Midterm Study Notes PDF

Definitions ● Health ○ A state of well-being, physical, mental, social, spiritual, emotional, environmental, and occupational ● Wellness ○ A state of optimal well-being that considers how a person feels ○ Optimal physical, mental, social, spiritual, emotional, environmental, and occupational ● Disea...

Definitions ● Health ○ A state of well-being, physical, mental, social, spiritual, emotional, environmental, and occupational ● Wellness ○ A state of optimal well-being that considers how a person feels ○ Optimal physical, mental, social, spiritual, emotional, environmental, and occupational ● Disease ○ Objective state of ill health and can use science to determine the problem ■ X-ray, tests ● Illness ○ A subjective state of health that is usually socially constructed or influenced by time and place ■ Eg: someone is ill because they are in despair from the passing of a person close to them, so they didn't take care of themselves ● Chronic ○ A long-term illness or disease and typically does not have a cure but has ways to maintain it or lessen it ● Acute ○ A short-term illness ● Impairment ○ A loss or abnormality of a psychological, physiological or anatomical functions ■ Eg: limb amputation, loss of vision, paralysis ● Disability ○ Any restriction or lack of ability to perform an activity in a “normal” manner ○ This could be a result of a genetic condition or injury-related ● Personal tragedy theory ○ Disability is a natural disadvantage when placed in social situations ● Social oppression theory ○ Prejudice and discrimination disable and restrict lives more than impairment Disability Models ● Individual/ Medical model ○ Personal tragedy theory, personal problem, individual adaptation, medicine can “cure” disability, physicians are experts, people with disabilities need to adjust ● Social model ○ Social oppression theory, social problem, social change, self-advocacy, and support groups enable disabled people to become empowered, they are their own experts Disabilities in Canada ● Disability rate varies by age ● Types of reported disabilities vary by age ● Reported disabilities vary across the country World Health Organization (WHO) ● Their definition of health ○ Health is the complete physical, social, and mental well-being ○ Health is seen as a resource for everyday living Individual health models ● Holistic model ○ The holistic model considers all parts of Health used by Alternative Health practitioners ● Wellness model ○ the wellness model Builds on a medical and holistic model ○ emotional, physical, social, occupational, Financial, environmental, spiritual and intellectual ● Social-ecological model ○ The social-ecological model looks at Health very broadly ○ An individual's health is affected by individuals, groups and communities and environmental interactions ● Eudamonistic model ○ this is the complete view of Health ○ trying to reach one's potential and true self and actualization ○ believes that illness prevents the actualization ● Salutogenic model ○ focuses on the origin of healthy life situations, life experiences, coherence and stress ○ this model attends to factors that enhance and protect an individual's health ○ Antonovsky discovered this model Social Marketing ● Approaches ○ Education ○ Policy ● Uses research and evaluation ○ Breast cancer ○ Smoking ○ Physical activity ○ Safety ○ Immunizations ○ Depression ○ Recycling ○ Sexual Health ● The four p’s ○ Product ● ■ Tangible products and ideas ○ Price ■ Time, effort, and cost that goes into education and policy ○ Place ■ Where is it ■ Where is the advertising ○ Promotion ■ What types of promotion is there Additional p’s ○ Public ■ Groups involved in the programs, including the target audience ○ Partnerships ■ Other groups that can partner within a campaign ○ Policy ■ Policies in place to support the campaign ○ Purse ■ What type of funding? ■ Grants, research, partner companies Sociology ● Theories ○ Structural functionalism (macro level) ■ Focuses on the society ■ It is a bunch of moving parts that move as one ● Eg: a gear ■ Everyone has a specific role ■ Everyone needs to have a role in society for society to function ■ Does not have rapid change ■ Order is very important ■ Assumptions: ● Good health and medical care are essential ● If a person becomes a patient, they are now entered into the sick role ● There is a physician and patient hierarchy ■ Criticisms ● This model is only relevant to acute problems, not chronic ● Society is not consensus-based ● Power is not always functional ○ Symbolic interactionism (micro level) ■ Focuses on individuals and meaning through interaction ■ Focuses on the agency perspective ■ Interact through symbols ● Eg: a wedding ring ■ Symbol meanings can change ■ ■ ■ ■ ■ ○ ○ Everyone has their own meaning for symbols There is no one set reality Reality is based on interactions People develop their identity by how others perceive them Assumption ● Health and illness are social constructs ● Health and illness changes based on our constructs ■ Criticisms ● Focuses only on a micro analysis, not a macro analysis ● More descriptive than explanatory ■ Deviance for medicalization ● Differing from the norm Postmodernism ■ Subjective ■ Copies of copies ■ Everything is relative ■ Many points of view ■ The patient carries out surveillance ■ Power shift ■ Rejection of science ■ No one truth can be uncovered or known; only different knowledge over time ■ Impacted healthcare ■ Many treatment choices ■ Healthcare globalization ■ Healthcare globalization ■ Global health tourism ■ Private health care ■ Informed from the internet ■ Growing medicalization problems ■ Choosing other options to help with health other than medicine Conflict theory (macro level) ■ Marxism ● Karl Max created Marxism ● Materialism ● Capitalist (owners) vs proletariat (workers) ● Oppressed eventually become oppressors ■ Feminism ● Society inherently gendered ● Men and women have different access to power ● Socially constructed ● Research is typically done on white men ● Control over women’s bodies ○ Eg: abortion laws ■ ■ ● ● Critical race ● Social structure, ideology, and experiences are racialized ● Differences in health status ● The patient and provider both experience critical race ● Equity differences Postcolonialism ● Conflict over power, land and resources ● It is currently happening ● We are examining the impact of colonialism ● Systemic and structured racism is the cause of social and economic circumstances Models ○ Biomedical model ■ The disease is caused by one thing ■ Objectification ● The body is just a part that needs to be fixed ■ Medical scientism ● Medicine is superior ■ Reductionism ● Focuses on physical health and microbes downplays social and psychological illness ■ Biological determinism ● Biology determines social, economic and health status ■ Victim blaming ● Blaming patient's behaviour for their illness or disease ○ Social model ■ Dr. Thomas McKeown developed the social model ● Agriculture and better living conditions contribute to health as well, not just medicine ■ Risk factors (individual cause) vs social determinant of health (social cause) ■ Dimensions ● Societal production and distribution ● Social constructs ● Social organization ■ Criticisms ● Unfeasible push for social change ● Overemphasis of harm for the medical approach ● Difficult and complex solutions in the short-term ● Lack of individual responsibility Perspectives ○ Structure ■ Economic and political ○ Agency ■ Social interaction Life perspectives ● Trajectory ○ Long term pattern ○ Not predictable ○ Sudden stops ○ Have many turning points ● Turning points ○ A major change in trajectory ○ Lasting change ○ Only obvious after time has passed ● Transition ○ Occurs in trajectories ○ Changes in role or status ■ Not a mom to now a mom ■ Married to widow ○ It can be a turning point if: ■ Followed by a crisis ■ Non-typical age Healthcare History ● 1600-1800 ○ Religious groups performed healthcare services ○ Friends and neighbours performed healthcare ○ There was indigenous health ○ Volunteer organizations ● British North American Act (1867) ○ Minimal government involvement in healthcare ○ Split healthcare between federal and provincial ○ Federal healthcare provided quarantines and marine hospitals ● Flexner Report (1910) ○ Biomedical model advocate ○ Had specialization in medicine (division of labour) ○ Science and lab-based practice ○ Medical schools and universities were established ○ Male-dominated ○ Hospitals were the main center of care ● Medicare (1947) ○ Tommy Douglas discovered ○ Government failing to provide medical care ○ World War 2 equated to poor health status ○ Tommy Douglas proposed that medical services be paid by taxes ○ 1961 all provinces covered inpatient hospital care cost ● ● ● ● ● Medical Care Act (1966) ○ The federal contribution to provinces depended on the following: ■ Comprehensiveness ■ Universal ■ Portable ■ Publicly administered Lalonde Report 1974 (health field concept) ○ Between 1966-1970 people were dying despite medical attention ○ Lalonde proposed that the biomedical healthcare model is wrong ○ Looked beyond the traditional and sick care system ○ Health is lifestyle, environment, human biology, healthcare organization Alma ATA declaration (1978) ○ Identified primary healthcare is key to health ○ The declaration had 10 points ○ Point 1 was health is a fundamental right ○ Point 6 was a definition of primary healthcare World Health Organization's definition of health (1984) ○ Realize aspirations ○ Change and cope with the environment ○ Health is a resource for everyday living ○ Positive concept ○ Social and personal resources ○ Physical capacities Canada Health Act (1984) ○ Provinces and territories must meet the following: ■ 2 provisions ● Discourage financial contributions by patience ○ User charges ○ Extra billing ■ 2 conditions ● Recognize federal payments ● Provide information to the federal government ■ 5 conditions ● Public administration ○ The program must be administered on a non-profit basis by a public authority ● Comprehensiveness ○ Must cover all medically necessary hospital and medical services ● Universality ○ Every permanent resident of Canada is entitled to receive insured healthcare ● Portability ○ ● ● ● Must cover insured health services for citizens while they are temporarily absent from the province or country Accessibility ○ Reasonable access that is not obstructed to an insured healthcare provider EEP Report (1986) ○ Achieving healthcare for all by: ■ Reducing inequalities ■ Improving prevention ■ Enhancing coping Ottowa Charter: Health promotion (1986) ○ Creating supportive environment ○ Reorienting health services ○ Developing personal skills ○ Strengthening community action ○ Building a healthy public policy Role of governments ● Federal ○ Deliver healthcare to ■ Indigenous ■ Veteran ■ Public service employees ■ Inmates ■ Some refugee claimants ■ Canadian armed forces ○ Healthcare financing for provinces ○ Enforce compliance with the Canada Health Act ○ National policy and programming to promote and prevent disease ○ On world stage with organizations like the World Health Organization ● Provincial ○ Administer and deliver healthcare services ○ Plan for each province ○ Provide insurance for hospitals, medical care and some extended care services ○ Promotion, prevention, diagnosis and treatment ○ Approve hospital budget and provide supplies Indigenous History ● Systemic racism ○ White superiority becomes embedded in policies and processes ○ Social determinants in health are more on the lower side of health ● Colonialism ○ Imperialism from Europeans ○ Doctrine of discovery ● ● ● ● ○ Settler colonization Paper trails ○ Royal Proclamation (1763) ■ Indigenous had title to land ○ British North American Act ■ The government took over responsibility from the crown for indigenous people ○ Gradual civilization and enfranchisement act ■ Intent to civilize and assimilate indigenous people ○ Indian Act (1876) ■ Controlled and worked indigenous people toward civilization and assimilation ○ Treaties ■ Rights negotiated by Indigenous people Indigenous people ○ First Nations ■ Indians ■ They can be treaty or non-treaty ○ Metis ■ Self identify ■ Must have metis ancestry to be metis ■ No treaty rights ○ Inuit ■ Northern Canadian Arctic ■ Colonized Treaties ○ The first Nations gave up their land in exchange for the following: ■ Healthcare ■ Education ■ Rights and benefits ○ Alberta has three main treaties ■ Treaty 6 ■ Treaty 7 ■ Treaty 8 Indian Act (1876) ○ Many amendments ○ Defines an Indian ○ Forced into chief and band systems ○ Indian agents in charge of First Nations on their own treaty Assessing population health ● National picture ● Gender ● Age ● ● Regions Surveys Dimensions of health ● Social ● Physical ● Mental ● Emotional ● Environmental ● Occupational ● Spiritual Health indicators ● Direct ○ Blood pressure ○ Respirations ○ Heart rate ○ Disease rate ○ Morbidity rate ● Indirect ○ Social development ○ Education ○ Poverty Consideration for population data ● Definition ○ The indicator must be well-defined ○ Must be applied uniformly ● Validity and reliability ○ The indicator must measure what it is supposed to measure ○ Must be replicable ○ Must be consistent ● Feasibility ○ Must be feasible and affordable ○ Must not overburden the system ● Utility ○ Provide information that is useful ○ Can be acted upon at a local and national level Research ● Qualitative ○ Explaining and understanding ○ Describes and gives meaning ○ Systematic and interactive ○ ○ ● Quality of experiences In health: ■ Purposive sampling to make generalizations about experiences like illness and conditions ■ Concerned with context ■ Exploratory Quantitative ○ Testing relationships ○ Cause and effect of variables ○ Always objective ○ Precise and highly controlled measurements and techniques are used to gather information ○ Analyzed and summarized statistically ○ Uses numbers ○ Data analysis involves the interpretation ○ Rigorous ○ In health: ■ Standardized procedures ■ Uninfluenced by politics ■ Subjectivity and culture ■ Randomized controlled trials ■ Evidence-based medicine ■ Social epidemiology ■ Population and public health research Epidemiology ● The study of the determinants, occurrence, and distribution of health and disease in a defined population ● Statistical study of patterns of diseases in the population ● Identify risk factors ● Target prevention and treatment of disease ● Develop effective health programs and services ● Prevention campaigns to target certain groups ● Effective use of resources Measures of health status ● Life expectancy ○ Gender ○ Income ○ Indigenous ○ G7 countries ● Incidence ○ Disease and health condition of individuals in a population that develops the condition in a specific time period ● ● ● ● ● ● ○ The population will be followed over a period of time called prospective Prevalence ○ Disease or condition that individuals in a population have at a specific time ○ One shot ○ Retrospective (looking back) Mortality rate ○ Total deaths from any cause in a given year and population Perinatal mortality rate ○ Greater than 28 weeks old or less than 7 days Neonatal mortality rate ○ Less than 28 days Infant mortality rate ○ Total deaths of infants in a given year and population that are less than 1 year Potential years of life lost (PYLL) ○ Premature mortality Health promotion ● Moving towards a high level of well-being and actualization ● The movement towards health goals ● Art and science to support lifestyle changes and create conducive environments ● Principles: ○ holistic approach ○ Long term perspective ○ Draws knowledge from many other disciplines ○ Multisectoral ○ Health in context ● Empowerment - gain greater control over decisions and actions affecting health ○ Individual ■ Individual ability to have control over their life ○ Community ■ People acting collectively to gain influence and control over their health determinants and quality of life in their community ● Ottowa charter ○ Health promotion and empowerment are linked in the Ottawa Charter from the action: ■ Develop personal skill Disease prevention ● Avoid or forestall illness and disease ● Reduce and eliminate risk for a specific disease ● Levels of prevention ○ Primary ■ Protect against disease before signs and symptoms ○ Secondary ○ ■ Promote early detection of diseases so it can be treated earlier Tertiary ■ Minimize and learn to adapt to the limitations of disease Health belief model ● Why do people take action to avoid illness, and why do some people not take preventative actions ● derived from social psychology Theory ● how beliefs may or may not influence behaviors ● model for health protection ○ Constructs ■ perceived susceptibility ● How likely a person believes they will develop a disease or health issue ● how vulnerable does the person believe they are ● do they believe they are at risk ■ Perceived seriousness ● do they believe they will have serious consequences if the disease is developed ● the severity of medical clinical, and social difficulties that could arise from disease ● how much emotion is created thinking about having a disease ■ perceived benefits ● is there something in it for them ● what are the positive results of preventative action against a disease ■ perceived barriers ● negative aspects of taking action ● what is the expense, danger, inconvenience, time commitment, and energy ■ cues to action ● factors that prompt action ● reminded and or alerted are more likely to take action ■ Self-efficacy ● confidence to successfully perform an action that is required ● Judgment of personal capability ○ modifying factors ■ demographic variables ■ socio-psychological variables ■ structural variables Transtheoretical model ● Stages of change model ● Behavior change is an ongoing process ● ● the six stages of change ○ Pre-contemplation ■ no intentions of changing ■ can't see the problem ○ Contemplation ■ aware of the problem ■ no commitment to change ■ Weighs the pros and cons ○ Preparation ■ start or has intentions to change ■ starts with small changes ○ Action ■ takes the leap to change ■ requires time and commitment ○ Maintenance ■ sustains change ■ new behaviour replaces the old Behavior ○ Relapse ■ falls back into old habits Processes ○ Experimental ■ conscious raising ■ dramatic relief ■ Self-revaluation ■ social liberation ○ Behavioral ■ self-liberation ■ Counterconditioning ■ stimulus control ■ reinforcement management ○ Self-efficacy ■ own competence and ability to self-regulate ■ High self-efficacy is more likely to change than low self-efficacy ■ main sources: ● Mastery experience ● vicarious experience ● social persuasion ● active state ○ decisional balance ■ weighing the pros and cons ● Pros ○ Action ○ Maintenance ● Cons ○ ○ ○ ○ Pre-contemplation Contemplation Preparation Ethics ■ Select health professionals or credible sources ■ not everyone will choose the right thing ■ avoid authoritarian and coercive actions ■ allow clients leadership and modifying their lifestyle Social Determinants of Health ● The economic and social conditions that shape the health of individuals ● moves Beyond individualist explanations to focus more broadly on underlying social structures as the causes of the causes of Health disease mortality ○ Determinants ■ Income and social status ■ Social support Networks ■ Education and literacy ■ Employment and working conditions ■ Physical environments ■ Biology and genetic endowment ■ Personal health practices and coping skill ■ Healthy child development ■ Health Services ■ Gender ■ Culture ■ Social environments Social Determinants of Health - Indigenous population ● Education ○ Disparities between non-indigenous and indigenous ○ Why ■ Mistrust the system ■ Taught European history and traditions ■ Racism ■ Teachers don't push their learning because teachers already have low expectations ■ Indigenous culture and tradition are undervalued and underresourced ■ Limited access to the internet ■ Poverty ● Post-secondary ○ Higher levels of mental health issues ○ Difficulties in adjusting to urban living coming from the reserve ○ Poverty ○ Intergenerationaltrauma ○ Loss of language and culture ● ● ● ● Initiatives being taken to encourage schooling ○ Developing policies connected to the truth and reconciliation for education ○ Increasing the funding for schools ○ Educating teachers and students on indigenous history and its impacts ○ Curricular reforms Jobs on the reserve ○ Unfavourable business climate ○ Lack of access to capital ○ Inadequate infrastructure ○ Lack of transportation Socioeconomic status ○ Low education and employment result in low socioeconomic status ○ Low self-esteem, depression, anger, and loneliness ○ Can lead to self-harm and abuse of substances ○ Can impact employability or ability to attend school Strengths to overcome the barriers ○ Family ○ Culture ○ Land ○ Resilience ○ Resistance