disability: disability from long-term mental impairment - Covid 19 impact on mental health - Youth, LGBTQ+, minorities were most affected Communicable Diseases: are preventable communicable, or infectious diseases caused by microorganisms that can be spread directly or indirectly - Modes of transmission - Direct Contact - Person to person - Mother to unborn child - Droplet spread - Indirect Contact - Airborne transmission - Contaminated objects - Food and drink - Animal to person contact - Insect bites - Syphilis: a bacterial sexually transmitted infection, and in pregnancy may lead to newborn death. - Symptoms: - Primary syphilis: hard sores on genitals - Secondary syphilis: rash on the palms and soles of feet, white or grey lesions in moist areas - Latent syphilis: no symptoms, can lead to brain and cardiovascular disease - Tuberculosis: is an infectious disease caused by bacteria that spreads through the air - About ¼ of the global population have been estimated to be infected  - Neglected Tropical Diseases: diverse group of conditions caused by a variety of pathogens and are mainly prevalent among impoverished communities (no access to clean water or safe ways to dispose of human waste) in tropical areas - Integrated approaches to Neglected TD: - Preventive chemotherapy - Innovative and intensified disease management - Public health services, safe water, sanitation and hygiene - International collaboration is needed to prevent and control Neglected Tropical diseases HIV/AIDS - HIV is an chronic infectious disease that attacks the body’s immune system, specifically the white blood cells, weakening the person’s immunity - AIDS is the most advanced stage of HIV - Symptoms: - First months: no symptoms and is most infectious - Fever, headache, rash and sore throat - Swollen lymph nodes, weight loss, fever, diarrhea, cough - Prevention: - Healthy lifestyle: condoms, harm reduction for injected drugs - ART - Statistic: - Prevalent in men, homeless, racial minorities, gender/sexual diverse people - Many people do not have access to treatment - Target by 2025: - 95% of people living with HIV will know their status - 90% of people with HIV will be receiving ART - 86% of people living with HIV will have a suppressed load - 5 C: - Consent - Confidentiality - Counseling - Correct results - Connection (treatment & services) Long Covid/Post Covid Condition - Covid 19 is an infectious disease - Impact: - Persistent symptoms, complications, pulmonary, cardiovascular, neurological and physical effects - Post Covid Condition is when symptoms persist 3 months after having Covid - Greater risk: females, people who had severe Covid 19, people with less than 2 vaccines, older adults - Testing and diagnosis:  1. Health history 2. Previous diagnosis of Covid 19 3. Health examination 4. Differential diagnosis (ruling out other conditions) Lifestyle: is a way of living based on identifiable patterns of behavior which are determined by an individual’s personal characteristics, social interactions, socioeconomic, and environmental living conditions - Risk Factors: Increased susceptibility to a specific disease, ill health or injury - Risk Behaviors: behaviors that are proven to be associated with increased susceptibility to disease - Low and middle income countries face more lifestyle risk factors - In Canada: 57% of men and 51% of women meet 150 minutes of physical activity per day Emerging disease: outbreaks of previously unknown diseases - Known diseases that are spreading quickly - Known infectious diseases that are persistent and can’t be controlled - Ex. Lyme disease, MPox, HIV - Factors that may lead to emerging diseases: - Environment change - Human and animal demography - Pathogen changes - Farming practices - Social and cultural factors - Effects: - Health cost - Effects on trade and travel - Economic effects Monkeypox: an illness caused by a double-stranded DNA virus closely related to smallpox. It is a viral zoonotic infection, meaning it can spread from animals to human, human to human, or environment to humans - Most symptoms go away on their own - At risk: babies, children, and people with immune deficiencies - Symptoms: - Fever - Back pain - Rash on face, palms, groin, genital area, mouth, throat Re-emerging disease: return of disease that were once treatable and controllable - May happen due to a breakdown in public health measures or when new strains of know disease-causing organisms appear - Ex. Malaria, Tuberculosis  - Measures of control: - Rapid diagnosis & treatment - Conventional vaccination - Quarantine Poliomyelitis: a disease transmitted by person-to-person mainly through the fecal-oral route - Symptoms: Irreversible paralysis - At risk: children - No cure, it can only be prevented (vaccine) Vaccine Hesitancy: refers to the delay in acceptance or refusal of vaccination despite availability of vaccination services Immunity: the way in which the immune system protects the body from infectious diseases - Obtained from vaccination or previous infection - Active immunity: due to exposure to a disease, naturally or vaccine-induced - Passive immunity: provided when a person has received antibodies for a disease (short period), ex. Mother breastfeeding to newborn Antimicrobial Resistance: occurs when pathogens no longer respond to antimicrobial medicines - Natural process that occurs over time - Threat to: global health, food security, medical costs, longer hospital stays, increased mortality - Misuse of antibiotics can cause this resistance - Global action plan on antimicrobial resistance: 1. Improve awareness & understanding 2. Strengthen surveillance & research 3. Reduce the incidence of infection 4. Optimize the use of antimicrobial medicines 5. Ensure sustainable investing in countering antimicrobial resistance Addiction: a chronic disease that affects a person’s brain, resulting in them being unable to overcome certain behaviours Bio-psycho-social model of addiction: 1. Psychological = meso-environment: the individual, their history and experiences, coping skills (childhood, trauma) 2. Biology = micro-environment: neurobiology and genetics 3. Social = the macro-environment: culture, society, and economic systems 4 Cs of Addiction: Craving, loss of Control of amount or frequency of use, Compulsion to use despite Consequences Diagnosis: Screening CAGE questionnaire 1. Have you tried Cutting down? 2. Have you ever felt Angry by someone else’s comments? 3. Do you feel Guilty? 4. Do you use it as an Eye-opener? Treatment Stages: - Detoxification - Relapse prevention - Maintenance treatment - Harm reduction - Treating overdoses Categories of SUD symptoms 1. Impaired control 2. Social problems 3. Risky use 4. Physical dependence Paradigms to approach addiction - Moral “addicts lack morals & will power” - Criminological “addicts are criminals” - Pathological ‘brain disease’ - Structural model “4 plan” approach 1. Prevention 2. Treatment 3. Harm reduction 4. Enforcement Covid & Opioid overdose: - Isolation - risky injection practices - Decreased access to treatment & recovery programs - Increased toxicity of available drugs Indigenous Health SDOH: - Language, culture and place - Geography and location - Self-identity - self-determination  - Colonization and systemic racism - social exclusion - Intergenerational trauma and effects - Access to health services Culturally Safe Environment Stages 1. Cultural awareness 2. Cultural sensitivity 3. Cultural competency 4. Cultural humility Injury Prevention Injury: the physical damage due to the body being subjected to energy amounts that exceed the threshold of physiological tolerance - Intentional - Unintentional - Occupational - Results in 4.4 million deaths per year - 8% of all deaths - Road traffic injuries, homicide and suicidee are 3 of the top 5 causes of death for people 5-29 years In Canada: - Suicide is the 2nd leading cause of injury death after falls In USA - Unintentional injuries are the leading cause of deaths of people under 45 - Drug overdoses is now the leading cause of deaths Economic Burden of Injuries - Direct: related to health care services - Indirect: social cost (individual, family, community) Road Traffic Injuries - 1.3 million deaths per year - 8th leading cause of deaths - 1st leading cause of deaths for children and young adults - Mortality is 3 times higher in low-income countries Health promotion Preventive Stages: - Primordial Prevention: Policies & legislation to address behavior and environment - Risk factors reduction - Underlying stage - Primary Prevention: Specific protection against risk factors  - Prevent disease (vaccines) - Susceptible stage - Secondary Prevention: Effective diagnosis and timely treatment - Subclinical stage (tests) - Tertiary Prevention: To overcome or deal with disability limitations/ rehab - Clinical and outcome stages Terms: - Empowerment for Health: a process through which people gain greater control over decisions and actions affecting their health - Primary Health Care: essential health care made accessible at a cost that is affordable, with methods that are practical, scientifically sound and socially acceptable - Health Education: constructed opportunities for learning including a design to improve health literacy, improve knowledge, and develop skills - Health Communication: a strategy to inform the public about health concerns and to keep important health issues in the public agenda. Increases awareness as well as the importance of health. - Advocacy for Health: a combination of individual and social actions designed to gain political commitment, support and social acceptance - Enabling: taking action in partnership with individuals or groups to empower them - Mediation: a process where different intersects are reconciled in a way that promotes and protects health - Disease Prevention: preventing the occurrence of disease, and reduce the consequences - Risk Factor: things that are associated with or cause increased susceptibility to a disease - Risk Behavior: forms of behavior that are seen to be associated with increase susceptibility to a disease - Health Policies: a formal statement or procedure that includes actions needed - Intersectoral Collaboration: a relationship that has been formed to take action on a health issues Environmental Health - A branch of public health that focuses on the relationship between people and their environment - Healthier environments could prevent almost ¼ of the global burden of disease The UN 6 climate -positive actions: 1. Green transition: investments must accelerate the decarbonization of all aspects of our economy 2. Green jobs and sustainable and inclusive growth 3. Green economy: making societies and people more resilient through a transition that is fair to all and leaves no one behind  4. Invest in sustainable solution: fossil fuel subsidies must end, and polluters must pay for their pollution 5. Confront all climate risks 6. Cooperation - no country can succeed alone One Health - Acknowledges that humans, animals and ecosystems are closely interlinked - Focuses on upstream interventions to provide benefits Canada’s 2030 Emissions Reduction Plan - 40 below what it was in 2005 - Net-zero emissions by 2050 Women’s Health Health Gender Bias - Missing or incomplete evidence for disease that disproportionately impact women (lack of funding or inclusion of women in clinical trials) - Existing evidence is interpreted considering men’s symptoms as default Female genital mutilation - More than 300 million girls have undergone this in Africa, the Middle East and Asia - Typically done on girls under the age of 15 Violence - 1 in 3 women have experienced physical and/or sexual abuse Adolescent Pregnancy - In low and middle income countries there were 21 million pregnancies of girls aged 15-19 - 50% were unintended resulting in 12 million births - 55% of unintended pregnancies ended in abortion - Adolescent mothers face higher risks Maternal mortality - Everyday approximately 810 women die from pregnancy or childbirth - The mortality rate is dropping - 94% of all maternal deaths occur in low to middle income countries SDOH - Income is lower for women - 41% of mothers are primary providers for their families Covid - Women experienced higher workload - More economic stress  - More gender-based violence - Less access to support services Ageing - In 2050 80% of older people will be living in low and middle income countries - The population of older people is rising SDOH - Social & physical frailty - Homelessness - Poverty & food insecurity - Access to health care services - Dementia Childhood - The UN states childhood as the ages between birth -15 - The number of children dying before the age of 5 was halved from 2000 to 2017 - Children in low to middle income countries experience the most disparities - Sub-Saharan Africa has the highest child mortality rate - Health equity can be improved through availability of vaccines & child feeding - Early childhood is critical for cognitive, social, emotional and physical development Leading causes of death among children: - Respiratory infections - Diarrheal disease - Measles - Malaria - Malnutrition - Newborn conditions 4 ways of improving early childhood development: 1. Responsive caregiving 2. Promote early learning 3. Integrate caregiving and nutrition interventions 4. Support maternal mental health In Canada: - 55% of children have a high level of life satisfactory - 27% report feeling sad or hopeless - ⅓ have symptoms linked to mental health disorders - ¼ go to bed or school hungry - More than ⅓ experience discrimination - 27% are bullied & 28% get in fights  - 17% feel time pressure & ¼ are overwhelmed with school Successful Interventions - The least explored stage is the phase of development of interventions 5 Key principles for intervention development: 1. Principles 2. Actions to consider 3. Outputs 4. Short term effects 5. Long term effects Approaches to intervention development: 1. Partnership 2. Target population centered 3. Theory and evidence based 4. Implementation based 5. Efficiency based 6. Stepped or phased 7. Intervention specific 8. Combination 9. Pragmatic 6SQUID - 6 essential steps for quality intervention development: 1. Defining and understanding the problem and its causes 2. Identifying which casual or contextual factors are modifiable: which have the greatest scope for change and who would benefit the most 3. Deciding on the mechanisms of change 4. Clarifying how these will be delivered 5. Testing and adapting the intervention 6. Collecting sufficient evidence of effectiveness to proceed to a rigorous evaluation 6 key areas for implementation: 1. Political commitment 2. Technical package 3. Communication 4. Partnership 5. Management 6. Innovation